what is the treatment for starting a statin

start statin treatment - statins should be taken in the evening for maximal effect, and require 4 weeks or more to exert their full effect on lipid concentrations LFT

should be carried out before and within 4-6 weeks of starting statin therapy (1).

Full Answer

What you should expect from statin therapy?

• Secondary prevention in people with established atherosclerotic cardiovascular disease.
• People with an LDL cholesterol level of 190 milligrams per deciliter (mg/dL) or higher, due to a genetic condition.
• People with diabetes ages 40 to 75 with an LDL level over 70 mg/dL and no atherosclerotic cardiovascular disease.

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When to start statin therapy?

• Maximally tolerated statin therapy is recommended for patients 20 to 75 years of age with an LDL-C level of 190 mg per dL or greater. • Moderate-intensity statin therapy should be initiated without calculating a 10-year ASCVD risk for patients 40 to 75 years of age with diabetes mellitus.

Which statin is the best choice for which patient?

These include:

• lowering cholesterol
• decreasing the risk of stroke and heart disease
• lowering the risk of blood clots
• reducing the need for an angioplasty or other procedure to increase blood flow in an artery

What are the benefits of taking a statin?

• The Current Paradigm. Atherosclerosis does not affect all of us, and does not affect all those struck by it to the same extent or at similar age.
• Expected Benefits of Statin Use. ...
• Remaining Uncertainties. ...
• The Road Forward. ...
• Footnotes. ...

How do you initiate statin therapy?

No trials have directly compared the effects of low-to-moderate- with high-intensity statin therapy for primary prevention. When the decision is made to treat, we suggest starting treatment with a moderate dose of a statin, such as 20 mg of atorvastatin or 5 to 10 mg of rosuvastatin.

What to expect when starting statins?

One of the most noteworthy side effects associated with statin therapy is muscle aching and stiffness, which can be more severe as the statin dose and potency increase and may make some people intolerant to the drugs.

What is the first line treatment for high cholesterol?

HMG-CoA reductase inhibitors, or statins, are the recommended first-line therapy for most patients. These are the most prescribed drugs in the world and are considered the most effective lipid-lowering agents available, both in lowering LDL-C levels and in the prevention of CV events.

Who should be started on a statin?

The USPSTF concludes that adults who smoke or have dyslipidemia, diabetes, or hypertension and a 10% or greater 10-year CVD event risk should be offered a low- to moderate-dose statin. Adults with diabetes or dyslipidemia and a 20% or greater 10-year CVD event risk are most likely to benefit from statin use.

What cholesterol level requires statins?

Providers prescribe statins for people who: Have high cholesterol (LDL above 190 mg/dL) that exercise and diet changes couldn't reduce. Had a stroke, heart attack or peripheral artery disease. Have diabetes and an LDL of at least 70 mg/dL and are 40 to 75 years old.

When should a statin be prescribed?

Doctors often prescribe statins for people with high cholesterol to lower their total cholesterol and reduce their risk of a heart attack or stroke.

At what level of LDL requires medication?

Medication is typically recommended when: your cholesterol levels are high enough to increase your risk for cardiovascular disease (or you already had a cardiovascular event, such as a heart attack or stroke) you have an LDL level greater than 190 milligrams per deciliter (mg/dL)

How was high cholesterol treated before statins?

For example, the FDA has approved a class of drugs known as bile acid binding resins, which were the first cholesterol drugs before statins.

What can I take instead of statins to lower cholesterol?

7 cholesterol-lowering alternatives to statinsFibrates. Mostly used for lowering triglyceride levels in patients whose levels are very high and could cause pancreatitis. ... Plant stanols and sterols. ... Cholestyramine and other bile acid-binding resins. ... Niacin. ... Policosanol. ... Red yeast rice extract (RYRE) ... Natural products.

Are statins worth the risk?

Research has shown that statins are highly effective in reducing the risk of fatal heart attack and stroke.

Who needs statin therapy?

The U.S. Preventive Services Task Force recommends low- to moderate-dose statins in adults ages 40 to 75 who have one or more risk factors for heart and blood vessel disease and at least a 1 in 10 chance of having a cardiosvascular disease event in the next 10 years.

Why do doctors push statins?

Statins are the go-to treatment option for lowering cholesterol levels and risk of cardiovascular complications, like heart attack and stroke. Statins work by slowing down cholesterol production and enabling the liver to remove low-density lipoproteins (LDL), or “bad cholesterol,” from the bloodstream.

