Statin Drugs Fight Heart Disease
Nicholas Licari, MSN, FNP-BC
As a health care provider, I consider the my personal mantra to be “live longer, feel better.” I carry this mantra with me as I treat patients for a variety of ailments, including heart disease. Heart disease is the leading cause of death in the United States and globally. Each year significant resources are allocated for research, treatment, and prevention of this deadly disease. Thankfully, significant advancements in the fight against heart disease have been achieved over the past 40 years, and perhaps no achievement has been more significant than the discovery of statins.
Statins are one of the most prescribed drugs in the U.S with over 40 million Americans taking them. Statins (HMG CoA reductase inhibitors) are a type of medication specifically designed to lower LDL. The term LDL stands for low-density lipoprotein and is frequently referred to as the “bad cholesterol,” since high levels of LDL in the blood leads to increased risk of heart blockages, heart attack, and stroke.
Over time, too much LDL in the blood builds up in arteries and causes plaque, a fatty, waxy substance. The process is called atherosclerosis and causes arteries to become harder and narrower. When this occurs in the coronary arteries (arteries of the heart), it restricts blood flow to the heart itself. A blockage in the coronary artery may result in chest pain or a heart attack. If the buildup is in the arteries leading to the brain, this increases the risk of having a stroke, and buildup of plaque in the arteries in the arms and legs leads to peripheral artery disease.
Statin drugs work to slow the liver’s ability to make cholesterol, which then helps to remove LDL from the blood and arteries. Additionally, statins may help reduce inflammation of the arteries. Medical research has clearly shown that statins reduce the risk of heart attack, stroke, and other vascular diseases.
Who is a candidate for statin therapy? There are multiple factors that come into play when your healthcare provider evaluates your cardiovascular risk. The higher your risk, the higher the potential benefit there is from taking a statin drug. Before prescribing a statin, a provider takes into consideration several health determinants:
- A personal history of cardiovascular disease including heart attack, stroke, and/or peripheral artery disease
- Very high LDL levels, 190 or greater
- People with diabetes
- People at increased risk for cardiovascular disease
When the decision is made to start any prescription drug, your provider will evaluate the risk versus the benefit of the treatment. The benefits of taking a statin include reduced risk of heart attack, stroke, and vascular disease. These events and diseases can be disabling or even cause death – prevention is a key consideration.
Taking statin drugs comes with potential side effects. The most common side effects are muscle aches, reported in up to 20% of people as muscle soreness, weakness, or fatigue. The use of CoQ10 supplements may help alleviate this side effect. There is also an associated increase in blood sugar with statins increasing the risk of developing diabetes by about 10%, although the reason for this is unclear. However, since many people with diabetes are already at an increased risk for heart attack and stroke, the benefit outweighs the risk in this case.
Around 1% of statin users develop elevated liver enzymes indicating liver inflammation, typically only seen with a high dose of statins. This can often be resolved by regularly taking a break from the statin for a period of time. It is important to discuss the risk of statin drugs use with your health care provider and report any side effects.
Being on a statin is typically a lifelong decision. LDL levels can be reduced significantly in three months’ time, with up to a 50% reduction seen with certain types of statins. However, when the drug is stopped, the LDL usually returns to its previous higher level. It is, therefore, recommended to continue use of the drug once use has started.
Statins are safe medications that have been widely studied. Many generic forms of statins are available, making them more affordable for patients. Side effects are possible but can be treated, and the benefit largely outweighs the risk for treatment of cardiovascular disease.
Statins help people decrease their risk of heart disease, improving overall quality of life for many patients and allowing them to “live longer, feel better.”
Nicholas Licari is a family nurse practitioner at HopeHealth Medical Plaza in Florence and is currently accepting new patients in his Family Medicine practice. Call 843-667-9414 or visit hope-health.org for more information.