Statins

Easy-to-read medicine information about statins – what it is, how to take statins safely and possible side effects.

What are statins prescribed for?

Statins are an important group of cholesterol-lowering medicines that could save your life by lowering your chance of a stroke or heart attack.There are two main reasons to prescribe statins:

  • Secondary prevention – Your doctor is likely to prescribe statins if you’ve survived a stroke or heart attack to reduce your risk of having another.
  • Primary prevention – if you have a higher cardiovascular risk (and at higher risk of heart disease or stroke), statins are often prescribed to lower this overall risk. This is common if you have a strong family history of early onset heart disease, an inherited high cholesterol condition or have diabetes.

Examples of statins

How do statins work?

Statins block the enzyme that controls production of LDL cholesterol. Studies show that having high levels of LDL in your blood increases your risk of coronary artery disease, heart attacks and strokes, and other arterial diseases, whereas lowering those levels reduces your risk. Statins are also thought to have an anti-inflammatory effect which may explain why they continue to provide benefit in people with low lipid levels but high cardiovascular risk.

Side effects?

Most people have few if any side effects, although a small number of people experience an increase in muscle pain. This is rarely serious, but if your pain is severe, sudden or comes on shortly after you start your statin see your doctor.

  • Your doctor will check an enzyme called creatine kinase to see if the aches and pains are possibly being caused or aggravated by the statins.
  • If so, a different statin may be prescribed, or you may have to make an informed choice between stopping your statin or living with the aches in return for its benefits. Your doctor will also want to eliminate the possibility of a rare but serious condition called rhabdomyolisis.

Which medications or foods do statins interact with?

Some medicines and foods affect the ability of your liver to process the statin, increasing the risk of side effects. Grapefruit is a common food that has this effect. Doctors generally recommend that you restrict your intake to half a grapefruit or a 200ml glass of grapefruit juice if you are taking statins.

How will my doctor know I am at high risk of heart disease?

By examining your family health history, age, weight and smoking history and diabetes status, and then testing indicators including your cholesterol levels and blood pressure, your GP will build up a picture of your risk profile. They may use a computerised tool called Predict to calculate your risk. This will give you a percentage risk of developing vascular disease and can even track your potential progress as you age.

What other ways could I lower my cholesterol before taking statins?

Eating a healthy diet, exercising regularly and drinking no more than one alcoholic drink a day have all been shown to improve your cholesterol picture. What seems to be most effective is eating a low-fat diet, and especially reducing the amount of saturated fat you eat. Read more about other ways to reduce your cholesterol

Once I start using statins will I be on them forever?

Usually. If you stop taking your statins it will take less than five days for your cholesterol to revert to its pre-statin levels and with this drop, your risk of vascular disease goes right back up. As long as you’re tolerating them, there’s no reason to stop.

References

  1. Bangalore S, Fayyad R, Hovingh GK, et al. Statin and the Risk of Renal-Related Serious Adverse Events: Analysis from the IDEAL, TNT, CARDS, ASPEN, SPARCL, and Other Placebo-Controlled Trials. Am J Cardiol. 2014 Jun 15;113(12):2018-20. doi: 10.1016/j.amjcard.2014.03.046. Epub 2014 Apr 3. (Original) PMID: 24793673 
  2. Interpretation of the evidence for the efficacy and safety of statin therapy. Collins, Rory et al. The Lancet, Volume 388, Issue 10059, 2532 - 2561 [Full article]
Credits: Used with permission from Pulse, ProCare. Updated April 2014 by Health Navigator NZ.