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Find your statin

There are multiple statins available, and that variety is a good thing. “Not all statins are alike,” says Dr. Steinbaum. Your doctor can check your cholesterol levels and assess your risk factors to figure out the right statin for you.

Keep up the healthy diet and exercise

A statin is not a quick-fix pill that means you can ignore your lifestyle choices. “I always tell my patients: By giving you this medication, I’m not telling you to eat poorly,” says Dr. Steinbaum.

Know you can still drink, but in moderation

When you take a statin, you don’t have to give up your glass of red wine on date night, but you do want to monitor your alcohol consumption. “Both alcohol and statins are metabolized by the liver, and the more strain you put on your liver, the more issues you might have,” says Dr. Steinbaum.

Ask exactly how to take it

As with any medication, there might be specific instructions to follow to make sure you’re getting the most benefit. “On some statins, you can't drink grapefruit juice, because it's metabolized by the same enzyme in the liver as those statins,” says Dr. Steinbaum.

Why do doctors prescribe statins?

Doctors may prescribe statins along with lifestyle changes to prevent or control cardiovascular disease. Purestock/Thinkstock. Atherosclerosis arises when fat, cholesterol, and other substances accumulate along artery walls and form a sticky buildup known as plaque.

How many cardiovascular events can be prevented by statins?

The researchers estimated that between 41,000 and 63,000 cardiovascular events would be prevented over a 10-year period by adopting the ACC/AHA guidelines compared to the previous guidelines.

Can you take statins for low cholesterol?

Medicines such as statins, which decrease low-density lipoprotein (LDL) cholesterol, may be prescribed if lifestyle changes aren’t enough. In 2013, the American College of Cardiology and American Heart Association, in collaboration with NIH’s National Heart, Lung, and Blood Institute (NHLBI), released new clinical practice guidelines on cholesterol ...

Is cholesterol treatment cost effective?

Two studies found that recent cholesterol treatment guidelines are a cost-effective way to prevent cardiovascular disease. The results suggest that it might be cost effective to lower the threshold for treatment with statins even further. Doctors may prescribe statins along with lifestyle changes to prevent or control cardiovascular disease.

How often can you take statins?

Advertising Policy. The statins are generally taken once daily and are available in generic forms. “It’s important to note that atorvastatin and rosuvastatin really are the workhorses of cardiology and statins at this point,” Dr. Laffin adds. “A lot of pharmacies typically will have one of the high-intensity statins.

Why are statins used for heart disease?

Why? It’s because a large body of research supports their benefits in reducing the risk of heart attack and stroke.

What is the recommended statin level for a person with atherosclerotic cardiovascular disease?

People with an LDL cholesterol level of 190 milligrams per deciliter (mg/dL) or higher, due to a genetic condition.

What age can you have a high LDL?

People with diabetes ages 40 to 75 with an LDL level over 70 mg/dL and no atherosclerotic cardiovascular disease. Non-diabetic adults ages 40 to 75 with a 20% or greater likelihood of developing atherosclerotic cardiovascular disease in the next 10 years (high-risk patients).

Which statins have the least side effects?

Certain statins — in particular, atorvastatin and simvastatin — are more likely to cause these side effects, while others, like rosuvastatin and pravastatin, have less of an effect.

Does statin help with cholesterol?

Statins inhibit the action of an enzyme that’s responsible for cholesterol production in your liver. In the process, they significantly reduce LDL and total cholesterol, while also having beneficial effects on HDL (“good”) cholesterol, triglycerides and inflammation.

Does statin lower LDL?

Preventive cardiologist Luke Laffin, MD, says statins lower your LDL ( or “bad”) cholesterol, which is associated with a reduced risk of atherosclerotic cardiovascular disease. (That’s the buildup of cholesterol, fatty cells and inflammatory deposits on the inner walls of your arteries aka “hardening” or “clogging” of the arteries).

What are the side effects of statins?

A small percentage of statin users report side effects, the most common being minor muscle aches (which can have many other possible causes). Other less common side effects are liver or digestive problems and a small increase in blood sugar. If you develop side effects on a statin, check if any other drugs you take—prescription, over-the-counter, or herbal—interact with statins. Last year, a study in the Journal of Clinical Lipidology found that many people who quit taking statins because of possible side effects were also taking an average of three other drugs that interfered with statin metabolism. Often, the drugs boosted statin exposure throughout the body. Doctors don't always pick up these potential interactions, so double-check with your pharmacist or online at /drugcheck. Taking a lower dose, using drugs that don't interact with statins, or trying a different type of statin can help.

