Heart disease risk is a major concern for people with high cholesterol levels. While cholesterol is essential for various bodily functions, not all types are beneficial. Low-Density Lipoprotein (LDL) cholesterol, often referred to as "bad" cholesterol, can build up in the walls of arteries, leading to atherosclerosis, a condition that increases the risk of heart attacks and strokes.
On the other hand, High-Density Lipoprotein (HDL) cholesterol, known as "good" cholesterol, helps remove LDL cholesterol from the bloodstream, reducing the risk of heart disease. It is essential that one takes proper care of their cholesterol levels either through proper lifestyle choices or cholesterol-lowering medications, like statins, as prescribed by doctors. However, one must assess their need for drug use and find out whether it will be beneficial for them or not.
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What Is The Role Of Statin In Cholesterol Management?
In an interaction with the OnlyMyHealth team, Dr Anantha Padmanabha, Senior Consultant - Internal Medicine, Fortis Hospital, Nagarbhavi, Bengaluru, says, "People use statins to lower cholesterol and reduce heart disease risk. Statins work by inhibiting an enzyme in the liver, reducing cholesterol production, and increasing LDL cholesterol removal. This helps reduce plaque buildup in arteries."
So, statins primarily target LDL cholesterol and modestly increase HDL cholesterol, which in turn reduces the risk of cardiovascular events. In fact, research suggests that early clinical trials with statins demonstrated their effectiveness in reducing heart attack, stroke, and death risks.
Possible Health Risks Of Long-Term Statin Use
While the benefits of statin use are somewhat known, one must be cautious about its side effects, especially in the case of prolonged use.
According to Dr Padmanabha, long-term statin use may cause muscle pain, liver damage, varying blood sugar, and cognitive impairment. He adds that statins can cause kidney damage, neuropathy, or pancreatitis, but only in rare scenarios.
To be one step ahead of these issues, the doctor recommends monitoring liver enzymes and reporting side effects, which can help minimise risks. Moreover, statins may not be recommended for those with liver disease, kidney failure, or muscle disorders. Pregnant or breastfeeding women and individuals with a history of statin intolerance should also avoid statins.
Do The Benefits Of Statins Outweigh The Risks?
As per Dr Padmanabha, whether or not the benefits of statins outweigh the risks depends on an individual's overall cardiovascular risk profile.
For those with a high risk of heart disease or established cardiovascular conditions, the benefits of statins in reducing cholesterol and preventing heart attacks or strokes generally outweigh the potential side effects. This was also established in a 2022 study published in the JAMA Network.
Researchers from the US Preventive Services Task Force (USPSTF) recommend that adults aged 40-75 with at least one risk factor for Cardiovascular Disease (CVD), such as high cholesterol, diabetes, high blood pressure, or smoking, and a 10% or higher risk of a heart attack or stroke in the next 10 years should take a statin medication.
For adults in the same age group with a lower risk of 7.5–10%, statin use is recommended, but the benefits may be smaller, they added. However, for adults over 76 with no history of CVD, the evidence is insufficient to determine if the benefits of statin use outweigh the risks.
In fact, for individuals with low cardiovascular risk, lifestyle modifications, such as diet and exercise, may be sufficient to manage cholesterol levels, and the use of statins may not be necessary, says Dr Padmanabha, who was not a part of the study.
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Statins Alone Won’t Help
It is important to note that medication alone will not suffice. If you’re someone taking statins, remember that healthy lifestyle choices must complement it to manage cholesterol more effectively.
According to Dr Padmanabha, these include a balanced diet, regular exercise, and healthy weight management. Combining both approaches often yields better results than either alone, he concludes.