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These medications help lower cholesterol levels in the blood and reduce the risk of heart disease and stroke
Statin therapy is one of the most prescribed treatments for managing cholesterol and is also used to prevent heart disease. Studies show that statins significantly reduce the risk of heart attack, stroke, peripheral artery disease and other cardiovascular events, especially in patients with high cholesterol, existing heart disease or diabetes.
“Statins work by reducing cholesterol synthesis in the liver,” says Duane Bryan, MD, chief medical director of nuclear cardiology at Montefiore Nyack Hospital and a cardiologist with Highland Medical, Advanced Cardiovascular Care in West Nyack, NY. “Statins block an enzyme the liver needs to make cholesterol, which causes the liver to remove cholesterol from the blood.”
Benefits of Statins
Statins are highly effective at reducing low-density lipoprotein (LDL), or “bad” cholesterol, which can build up in artery walls and lead to plaque formation known as atherosclerosis. Plaque buildup narrows the arteries and increases the risk of heart attacks and strokes. Statins help slow the progression of the disease and reduce the risk of major heart events like heart failure or the need for coronary artery bypass surgery. Statins may help stabilize plaques in the arteries, making them less likely to rupture, which could otherwise trigger clot formation that leads to heart attacks.
Statins are also prescribed to people with diabetes due to their ability to prevent cardiovascular complications. Despite some risks of raising blood sugar levels, the benefits of reducing heart disease risk generally outweigh this concern.
Risks and Side Effects
One of the most common side effects is muscle pain or weakness. Patients may feel this pain as soreness, tiredness or muscle weakness. Some people report memory loss, confusion or cognitive impairment while on statins, though the evidence is mixed regarding whether statins directly cause these issues.
Statins can interact with certain antibiotics, antifungals, HIV drugs and some blood thinners since they are metabolized in the liver sharing a common pathway with other medications. Levels can be affected by simultaneously taking other medications and could either be increased or decreased based on the drug interaction.
“It is important that your doctor is aware of all the medications you take for this reason,” advises Dr. Bryan. “Also, grapefruit juice can deactivate an enzyme that clears statins from your system and can increase statin levels.”
Dr. Bryan acknowledges that while statins do carry some risks and potential side effects, they are often exaggerated.
Alternative Treatments to Statin Therapy
Some alternatives to statins include medicines that reduce cholesterol in different ways. Ezetmide works by blocking cholesterol absorption in the gut. Bempedoic acid slows down the ATP citrate lyase enzyme in the liver to reduce cholesterol production. PCSK9 inhibitors are a class of injectable medication taken twice monthly that targets the enzyme that lowers cholesterol.
For individuals who cannot tolerate statins or prefer non-pharmacological options, alternative treatments and lifestyle changes, such as dietary changes, exercise and supplements, can help manage cholesterol levels and improve heart health.
A heart-healthy diet is key to managing cholesterol levels. A plant-based or vegan diet has been shown to reduce LDL cholesterol. Incorporating fiber-rich foods such as oats, fruits, vegetables, and legumes can also help lower LDL levels.
Regular physical activity and weight loss, particularly around the abdomen, can help improve cholesterol levels, lower triglycerides and reduce the risk of heart disease. Stopping smoking improves HDL cholesterol and limiting alcohol can reduce triglyceride levels.
Before starting statins or considering alternatives, speak with a physician or healthcare provider to weigh the benefits and risks to your specific health condition.
To make an appointment with a cardiovascular specialist, call 845-268-0880. Highland Medical Advanced Cardiovascular Care is at 2 Medical Park Drive, Suite 3, West Nyack, NY.
