Should You Be Taking a Statin? Here’s What You Need to Know
- Statins are a common medication for lowering high cholesterol and reducing the risk of heart disease and strokes.
- Statin therapy is recommended for:
- Individuals with existing cardiovascular conditions
- Individuals with very high LDL-C levels
- Middle-aged adults with diabetes
- Additional benefits of statins include raising HDL and lowering triglycerides, as well as stabilising arterial plaques.
If you have high cholesterol, your doctor may recommend statins. These medications are the most common ways to lower cholesterol and help protect against heart disease, which is the leading cause of death worldwide.
In the U.S., around 94 million adults have cholesterol levels that are considered too high, and more than 35 million Americans take a statin to lower their risk of heart attacks and strokes.
But not everyone with high cholesterol needs a statin. Some patients can manage their levels with diet and exercise alone, while others may need medication based on their overall risk.
What is Cholesterol?
Cholesterol is a waxy, fat-like substance found in your body. It comes from 2 sources; your liver makes most of it, and it also comes from food sources, particularly animal-based products, including meat, dairy, and fried foods. Cholesterol is necessary for building cells and producing hormones, but too much of it can lead to serious health problems.
Cholesterol Levels
High cholesterol means there is too much cholesterol circulating in your blood. Over time, excess cholesterol can build up in the walls of your arteries, leading to blockages that increase your risk of heart disease, heart attacks, and strokes.
The only way to determine cholesterol levels is through a blood test called a lipid panel. This test measures different types of cholesterol and fats in your blood.
LDL cholesterol (low-density lipoprotein)
Often called "bad" cholesterol because high levels contribute to plaque buildup in your arteries.
| LDL | |
| Ideal | Lower than 100 |
| Borderline | 100 – 129 |
| High | 130 or higher |
HDL cholesterol (high-density lipoprotein)
Referred to as "good" cholesterol because it helps remove LDL from your bloodstream.
| HDL | |
| Ideal | 60 or higher |
| Low (Men) | Lower than 40 |
| Low (Women) | Lower than 50 |
Total cholesterol
The combined amount of LDL, HDL, and other lipids in your blood.
| Total Cholesterol | |
| Ideal | Lower than 200 |
| Borderline | 200 – 239 |
| High | 240 or higher |
Triglycerides
A type of fat in your blood that your body stores for energy. High levels can increase your risk of heart disease, especially when combined with high LDL and low HDL.
| Triglycerides | |
| Normal | Lower than 150 |
| Borderline high | 150 – 199 |
| High | 200 – 499 |
Symptoms of High Cholesterol
High cholesterol does not cause noticeable symptoms. Many patients do not know their levels are high until they experience a serious problem such as a heart attack or stroke. That is why routine cholesterol testing is important, especially for adults over 20 and those with risk factors including a family history, high blood pressure, or diabetes.
Keep in mind that even if cholesterol levels are high, they can be managed through lifestyle changes and medication if needed.
What Are Statins?
Statins are used to lower cholesterol levels. Statins help slow down your body’s production of LDL cholesterol. This can help prevent cholesterol buildup in your arteries, which can lead to serious heart-related problems over time.
What Statins Do
Lower LDL-D: Statins lower cholesterol by blocking a liver enzyme (HMG-CoA reductase) that is responsible for cholesterol production. By slowing down this process, the liver makes less LDL cholesterol, which reduces the amount released into your bloodstream.
Raise HDL-C; lower trigycerides: HDL helps remove excess cholesterol from your arteries. Triglycerides is a type of fat that's linked to heart disease.
Slow down plaque buildup in the arteries and help stabilize existing plaques, making them less likely to rupture and cause heart attacks or strokes.
Because of these effects, statins are widely used to reduce cardiovascular risk in patients with high cholesterol or those who have already experienced heart-related issues.
Statin Intensity
Statin intensity is a term used in the medical community to describe how much you can expect a statin to lower your bad cholesterol levels. There are low, moderate, and high intensity statins.
- Low intensity statins: Expect less than a 30% decrease in LDL-C or bad cholesterol
- Moderate intensity statin: Expect a 30-49% decrease in LDL-C or bad cholesterol
- High intensity statin: Expect greater than a 50% decrease in LDL-C or bad cholesterol
Who Should Consider a Statin?
The Centers for Disease Control and Prevention (CDC), recommend statin therapy in the following scenarios:
- Existing heart conditions: Patients who have had a heart attack, stroke, or have peripheral arterial disease are at a higher risk for subsequent cardiovascular events.
- High LDL-C levels: An LDL cholesterol level of 190 mg/dL or higher is considered very high. Statins are often prescribed to lower these levels and help prevent cardiovascular diseases.
- Diabetes in middle-aged patients: For adults aged 40 to 75 who have diabetes and an LDL cholesterol level of 70 mg/dL or higher, statins are commonly recommended to decrease their risk of heart disease associated with diabetes.
- High risk of heart disease or stroke: Adults aged 40 to 75 with an elevated risk of developing heart disease or stroke, combined with an LDL cholesterol level of 70 mg/dL or higher, may benefit from statin therapy.
How to Talk to Your Doctor about Statins
Discussing statin therapy with your doctor can help you understand whether these medications are right for you. If you have high cholesterol or an increased risk of heart disease, it is important to speak to your doctor about the different treatment options. Your doctor will consider factors such as your cholesterol levels, overall heart disease risk, and medical history before making a recommendation.
If you are hesitant about taking a statin, let your doctor know. They can explain the long-term benefits, go over possible alternatives, or address any concerns you have. The goal is to make an informed decision that considers your health needs, preferences, and lifestyle. Working with your doctor to develop a personalized plan can help you take the best approach to managing your cholesterol and reducing your risk of heart disease.