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Should You Take Statins?
Should You Take Statins? -- Posted by Gumbo on 10-23-04 05:51
Should You Take Statins?
a.. What Are Statins?
b.. What Are The Benefits Of Taking Statins?
c.. How Do Statins Work?
d.. Should I Use Statins?
a.. What Are The Disadvantages Of Taking Statins?
b.. What Are Guidelines For Taking Statins?
c.. If I Can't Take A Statin, What Are My Alternatives?
d.. What Is The Next Step?
What Are Statins?
Statins are a group of drugs prescribed to lower cholesterol, protect
against damage from coronary-artery disease and prevent heart attack.
Statins are extremely effective in decreasing heart disease and preventing
death. In terms of providing health benefits to a broad segment of the
population, statins may be the most important drugs to emerge in recent
times. Commonly prescribed statins include lovastatin (Mevacor), simvastatin
(Zocor), pravastatin (Pravachol), fluvastatin (Lescol), and Atorvastatin
(Lipitor).
Statins provide the greatest benefit to people with:
a.. Heart disease
b.. Diabetes
c.. High cholesterol levels and other risk factors for heart disease.
Keep in mind that you don't have to be a heart patient to benefit from
statins. Indeed, statins may even have benefits for people with moderate
cholesterol levels, as long as they are at an increased risk of heart
disease. These high risk factors include diabetes, cigarette smoking, high
blood pressure, and family history of early onset coronary heart disease.
You need to be aware of your own personal cardiac-risk profile to decide if
you may benefit from this remarkable group of drugs.
What Are The Benefits Of Taking Statins?
Statins lower the level of low-density-lipoprotein (LDL ) cholesterol in
your blood. Cholesterol is a type of lipid, a soft, fat like substance. LDL
cholesterol can accumulate on the walls of arteries, producing
atherosclerotic plaque. Atherosclerotic plaque can clog the coronary
arteries, causing coronary-artery disease and impeding blood flow. Taking a
statin, as prescribed by your doctor, will help you to reach the target
LDL-cholesterol level that is right for you. Further, it will reduce your
risk of:
a.. Developing angina (chest pain resulting from clogged coronary
arteries)
b.. Having a heart attack (which may occur if clogged arteries prevent
blood from reaching the heart muscle)
c.. Experiencing sudden cardiac death
Statins also slightly raise levels of high-density-lipoprotein (HDL)
cholesterol. Unlike LDL cholesterol, high levels of HDL cholesterol are an
indication of cardiac health. For more information on LDL and HDL
cholesterol, click here.
Researchers are discovering evidence suggesting additional uses for statins.
For example, statins may help to prevent stroke. Other studies have linked
statins to decreased risks of diabetes and dementia. However, these benefits
remain unproven; it may be a long time before statins are prescribed for
these uses.
How Do Statins Work?
Statins block an enzyme that causes the liver to produce cholesterol,
thereby preventing excess amounts of cholesterol from entering the
bloodstream.
Researchers are identifying additional ways that statins protect the heart
and blood vessels. Statins have antioxidant properties. (An antioxidant
helps to prevent deterioration by the action of oxygen.) By preventing
oxidation of LDL cholesterol, statins decrease plaque formation. Statins
also have anti-inflammatory properties; they reduce inflammation in plaques,
preventing plaques from rupturing and forming clots that can lead to a heart
attack. Statins also act on platelets and other clotting factors to reduce
clot formation.
Should I Use Statins?
To answer this question, first consider your health history. You should
probably take a statin if you:
a.. Are you diagnosed with a heart disease, especially coronary artery
disease
b.. Have already experienced a heart attack
c.. Have diabetes
If you do not have heart disease or diabetes, consider your risk-factor
profile. Certain risk factors increase your chances of developing heart
disease. These include:
a.. Cigarette smoking
b.. Hypertension (defined as blood pressure of 140/90 or more)
c.. Family history of coronary heart disease (whether you have had a
mother, father, sister, brother, daughter or son with heart disease)
d.. A low HDL-cholesterol level (under 40 mg/dl)
e.. Your age (men over 45 and women over 55 have a higher risk)
f.. Elevated C reactive protein level
The more risk factors you have in association with an elevated cholesterol
level, the greater your need for a statin.