Is statin a target or risk driven approach?

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Is statin good for HDL?

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Can statins cause side effects?

If you develop side effects on a statin, check if any other drugs you take—prescription, over-the-counter, or herbal—interact with statins. Last year, a study in the Journal of Clinical Lipidology found that many people who quit taking statins because of possible side effects were also taking an average of three other drugs ...

Can statins cause heart attacks?

For anyone who's had a heart attack or a stroke, or has chest pain with exercise or stress (angina), taking a statin makes a lot of sense. These cholesterol-lowing drugs slash deaths from cardiovascular disease by 20%. Doctors also recommend statins for most people with diabetes, because they face two to four times the risk ...

When did the AHA update statins?

In the fall of 2013, the American Heart Association (AHA) and the American College of Cardiology (ACC) updated their recommendations about statin medications. In addition to expanding the possible pool of people who may benefit from the medicine, they also updated lifestyle guidelines for people with high cholesterol.

How to lower cholesterol?

Diet and exercise can go a long way toward reducing cholesterol levels, but sometimes these measures aren’t enough. The most common high cholesterol treatment is a statin. Statin medications are designed to reduce LDL levels in the blood. For most people, statins safely lower LDL levels.

Do you need a liver enzyme test before statins?

The new recommendation: Doctors should perform a liver enzyme test before statin use begins. Then patients should be checked again if symptoms of liver damage appear. A warning that people taking statins may experience increased blood sugar levels and may develop type 2 diabetes.

Can you stop taking statins for high cholesterol?

However, some may be able to stop if they successfully lower their cholesterol levels through diet, weight loss , exercise , or some other means. These medicines aren’t for everyone.

Can statins cause memory loss?

A warning that statins may cause cognitive impairment. These issues include memory loss, confusion, and forgetfulness. A notice that routine liver enzyme monitoring is no longer necessary. Liver enzyme tests were used for decades as a way to catch potential liver damage.

Is statin medicine safe for everyone?

These medicines aren’t for everyone. In light of their possible side effects, the FDA released new guidelines that can help patients and their physicians effectively monitor potential side effects and issues caused by statin medicines.

Do you have to check blood sugar for lovastatin?

People taking statins should have their blood-sugar levels checked regularly. A warning that those taking lovastatin, a type of statin medication, are at risk for muscle damage. People taking this type of medicine should be aware of this possible drug interaction.

How do statins work?

And that could cut your chance of a heart attack or stroke. Statins work in your liver. They block an enzyme that helps your body make cholesterol.

Do doctors consider other factors before making a recommendation for statins?

Regardless of whether your doctor is on board with the newer guidelines, they should also consider other heart disease risk factors before making a recommendation. Ultimately, the decision about statins is yours. You’ll want answers to these questions to help you decide.

Do statins lower the risk of heart disease?

She notes that several major studies -- including a review of 18 trials based on data on nearly 57,000 people -- have shown that statins lower the chances of developing both fatal and non-fatal heart disease, as well as cut the risk of dying from any cause during those trials.

Can you take statin every other day?

If that happens, switching to a different statin, lowering your dose, or taking your pill every other day instead of daily might help. (Talk to your doctor before you change how you take any medicine.) In very rare cases, statins can cause severe muscle damage that can be life-threatening.

Can you take statins with a prescription?

Although statins are still a go-to medicine, there is no one-size-fits all prescription. And if they don’t help you enough (along with diet and exercise), or you can’t take them because of side effects, there are also other types of cholesterol-lowering medicines.

Can statins help prevent a heart attack?

Cardiologists generally agree that statins are a no-brainer for people who've already had a heart attack or stroke, because there’s strong evidence that they can help prevent a second one. There's been some debate as to whether statins are as helpful in preventing a first heart attack or stroke. But most experts say there's plenty ...

Can statins cause liver damage?

This may happen with certain statins, especially if it interacts with another drug that you take. Be sure to review all your prescription and over-the-counter medications and supplements with your doctor. Other rare side effects include liver injury, so ask your doctor how often your liver enzymes should be tested.