What are the guidelines for starting a statin?
• 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.
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.
How long should someone take statin?
You usually have to continue taking statins for life because if you stop taking them, your cholesterol will return to a high level within a few weeks. If you forget to take your dose, do not take an extra one to make up for it.
Should everyone over 65 take a statin?
People over 65 with perfect cholesterol numbers, normal blood pressure and no family history of heart disease would be told to take statins to lower cholesterol. That would be true even if they ran marathons, followed a vegetarian diet and meditated three hours daily.
When should you start statin therapy?
According to the 2018 guidelines, moderate-intensity statin therapy is indicated in patients aged 40-75 years with diabetes, regardless of their 10-year ASCVD risk.
At what cholesterol level are statins prescribed?
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.
What are the new guidelines for statins?
The following are guideline recommendations for statin treatment:Patients ages 20-75 years and LDL-C ≥190 mg/dl, use high-intensity statin without risk assessment.T2DM and age 40-75 years, use moderate-intensity statin and risk estimate to consider high-intensity statins.More items...•
At what LDL level is medication required?
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)
Should you take statins if your cholesterol is normal?
Statin drugs reduce LDL ("bad") cholesterol, the type that puts you at risk for cardiovascular disease. But even if your cholesterol is not particularly high, it could still be smart to consider starting a statin.
Are statins worth the risk?
Research has shown that statins are highly effective in reducing the risk of fatal heart attack and stroke.
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.
Should You Be on A Statin?
Whether you need to be on a statin depends on your cholesterol levels and other risk factors for cardiovascular disease. Your doctor will consider...
Healthy Lifestyle Is Still Key For Preventing Heart Disease
Risk factors for heart disease and stroke are: 1. Smoking 2. High cholesterol 3. High blood pressure 4. Diabetes 5. Being overweight or obese 6. Fa...
Consider Statins A Lifelong Commitment
You may think that once your cholesterol goes down, you can stop taking statin medication. But if the drug helped lower your cholesterol, you'll li...
The Side Effects of Statins
Statins are well-tolerated by most people, but they do have side effects. Some side effects go away as the body adjusts to the medication. But alwa...
What Other Benefits Do Statins have?
Statins may have benefits other than just lowering your cholesterol. One promising benefit seems to be their anti-inflammatory properties, which he...
Weighing The Risks and Benefits of Statins
You should not take statins if you are pregnant or have some forms of advanced liver disease.When thinking about whether you should take statins fo...
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.
Public Versus Individual Decisions
If starting a statin in all adults at 40 years of age would really save hundreds of thousands of quality-adjusted life years (QALYs), implementing such a policy would seem to be a public health priority. However, this perspective has several problems.
Preference-Sensitive Decisions
An appreciation of the individual perspective for individual decisions inevitably leads to acknowledging a continuum of benefit and the existence of grey zones—a range within which the right decision almost is determined completely by an individual patient’s personal preferences.
Unknowable Unknowns
Donald Rumsfeld famously referred to “known unknowns . things that we now know we don’t know.” Such unknowns are the raison d’être for researchers, but as Secretary Rumsfeld was implying, decision makers need to make decisions based on the information in hand (see Known Unknowns, below).
Known Unknowns
Simulation models are powerful tools, but for informing policy, the known unknowns can have a large impact. Heller et al 1 fully acknowledge that one highly influential assumption in their model is unknown.
Summary Thoughts
Heller et al 1 rightly point out that if there are no unknown harms of long-term statin use, then starting a statin much earlier would have a small chance of helping an individual but a large public health benefit because it would extend statin treatment to >28 million more Americans.
Footnotes
The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.
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?
"The new guidelines shift away from a target-driven approach to a risk-driven approach," says Dr. Reena Pande, a cardiologist at Harvard-affiliated Brigham ...
Is statin good for HDL?
Taking a statin is not a free pass to an unhealthy lifestyle. It's just one part of the "staying healthy" puzzle, says Dr. Pande. Diet is an important part of that puzzle; so is regular exercise, which boosts HDL.
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 ...
Understanding Cholesterol
Cholesterol is a type of lipid, a fatty, waxy substance in your blood. High amounts of cholesterol can build up inside your arteries. This can clog and narrow your arteries so blood can’t flow easily. Blood clots can form, break away, and cause a stroke or heart attack.
Types of High Cholesterol
There are different types of high cholesterol, based on what’s causing it:
How to Know if You Need Treatment
Everyone with high cholesterol should start with heart-healthy lifestyle changes like diet, exercise, quitting smoking, and weight loss. But if your cardiac risk is high, you may need treatment with medications, too.
