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Top questions about statins, answered 

Top questions about statins, answered (Getty Images)

These cholesterol-lowering drugs are incredibly common, but they’re often misunderstood. Here’s what to know about them.

Last time you saw your doctor, they told you that your cholesterol was too high. And in addition to sending you home with a new meal and exercise plan, you also got a prescription for a statin. 

That’s a type of medication that can help lower your cholesterol.1 (High levels of cholesterol, a waxy substance found in your blood, may lead to heart disease.2)  

But when you got back from filling your prescription, you searched “statins” on your smartphone. After reading about them, it got you thinking: Are statins the right choice for me?   

For most people the answer is yes. “There’s a lot of misinformation out there about statins,” says Michael Almaleh, MD. He’s the chief of cardiology and specialty care at Optum in San Antonio, Texas. “But we would never prescribe a medication unless the benefits significantly outweighed the risks.” 

Read on to find answers to your top questions about statins. 

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Why did my doctor prescribe statins for me?

Simply put, statins help reduce your risk of heart disease by lowering the amount of cholesterol in your blood.3 It may be a life-saving treatment for many people.  

Heart disease is the leading cause of death in the United States, and high cholesterol is one of the main factors. It can form plaques that narrow arteries and restrict or even block blood flow.4  

While many people can reduce their cholesterol with diet and exercise alone, others can’t.5 This is usually the case for those with a family history of high cholesterol, with diabetes or who already have heart disease, among other risk factors. If that’s you, medication may be the best way to reduce your risk of heart disease, heart attack and stroke.6  

How do statins work?  

You might think cholesterol comes primarily from food. But the truth is, most of it is produced by your liver.7 Statins work by interfering with that production process. They block a type of protein (enzyme) your liver needs to produce cholesterol.3  

This has the added benefit of increasing the amount of cholesterol your liver removes from your blood.3  

Do statins actually do their job? 

Million Hearts, a national initiative co-led by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services, reports that statins may be able to cut your risk of a heart attack or stroke by half. And the longer you take them, the better they work.7  

For this reason, the U.S. Preventive Services Task Force strongly recommends them for people ages 40 to 75 who have certain risk factors for heart disease.8  

However, they don’t make any recommendations for those over the age of 75.8 If you’re in that age group, talk with your Optum doctor. They can help you decide if statins are good option for you. 

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Do statins have any side effects?

Most people who take statins don’t experience any side effects. And if they do, they’re mild. Serious side effects are rare. For example, if you have chronic liver disease, it’s not a good idea to take statins.5  
 
That said, 29% of people who take statins report having some side effects, according to Million Hearts.7 The commonly reported ones are muscle aches or weakness.  
 
But as the CDC notes, aching muscles and weakness may also be symptoms of aging. So, some people may mistake those for side effects of statins.3, 7 

Other possible side effects of taking statins may include:9  

  • Dizziness 
  • Headache 
  • Nausea 
  • Stomach trouble, such as gas, diarrhea or constipation 

While side effects such as these may sound manageable, they might not be for you. Your doctor may be able to help by adjusting your dose or prescribing you a different type of statin.7  

Can taking statins lead to other health conditions? 

Although it’s rare, statins may raise your blood sugar (glucose) to a point where you can develop type 2 diabetes.3 This happens mostly to people who are already at risk of developing or who already have the condition.3, 7  

That said, for most people the benefits of statins far outweigh the risks, according to Million Hearts.7 A small increase in blood sugar may be a small price to pay for a much lower risk of heart attack or stroke. 

Can I control my high cholesterol with lifestyle changes?  

Even if you’re on statins, regular exercise and a healthy diet can also help lower your cholesterol.2 For exercise, any amount will help, according to the American Heart Association.10  

But for most adults, the CDC recommends at least 150 minutes of moderate-intensity exercise each week (or 75 minutes of vigorous exercise).11  Before you make any changes to exercise regimen, it’s a good idea to talk to your doctor. 

