One of the most common questions I get as a cardiologist pertains to the use of statins. Statins are drugs that can lower your cholesterol. They work by blocking a substance your body needs to make cholesterol. Because of their significant benefit in treating and preventing cardiovascular disease, statins are one of the most commonly prescribed classes of medications.
Statins play a key role in improving a cholesterol profile by:
Lowering cholesterol isn’t the only benefit associated with statins. These medications have also been linked to a lower risk of heart disease and stroke.
Some confusion understandably arises when I recommend that patients initiate a statin despite having normal or near normal cholesterol levels. This situation can occur when patients have a significantly elevated risk of future cardiovascular events (such as heart attack and stroke) as estimated by their overall risk factor profiles, with cholesterol levels only being one of the components used to assess that risk.
Other risk factors that determine whether a patient is at increased risk of cardiovascular disease and can benefit from statins include:
Based on the combination of these risk factors, if your risk of having a cardiovascular event is determined to be high enough, statin therapy will be recommended to reduce this risk and the risk of cardiovascular death.
In patients with established cardiovascular disease (peripheral arterial disease, carotid arterial disease, coronary artery disease, abdominal aortic aneurysm, or diabetes mellitus), statin therapy is recommended regardless of LDL cholesterol levels for the prevention of cardiovascular events or death. This is because statins have other positive effects on the cardiovascular system separate from lowering cholesterol. Statins promote normal functioning of the cells lining our blood vessels, reduce local inflammation, and stabilize plaque already in the artery, preventing it from rupturing and causing a heart attack or stroke.
Patients are often understandably concerned about side effects with statins and, fortunately, they are usually mild.
Overall, statins have had a dramatic impact in the field of cardiovascular medicine and have some of the best medical evidence supporting their efficacy and safety in the prevention of cardiovascular disease, cardiovascular events, and cardiovascular death in patients that meet criteria for their use.
Talk to your cardiologist to learn more and determine if you are a good candidate for statins.