Cholesterol lowering drugs: Are they right for you?

ADC Cardiologist Joseph Imsais, MD, talks about statins.

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Statin drugs — the drugs that are used to lower cholesterol — are being hailed as a great step forward in medical treatment. You’re sure to have seen television and magazine ads for drugs like Lipitor, Zocor, and Crestor, but how do you know if you should be taking a statin? What are the risks and benefits?

“Statin drugs work by blocking a substance that your body needs to make cholesterol,” says Dr. Imsais, a cardiologist with The Austin Diagnostic Clinic. “They may also help your body reabsorb cholesterol that has built up in plaque on artery walls. Reabsorbing the cholesterol can help to prevent further blockage of blood vessels.”

While statins have been shown to be very effective in lowering high cholesterol, doctors will likely consider your risk factors for cardiovascular disease before prescribing you the medication. If the only risk factor you have is high cholesterol, you may not need to take medication.

Should I be taking a statin?

Whether you need to be on a statin is usually determined by your cholesterol level along with your other risk factors for heart disease. Generally, an ideal total cholesterol level is around 200 mg/dL or lower. Before prescribing a statin, doctors will usually look at other risk factors for cardiovascular disease, including:

  • Family history of high cholesterol or cardiovascular disease
  • Lifestyle
  • Age
  • Blood pressure
  • Alcohol use
  • General health

Other factors include the presence of diabetes or peripheral artery disease (PAD). If your doctor decides to prescribe a statin, you and your doctor will likely talk about what dose you should take. If you need to decrease your cholesterol significantly, you will likely be prescribed a higher dose.

Do statins have side effects?

Though statins are usually tolerated well, they often do have side effects, including muscle and joint aches, nausea, diarrhea, and constipation.

“There are two potentially serious side effects of statins that patients need to be aware of,” cautions Dr. Imsais. “Statin use can sometimes cause an increase in liver enzymes and eventual liver damage. People who take statins should have liver function tested periodically. The other side effect is muscle pain and tenderness. The higher the dose you take, the higher the risk of muscle aches.”

Before you take any drug, it’s important to consider the side effects that it may have on your body. Also, tell your doctor about any medications you take and find out if statins can interact with those medications.

Keep in mind that if your cholesterol is lowered as the result of taking a statin, you’ll probably stay on the drug for the rest of your life. If you stop taking it, it’s likely that your cholesterol levels will go up again.

“Side effects are often minor, but if you do have them, talk to your doctor about decreasing your dose or trying a different statin,” says Dr. Imsais.

Are there other options besides statins to lower cholesterol?

Statins are very effective in reducing cholesterol levels, but because everyone is different, the type or dose of statin can vary for each person. For some people, lifestyle changes may be all that are necessary to lower your cholesterol levels. For others, supplements like niacin and omega-3 fatty acids, in addition to a statin, may be a good option. Your doctor can help you decide the best option for you.

How important is lifestyle change?

“Lifestyle changes are essential if you want to lower your risk of heart disease,” says Dr. Imsais. “Not smoking, eating well, getting exercise, and managing your stress levels are lifestyle factors that can lower your cholesterol and your overall risk of heart disease.”

Whether you are taking cholesterol-lowering medications or not, lifestyle changes can have a great impact on reducing the risk of heart disease, and on your overall health.

Dr. Imsais practices at ADC’s Main Clinic located at 12221 MoPac Expwy N. (inside North Austin Medical Center).  Call 512-901-4001 to make an appointment.