Limit foods that are high in saturated fat or trans fat, which can both raise “bad” LDL cholesterol.12 Examples include many fast foods, fried foods, deli meat and full-fat dairy products. 

Here are some general dietary strategies for helping reduce your cholesterol levels:12, 13 

  • Stick to lean cuts of meat. 
  • Swap out butter for unsaturated oil, such as olive oil. 
  • Eat plenty of fruits and vegetables. 
  • Eat more fiber, including whole grains, beans and other legumes. 
  • Limit high-cholesterol foods, such as egg yolks and shrimp 

While these changes can help, you may still need to take a statin.5 That doesn’t mean you’ve failed, since your genes play a big role in your cholesterol levels.  

But don’t lose faith in healthy habits. Exercise and a healthy diet will still help protect your heart.

Is there anything else I should know about statins?

Statins come in pill form, and most people only need to take one a day.14 But since there are many types on the market, you’ll want to read the label carefully or ask your doctor for specific advice on how to take yours.  

For instance, some statins may interact with certain medications or foods. That means the statins may work differently or cause side effects.14  

Dr. Almaleh points to grapefruit juice as an example. Grapefruit juice can affect how the body absorbs some statins.14 “Normal quantities of grapefruit juice are likely to be safe, regardless of the statin you choose,” he says. However, if you drink large amounts of grapefruit juice, talk with your doctor. A different statin may work better for you. 

Bottom line: If you don’t get high cholesterol treated, it can be dangerous. And often, it comes with no warning signs. Some people don’t discover they have high cholesterol until after they’ve already had a heart attack or stroke.6   

That’s why it’s important to work with your Optum doctors and specialists to create a care plan that works for you. If you’re worried about taking statins or dealing with side effects, talk to your prvoider. But don’t let myths you find online keep you from getting the treatment you need and meeting your health goals.  

Sources

  1. Mayo Clinic. Statins: Are these cholesterol-lowering drugs right for you? Last updated March 18, 2022. Accessed December 19, 2023. 
  2. Mayo Clinic. High cholesterol. Last updated January 11, 2023. Accessed December 19, 2023.  
  3. Mayo Clinic. Statin side effects: weigh the benefits and risks. Last updated May 27, 2023. Accessed December 19, 2023.  
  4. Centers for Disease Control and Prevention. Heart disease facts. Last reviewed May 15, 2023. Accessed December 19, 2023.   
  5. American Heart Association. Cholesterol medications. Last reviewed November 11, 2020. Accessed December 19, 2023. 
  6. Centers for Disease Control and Prevention. Cholesterol myths and facts. Last reviewed October 24, 2022. Accessed December 19, 2023. 
  7. Million Hearts. The scoop on statins: What do you need to know? Last reviewed September 27, 2021. Accessed December 19, 2023. 
  8. U.S. Preventative Services Task Force. Statin use for the primary prevention of cardiovascular disease in adults: preventative medication. Published August 23, 2022. Accessed December 19, 2023.  
  9. Cleveland Clinic. Statins. Last reviewed January 14, 2022. Accessed December 19, 2023.  
  10. American Heart Association. Doctors should ‘prescribe’ exercise for adults with slightly high blood pressure, cholesterol. Published June 2, 2021. Accessed December 19, 2023.  
  11. Centers for Disease Control and Prevention. How much physical activity do adults need? Last reviewed June 2, 2022. Accessed December 19, 2023.  
  12. Cleveland Clinic. Cholesterol and nutrition. Last reviewed October 17, 2022. Accessed December 19, 2023.  
  13. National Library of Medicine: MedlinePlus. How to lower cholesterol with diet. Last updated May 5, 2021. Accessed December 19, 2023.  
  14. National Library of Medicine: MedlinePlus. How to take statins. Reviewed January 18, 2022. Accessed December 19, 2023.  

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