As a cardiologist, I often get many questions related to “statin” medications. These are the medications primarily used in treating high-cholesterol disorders. There are a number of medications now available under brand names of Lipitor, Zocor, and Crestor, just to name a few.
For medications that have been tested in tens of thousands of patients, these drugs manage to stir a lot of controversy. There are entire internet sites devoted to people suggesting these medications cause “harmful” and “lasting” side effects.
High cholesterol is a major risk factor for cardiovascular disease. The higher your cholesterol the more likely you are to develop chronic heart blockages.
The statin medications have been shown in a number of randomized clinical trials to prevent both first time and second time heart attacks. In addition, they have been shown to actual decrease plaque size using an ultrasound technique that measures the size of heart artery plaques from inside the artery.
The most common and very real side effect of statin medications is muscle aches and pains. I always warn my patients about this. The good news is if you develop this symptom, it is always reversible once the medication is stopped.
There is a very rare side effect of statins that can lead to widespread muscle breakdown. This can be serious. A simple blood test will tell your doctor if you are experiencing this but again, once the medication is stopped, this process is reversible.
There is some evidence that taking the over the counter supplement coenzyme Q10 will help with the muscle pains felt by taking statins and so I do recommend patients try this before stopping the statin. Just because a patient feels muscle pain with one statin does not mean another statin will cause it.
Therefore, in patients who can really benefit from taking the medication (like those who have had a heart attack), I would recommend changing to another of the several statins out there before giving up.
Another concern about statin medications relates to the risk of developing liver disease. The FDA this year realized what an extremely rare occurrence this is and so stopped making the recommendation that routine liver testing had to be checked while taking statins. I think this is another example of how truly safe these medications are.
Cholesterol is not the only risk factor for cardiovascular disease but in my opinion it is the easiest to modify. Losing weight and quitting smoking requires a strong commitment and real lifestyle changes.
Treating diabetes is difficult with having to balance insulin injections. Getting hypertension under control often requires 2-3 medications with some of these pills taken multiple times a day.
The statin pills are a single pill taking once a day and, as I have explained above, are very safe. They are very effective at lowering blood cholesterol levels by approximately 30-50 percent depending on the dose of the drug.
I would tell patients concerned about taking these medications that the terrific benefits outweigh very small risks.