Statins are a class of prescription drugs that help to lower cholesterol. They block the enzyme that the body uses to make cholesterol in the liver. They’re also helpful in lowering the level of low-density lipoprotein (LDL) cholesterol, which is known as the “bad” cholesterol.
The liver, along with other cells in the body, makes about
Cholesterol — a fat-like waxy substance found in all cells — is necessary for the body to function.
Statins can help to regulate cholesterol levels and may help address other health issues too, although they’re not without risk.
If you have too much cholesterol in your system, you can be at greater risk of heart disease and other vascular diseases. Cholesterol can cause a buildup of plaque in the artery walls, which affects blood flow and can raise your risk of a heart attack. This is where statins come in.
Various types of statins are available. They all work similarly and offer the same level of success, but one might work better for you than another. A doctor or other healthcare professional will prescribe a statin based on your cholesterol level and other risk factors for cardiovascular disease.
You may need to try two to three different statins before finding the one that’s the most effective for you.
Statins work by lowering the level of LDL cholesterol that flows from the liver into the bloodstream. To do this, statins slow down LDL production by blocking an enzyme called 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, which makes LDL cholesterol. Statins have also been shown to lower triglycerides.
As statins lower LDL and triglycerides, they can also sometimes increase levels of the “good” cholesterol, called HDL.
When being prescribed statins, there are numerous types to choose from. Read on to find out about the most common types.
- atorvastatin (Lipitor and Torvast)
- simvastatin (Zocor and Lipex)
- lovastatin (Mevacor, Altocor, and Altoprev)
- pitavastatin (Livalo and Pitava)
- rosuvastatin (Crestor)
- fluvastatin (Lescol)
- pravastatin (Pravachol, Lipostat, and Selektine)
A doctor or other healthcare professional will help determine which statin, or combination of medication, is the best fit for your particular condition.
Statins are helpful in controlling cholesterol levels, but not everyone needs to take them. It’s important to consult a doctor or other healthcare professional to discuss if they’re the right medication for you. There can be a few factors to determine whether you’re a good candidate.
These can include having:
- a family history of high cholesterol
- a high risk of having a heart attack or stroke
- cholesterol levels that can’t be lowered through diet or exercise alone
Most statins successfully help lower LDL, or “bad” cholesterol. Lowering your cholesterol levels with statins helps decrease your risk of stroke, heart attack, and other vessel-related diseases.
“They work better than any other cholesterol treatment,” says Dr. Richard N. Fogoros, a cardiologist and former professor of medicine.
Statins offer other benefits besides lowering your cholesterol. For example, they help stabilize the blood vessel lining, which benefits the whole body. This also makes plaque less likely to rupture in the heart, lowering the risk of a heart attack.
Statins help prevent cholesterol from forming in the liver. They may also help lower triglycerides and increase HDL levels.
Statins also help to relax the blood vessels, which leads to a decrease in blood pressure.
Pros
- reduces the risk of narrowed arteries
- helps fight inflammation, which can reduce artery damage
The most common side effects of statins include nausea, vomiting, and aches and pains in the muscles and joints. You may also have constipation, gas, or diarrhea. Most people are able to take statins without experiencing side effects, and the most common side effects of statins are mild.
As your body adjusts to the medication, the side effects often go away.
Some more serious side effects of statins
- type 2 diabetes or higher blood sugar
- confusion and memory loss
- liver damage
- muscle damage
- kidney damage
Who’s more likely to have side effects from statins?
Not everyone who takes a statin has side effects. According to a
- were assigned female at birth
- are 65 years old or older
- have type 1 or 2 diabetes
- take multiple medications to lower your cholesterol
- have a smaller body frame
- have liver or kidney disease
- consume too much alcohol
If you’re experiencing side effects, a doctor or other healthcare professional may want you to try another statin, change your dosage, or try a different medication.
Cons
- dizziness
- risk of liver damage and kidney failure when mixed with grapefruit
Mixing statins with grapefruit suppresses an important enzyme that normally helps the body process the medication. This enzyme balances out how much of it goes to the bloodstream. The compounds in grapefruit hinder the enzyme and create higher amounts of the drug in the bloodstream.
There’s also the possibility for negative reactions when mixing statins with grapefruit.
This means grapefruit can cause an increase to the side effects of the drug, which could put you at risk of muscle breakdown, liver damage, and kidney failure. More mild cases can cause painful joints and muscles.
In November 2018, the
These groups are at high risk of having a stroke or heart attack:
- people who have cardiovascular disease
- people with elevated LDL levels
- people with type 2 diabetes who are between 40 and 75 years old
- people who have a higher 10-year risk of heart attack
Taking statins is often (but not always) a lifelong commitment. Even if your cholesterol levels decrease, you may still need to take the medication. Otherwise, your levels will likely go back up once you’re off the medication.
However, if you change your lifestyle significantly, you may be able to go off the medication. This might include losing a significant amount of weight or radically changing your diet.
Regardless, never stop taking your medication without first speaking with a doctor or other healthcare professional.
There are other ways you can help decrease your cholesterol. Many of these involve lifestyle changes.
Dietary changes
Certain foods have been found to help lower cholesterol and the risk of vessel disease:
- soluble fiber, which is found in oatmeal, prunes, apples, pears, kidney beans, and barley
- fatty fish, such as herring, salmon, and halibut
- nuts, such as walnuts and almonds
- olives, olive oil, and canola oils
- foods fortified with plant-based substances called sterols, such as yogurt drinks, margarines, or orange juice
- whole grain, high fiber unprocessed grains
Quitting smoking
If you smoke, stopping can help improve your cholesterol levels, lower your blood pressure, and decrease your risk of a heart attack. “The benefits of quitting smoking begin within hours,” adds Dr. Fogoros.
Exercise
Losing excess weight — even 5 to 10 pounds — and regularly engaging in physical activity can help improve your cholesterol numbers.
Walk, bike, swim, or do anything to get your heart pumping. Talk with a doctor or other healthcare professional before starting a new fitness routine.
If you experience serious side effects or aren’t a statin candidate, a doctor or other healthcare professional may prescribe another type of medication to treat your cholesterol levels.
Cholesterol absorption inhibitor
The small intestine absorbs your diet’s cholesterol and releases it into the bloodstream. A cholesterol absorption inhibitor helps to limit this absorption of the cholesterol you consume.
Ezetimibe is one type of cholesterol absorption inhibitor.
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors
A gene called PCSK9 determines the number of LDL receptors in the body. These receptors then regulate how much LDL cholesterol goes into your bloodstream.
PCSK9 drugs work by suppressing the PCSK9 enzyme expressed by the gene.
Bile acid sequestrant
The liver makes bile acids, which are needed for digestion, using cholesterol. Sequestrants bind to bile acids, making the liver use the extra cholesterol to produce more bile acids. This lowers the cholesterol in the blood.
Combination cholesterol absorption inhibitor and statin
This combination drug lowers the absorption of cholesterol in your small intestine and your liver’s cholesterol production.
Each person is unique, and it’s important to remember that there’s no one-size-fits-all solution. Statins are a very good option for many people with high cholesterol. For others, lifestyle changes (in some cases, drastic changes) may work wonders. It’s important that you speak with a doctor or other healthcare professional to see what is best for you.