For example, consider two 50-year-old men, both with an LDL-cholesterol
level of 130 mg/dl. The first man smokes, has high blood pressure, a family
history of heart disease, and an HDL cholesterol level less than 40 mg/dl.
The second doesn't smoke, has normal blood pressure, no family history of
heart disease, and an HDL-cholesterol level greater than 60 mg/dl. The first
man is a likely candidate for statin therapy and the second man is not, even
though they both have the same LDL cholesterol level.
In Brief
If you have known heart disease you should be on a statin; the more risk
factors you have the more you need to consider taking one.
What Are The Disadvantages Of Taking Stains?
Disadvantages of taking statins appear relatively minor. Serious side
effects are uncommon. Rarely, you may experience an upset stomach, gas,
constipation and abdominal pain or cramps. Usually, these symptoms fade as
your body adjusts to statin therapy. Although rare, liver toxicity can
occur. If you have underlying liver disease, your liver function may need to
be monitored. Also rare are achy, tender muscles (a condition called
myositis). If you experience muscle soreness, pain and weakness, you may
need to stop taking the drug and undergo a muscle enzyme blood test.
To prevent dangerous drug interactions, let your doctor know about any other
drugs you are taking, including prescription and over-the-counter drugs and
herbal remedies. Erythromycin and clarithromycin (Biaxin), two commonly
prescribed antibiotics, can increase the risk of statin-induced myositis.
People taking the anti-coagulant warfarin should probably avoid lovastatin
and fluvastatin.
What Are Guidelines For Taking Statins?
Most likely, you will take one pill per day, at your evening meal or at
bedtime. Because your body manufactures more cholesterol at night than
during the day, taking statin drugs in the evening is key. If you miss a
dose, don't double up the next day; simply return to your usual regimen.
Expect to wait several weeks before seeing results from statin therapy.
After about six to eight weeks, expect your doctor to measure your LDL
cholesterol. This measurement will be averaged with a second measurement of
LDL cholesterol to determine if any changes to your regimen are necessary.
If I Can't Take A Statin, What Are My Alternatives?
If you cannot tolerate statins, other medications are available that may
help lower cholesterol levels.
a.. Niacin lowers total cholesterol, LDL cholesterol and triglyceride
levels, and it raises HDL-cholesterol levels (the good cholesterol).
Unfortunately, niacin is poorly tolerated by most people. Niacin may be sold
under the trade names Niac, Niacor or Slo-Niacin.
b.. Fibrates can help lower triglyceride levels. (Triglycerides are lipids
that circulate in your blood.) They also raise levels of HDL cholesterol
(the good cholesterol). Some common fibrates are clofibrate (Atromid),
gemfibrozil (Lopid), and fenofibrate (Tricor)
c.. Bile-acid sequestrants lower LDL-cholesterol levels. However, these
drugs are rarely used because they lower HDL-cholesterol levels and cause
constipation. Common bile-acid sequestrants include cholestyramine
(Questran) and colestipol (Colestid).
d.. Cholesterol absorption blockers such as the new drug Zetia can help
lower cholesterol levels, especially when used with a statin.
Regardless of whether you take cholesterol-lowering drug therapy, lifestyle
changes are key to preventing heart disease. These changes include deceased
intake of saturated fat and cholesterol, increased physical activity and
weight control. For information on how to maintain a heart healthy diet,
What Is The Next Step?
If you have heart disease or diabetes and are not taking statins, talk to
your doctor about being prescribed these drugs. If you do not have heart
disease or diabetes, ask your doctor about undergoing a complete lipid
profile (you should know the numbers for your total cholesterol,
LDL-cholesterol, HDL-cholesterol and triglyceride levels). Discuss with your
doctor whether lifestyle changes are sufficient to maintain desirable
cholesterol levels and cardiac health or whether you should consider statin
therapy.
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