About 40 million Americans take a statin medication to lower their LDL cholesterol and reduce their risk for cardiovascular disease. We talked to Dr. Natalia Pawlowski, a Roper St. Francis Healthcare-affiliated family medicine doctor, about the factors people should consider as they think about this option.
Think about making lifestyle changes first
Some people “inherit” high cholesterol through genetics. But for most people with high cholesterol, unhealthy habits are the main culprit, Dr. Pawlowski says.
Before prescribing a statin or other cholesterol-lowering drug, your doctor may talk to you about lifestyle changes you can make to reduce your risk for this disease. These include:
- Eating a diet that’s rich in vegetables, fruits, fish and whole grains (and limiting your intake of saturated fat, trans fat, refined carbohydrates and salt)
- Being physically active and sitting less
- Losing weight if you are overweight. Dropping even 7 to 10% of your body weight if you’re obese can go a long way toward improving your heart health.
- Not smoking, and avoiding secondhand smoke
“People often get very intimidated by the whole ‘diet and exercise’ concept, but I remind my patients that small changes can go a long way,” says Dr. Pawlowski says. “You don’t have to run marathons or get a gym membership. Exercising just 150 minutes per week – which is a fast-paced 30-minute walk five days a week—can make a big impact on your heart health.”
It’s important to consider high LDL in the context of a person’s overall health, Dr. Pawlowski says. “We look at the patient’s situation holistically,” Dr. Pawlowski explains. “People whose LDL is slightly abnormal but are physically active, non-smoking and otherwise healthy with no major medical or genetic risk factors usually have a high level of HDL, the ‘good cholesterol.’ This protects their heart even if their LDL or total cholesterol are a little higher than what the lab calls ‘normal.’ So they may not need a statin after all.”
Consider your other risk factors
Your doctor also will consider your other risk factors for cardiovascular disease, such as heart attack and stroke. In addition to high LDL cholesterol, other risk factors are:
- Having diabetes
- Having high blood pressure
- Being a past or current smoker
- Being diagnosed with atherosclerosis, which causes your arteries to become narrower and less flexible
- Having a previous heart attack or stroke
- Having a family history of early coronary artery disease
The more risk factors you have and the more severe they are, the higher your overall risk for cardiovascular diseases such as heart attack and stroke.
Be aware of possible side effects
Statins can cause liver damage for a small percentage of people. If that happens, you’ll have to stop taking the stain, but your doctor may try another, non-statin drug instead.
“Other common side effects are muscle aches and nausea, which tend to go away after a couple of weeks,” Dr. Pawlowski says. “If they don’t, patients can take a lower dose or take the statin every other day. Another option is to switch to a different statin that is metabolized a little differently, or to a weaker statin with the idea that ‘some is better than none.’ Statins are very helpful for many people with high LDL cholesterol, so it’s worth taking the time we need to find the right statin for them.”
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