Statins are a class of medications that help to lower blood cholesterol levels. They are primarily prescribed for individuals wishing to decrease their risk of having a heart attack or stroke.
But, according to a recent study, they may help prevent heart attacks in those individuals whose cholesterol levels are normal. Should you take them? Which one should you take? Are there other benefits associated with them?
I will answer these questions and more in this article.
How Do They Work?
Regarding cholesterol's role in atherosclerosis, researchers agree that it plays a part in the development of heart disease. Scientists have also learned that greater reductions in cholesterol are more beneficial than modest ones.
In fact, atherosclerosis involves much more than cholesterol. Inflammation of the arterial walls may also contribute to the development of atherosclerosis.
As Statins can help lower inflammation in the arterial walls, this could be another reason why they help to lower the risk of developing atherosclerosis.
Statins lower blood cholesterol levels by reducing the production of cholesterol by your liver.
They do this by inhibiting the production of an enzyme called HMG-CoA reductase that slows the rate of cholesterol production.
By reducing the amount of cholesterol that is produced, these medicines allow your body to slow the formation of new areas of plaque on your arterial walls, while possibly reducing the size of existing plaques.
They also help improve the liver's capacity to reduce the bad, or LDL, cholesterol already in the blood. They also help to reduce levels of triglycerides in the blood.
Statins differ in several ways, primarily in their ability to reduce blood cholesterol levels. Currently, Lipitor and Crestor are the strongest, with Lescol the weakest.
What Are the Benefits Of Statins?
Regarding their cholesterol-lowering capabilities, your LDL cholesterol levels can be reduced 18 to 55%. Your HDL cholesterol levels can be increased 5 to 15% from taking them.
Here are some additional ways they may be of benefit to you.
As an anti-inflammatory. Statins' anti-inflammatory properties can help to stabilize the linings of blood vessels. This can translate to a decreased likelihood of rupturing of arterial areas where there is plaque build up.
Preventing cancer. The verdict is still out on this one, as some studies have suggested that they may reduce cancer risk, while others have not.
Preventing arthritis and bone fractures. Although more research is needed in this area, they may prove useful in preventing the development of osteoporosis, bone fractures and arthritis.
A reduced risk of developing Alzheimer's disease. Here again, the research is inconclusive, but they may help keep your brain healthy as you age, subsequently preventing Alzheimer's disease from developing.
They can reduce the size of plaque areas on the arterial walls.
They also decrease your risk of developing a blood clot. Blood clots typically form where areas of plaque rupture on the arterial walls, and are a common cause of heart attacks.
Statins can also decrease levels of C-reactive protein (CRP) in the blood. CRP is associated with an increased risk of heart disease.
Increased levels of CRP indicates that there is widespread inflammation somewhere in the body.
Which One Is Best For Me?
Here is a list of the Statin medications that are currently approved for use in the United States:
atorvastatin (Lipitor) - If you've had a heart attack and have high LDL levels, this should be your medicine of choice.
fluvastatin (Lescol)
lovastatin (Mevacor) - If you need to lower your LDL levels less than 30%, this medication would be a good choice.
pitavastatin (Livalo)
pravastatin (Pravachol) - If you need to lower your LDL levels less than 30%, this medication would be a good choice.
rosuvastatin (Crestor)
simvastatin (Zocor)
If your HDL cholesterol levels are low, then prescription niacin might be a better choice.
Are There Any Side Effects, Contraindications and Drug Interactions?
Although Statins are well tolerated, they are not without side effects. Some common side effects include:
However, there are two serious side effects associated with Statins that you should be aware of:
Liver damage. They may cause an increase in the production of liver enzymes. If the increase is modest, it is safe to continue taking these medications. But, if the increases are significant, long-term use of them can cause permanent liver damage.
Muscle problems. These medications can cause muscle pain and tenderness (myopathy). The higher your dosage is, the more likely you are to experience pain.
In severe cases, a condition called rhabdomyolysis develops. With this condition, muscle cells break down and release a protein called myoglobin into the bloodstream. Myoglobin can cause damage to your kidneys.
There have been rare reports of neuropathy developing. Neuropathy refers to numbness or tingling of the arms, hands and feet.
Be advised that women are more likely to develop side effects than men.
Individuals with liver disease should not take these medicines. If liver disease develops after starting to take them, you should immediately stop.
Also, pregnant or breast-feeding women should not take Statins.
If you have a history of myopathy, a muscle disease where the muscle fibers do not function for various reasons, you should avoid these medicines.
They should not be taken in conjunction with other medications and supplements, including:
Erythromycin
Clarithromycin
Itraconazole
Verapamli
Ditiazem
Certain vitamins
Herbal supplements
Birth control pills
Immunosuppressant medications such as cyclosporine
Medication for HIV or AIDS
Coumadin - Coumadin may have an increased effect when taken with rosuvastatin or simvastatin
Or fibrate drugs (drugs that also lower LDL cholesterol levels)
You should avoid drinking large quantities of grapefruit juice. Drinking more than 1 quart of grapefruit juice daily decreases the liver's ability to metabolize these medicines.
Specifically, Crestor and Pravachol levels in the blood are less likely to be elevated when taken in conjunction with other medications.
You should consult a drug reference for a complete list of their interactions.
Are They Right for Me?
They are primarily used to lower cholesterol levels in individuals that are at risk for developing cardiovascular disease.
If your total cholesterol level is 240 mg per deciliter or higher, or your LDL cholesterol levels are 130 mg per deciliter or higher , these statistics may determine whether these medications are appropriate for you.
Statins are also used for treating a condition called intermittent claudication. This condition is characterized by muscle pain, typically in the calves, and is caused by exercise, and is usually relieved by rest.
Whether you should be taking them, depends on your overall cholesterol levels, with an assessment of the following risk factors.
Do you have a family history of high cholesterol or cardiovascular disease?
Women are far less likely to experience a heart attack as their first manifestation of cardiovascular disease. They are far more likely to have chest pain, also known as angina, and strokes.
Remember that there are no warning signs for high cholesterol levels.
If the only risk factor you have for heart disease is high cholesterol, your doctor may not prescribe these medicines for you as you are already at a low risk of developing heart disease.
Instead of starting you on Statin therapy, your physician may recommend lifestyle changes first, to try to lower your cholesterol levels. These lifestyle changes can include the following:
If these lifestyle changes have not lowered your overall risk for developing heart disease, your doctor may recommend these medications. You will typically see results in four to six weeks
Furthermore, according to a recent study, millions of individuals without heart disease could benefit from taking Statins.
Clinical trials of over 70,000 individuals without cardiovascular disease, but were at risk for developing it, indicated that they were 12% less likely to die when taking this medication.
They also experienced 30% fewer heart attacks and 20% fewer strokes. However, the researchers felt that it was not entirely clear which patients without cardiovascular disease would benefit from taking these medications.
Also, in another study published by the New England Journal Of Medicine, found that by taking 20 mg of Crestor, twice daily, reduced the likelihood of having a heart attack, stroke or other cardiovascular event by 50%.
This study also revealed that taking Crestor at the dosage mentioned above reduced the number of deaths by any cause by 20%.
However, researchers also were unsure how safe these medicines were, when taken for extended periods, such as 20 years or more.
Statins may be one of the wonder drugs of the 21st century. They are one of the most commonly prescribed drugs in medicine.
They can lower your risk of developing cardiovascular disease for those individuals whose cardiovascular risk profile is high, and for normal, healthy individuals.
Consequently, the future for these medications looks promising, as they may be used to treat conditions such as arthritis, cancer, even Alzheimer's disease according to recent research.
