Cardiologist, author, and heart health expert Dr. Sarah Samaan offers advice on how to live a heart smart life.See all posts »
Statins and Diabetes: What You Need to Know
Statins are the closest thing we have to cardiovascular wonder drugs. These cholesterol-lowering drugs cut the risk of heart attacks and strokes by 30 percent or more, slow the progression of cholesterol buildup, and in some people can even shrink cholesterol plaques. This means fewer heart bypass surgeries and coronary stents. Several years ago, 100 mg/dL was the goal for LDL cholesterol. Now we know that for high risk individuals, bringing the LDL under 70 mg/dL provides additional benefit when compared with LDLs over 70 mg/dL.
Of course, statins don’t take the place of a healthy diet and heart smart lifestyle. One reason that we are seeing fewer heart attacks is because doctors are prescribing statins for so many more people than ever before, and at higher doses. It sure isn’t because Americans are eating right and exercising.
In 2010, the JUPITER trial, which evaluated the use of Crestor (rosuvastatin) for heart attack prevention, reported a slight but real increase in the risk of diabetes for people taking the drug. This prompted medical investigators from St. George’s University in London to look back over five large statin studies that included a total of over 30,000 patients who did not have diabetes before starting the drugs. Lipitor (atorvastatin), Crestor, Zocor (simvastatin), and Pravachol (pravastatin) were included in the analyses, and the studies ran anywhere from two to five years.
When high-dose statins were compared to more moderate doses of the drugs, the risk of diabetes rose by about 12 percent. On the other hand, high versus moderate dose statins reduced the likelihood of a heart attack by an extra 16 percent. Since heart disease is even more prevalent than diabetes, statins came out ahead.
What does this mean for you? If you do require a high-dose statin, realize that you are lowering your risk for a heart attack significantly more than you are increasing your likelihood of diabetes. Don’t cut your statin dose without discussing it with your doctor. You might not need a high dose if you can improve your diet, drop some weight, and exercise at least two and a half hours every week.
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