Should i start statins

So may consuming large quantities of grapefruit or juice and taking certain medications. Addressing these factors may ease or prevent statin-related muscle effects. Your doctor may switch you to a less-potent statin, change the dose, or explore alternative dosing strategies. This may include taking the drugs every other day or less frequently. With some perseverance, you and your physician can develop a statin regimen that works for you. Age is the most significant risk factor for atherosclerotic cardiovascular disease.

However, the risks and benefits of statins must be carefully considered in older populations, especially those with health problems. Older adults, as a whole, may be more likely than their younger counterparts to experience serious side effects from statins. Many seniors take multiple medications, making them more likely to experience adverse medication interactions with a statin.

Importantly, seniors with other medical conditions that shorten their life expectancy may not reap the benefits of statin therapy.

Laffin advises. And many of these things can address the side effects that you're worried about. But the important thing is that, to keep taking your statin if your doctor has determined that it's beneficial for you in the long run.

I always say that prevention is the best medicine. And statins are certainly one of the most important tools we have in cardiology to prevent heart attacks and strokes. What's the magic number? I mean, I mean, we know that you can lower your cholesterol with changing what you eat or getting some exercise. Obviously, genetics play a role there.

And sometimes you're just a little bit out of luck. But is there a magic age? Is there a magic number? Like, OK, I'm 49 years old right now. And my cholesterol is , No doctor's ever told me that I need a statin.

Every time I've been to my doctor, which isn't as often as I should go, but once every year plus, they've said, you know, change what you eat a little bit or get a little bit more exercise.

But never has anyone said you should be taking a statin. And then I'm guessing I'm not old enough. Or my cholesterol is not too high. There has to be some factor.

Well, I think it starts first of all with suspicion and knowledge. You know, I'm a preventive cardiologist, and so I focus highly on risk and long-term risk. And so, in order to, you know, to have an indication to be on a statin, you have to understand that in the context of someone's risk. So, you know, people who have heart disease already, people who have diabetes, people whose LDL cholesterol is very high, it's called severe hyperlipidemia, so that would be an LDL cholesterol greater than equal to And then people with premature history of coronary disease, such as familial hypercholesterolemia, those people should really be on a statin.

And so, those people who don't, you know, if patients do not meet those criteria, then it's all about what your long-term risk of developing a heart attack or stroke would be. And then that helps us guide whether or not you should be on a statin.

So, in general, you know, people who are younger, who don't have any risk factors for heart disease can usually get away with lifestyle changes, diet and exercise. But as you age or develop any risk factors like high blood pressure, diabetes, obesity, inflammatory diseases, such as lupus or rheumatoid arthritis, all those things can enhance your risk for getting heart disease and would be an indication to go on a statin.

Now, you mentioned, you know, diet and exercise. So, you know, to a moderate degree, changing your eating habits and getting some exercise can lower your bad cholesterol, specifically decreasing saturated fat in your diet, decreasing dietary cholesterol and increasing soluble fiber and plant sterols in your diet can lower your LDL cholesterol. On the other hand, exercise and weight loss can improve your triglycerides and raise your HDL cholesterol, that good cholesterol.

But, you know, in general, the effects are relatively modest, usually about a 10 to 20 percent change, whereas statins can decrease your LDL cholesterol by over 50 percent in many cases. So, if you put me on a statin, I can just go on eating my cheeseburgers and fried chicken all the time. I wouldn't really put it that way. You know, diet has a lot of components in it.

And even though the statin will help lower your cholesterol, a poor diet that's high in saturated fat, high in sodium or salt, you know, and low in potassium and essential nutrients can have negative effects on your health way beyond the cholesterol.

First of all, high sugars are stored in your body as fat. So, even though you're not eating a high-fat diet, you will definitely gain weight by eating sugary drinks, like, you know, non-diet sodas, sugar-sweetened beverages. Things that are high in fat and cholesterol and sodium will cause blood pressure to go up and cause your triglycerides to go up.

And triglycerides, you know, I mentioned briefly, but are another, you know, lipid risk factor that many people overlook. And so, we know that even if you could get your LDL cholesterol down to low levels with a statin, there are many other, these lipoproteins out there in your blood that contribute to heart disease that are not necessarily lowered by the statin, and the diet plays a really important role in that.

So, you're not off the hook eating the cheeseburgers and fried chicken just yet. So, conventional wisdom has always told us that what we eat affects our health, and it does. But what I'm hearing from you is that genetics play a huge role as well.

And when it comes to high cholesterol, could you actually break that down for us? You know, genetics do play a role in your cholesterol set point. So, in other words, the amount of cholesterol that the liver makes and reabsorbs from your bloodstream is primarily determined by your genetics.

However, statin and other lipid lowering medications can alter how your liver handles cholesterol and drive down bad cholesterol to very low levels. Now, there are some genetic diseases associated with very high levels of cholesterol, such as familial hyperlipidemia, or FH, that can cause premature development of heart disease, heart attacks, and death.

And those diseases which are, you know, genetic diseases can run in families and are very dangerous. So, Doctor, you have the last say here. What would you like to say to everyone out there listening who might be on the fence about statins? What is your argument? So, I would say, you know, talk to your doctor, see a preventive cardiologist, if you're concerned. We can address all of your questions. We can, you know, help you understand the risks and the benefits of taking medicines like statins as well as other medications to prevent heart disease and stroke.

And it's really important to have the correct information and to feel comfortable in understanding what it means to take a statin. Cholesterol-lowering statins have transformed the treatment of heart disease. But while the decision to use the drugs in patients with a history of heart attacks and strokes is mostly clear-cut, that choice can be a far trickier proposition for the tens of millions of Americans with high cholesterol but no overt disease.

Now a report from preventive cardiologists at Johns Hopkins and elsewhere offers a set of useful tips for physicians to help their patients make the right call. Atherosclerotic heart disease — the most common form of the disease — develops gradually as fat builds inside the blood vessels and makes them stiff, narrowed and hardened over time, greatly reducing their ability to supply oxygen-rich blood to the heart muscle and brain. Statins work by lowering the amount of circulating cholesterol in the blood and halting or slowing the formation of dangerous fatty plaque.

Rarely, however, statins can precipitate the onset of other serious conditions, including muscle damage and diabetes. The risk of such infrequent side effects pales in comparison with the very real risk of heart attack or stroke among those with established heart disease or history of stroke.

However, the risk-benefit balance is much trickier to gauge among those who have no actual disease but whose high cholesterol and other risk factors render them likely yet not definite candidates for heart attacks and strokes. Stone, M. Ekaterina Pesheva epeshev1 jhmi. Contact us or find a patient care location. Privacy Statement. Non-Discrimination Notice. This content does not have an English version.

This content does not have an Arabic version. See more conditions. Statins: Are these cholesterol-lowering drugs right for you? Products and services. By Mayo Clinic Staff. Thank you for Subscribing Our Housecall e-newsletter will keep you up-to-date on the latest health information.

Please try again. Something went wrong on our side, please try again. Show references Cholesterol medications. American Heart Association. Accessed Jan. Rosenson RS. Statins: Actions, side effects, and administration. Ferri FF. In: Ferri's Clinical Advisor Elsevier; Kellerman RD, et al. In: Conn's Current Therapy Adhyaru BB, et al.

Safety and efficacy of statin therapy. Nature Reviews — Cardiology. High blood cholesterol. National Heart, Lung, and Blood Institute. Listen to your heart: Learn about heart disease.

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