This blog post is part of the Google+ Healthy Hangouts series on breaking and timely health news.
Some people are calling statins, a class of medications that lower bad (LDL) cholesterol, the greatest drug breakthrough since Penicillin. Others though, are cautioning about the overuse of these drugs and potential side effects.
With new guidelines recommending an increase in the use of statins to treat elevated cholesterol, what should patients think if their doctor recommends that they start taking a statin?
Roger Khetan, M.D., and Cherese Wiley, M.D., both internal medicine physicians on the Baylor University Medical Center at Dallas medical staff, and Jeff Schussler, M.D., interventional cardiologist on the Baylor Heart & Vascular Hospital at Dallas medical staff, join me to talk about this hot topic.
While an argument can be made that some medications are probably being over-prescribed, Dr. Khetan, Dr. Wiley and Dr. Schussler all agree that this is not the case with statins.
In fact, all three cite statins as one of the primary drivers of the decrease in incidence of heart attack and lowering the risk of heart disease.
They also believe that getting younger patients on statins who have elevated cholesterol or a heightened risk of heart disease can pay off down the road. But a healthy lifestyle is also critical to managing cholesterol and heart disease.
The classic understanding of high cholesterol as it relates to heart disease is:
- LDL cholesterol below 130 for people at normal risk
- LDL cholesterol below 100 for people at high risk (e.g. strong family history)
- LDL cholesterol below 70 for people who have had heart procedures like stents
Dr. Schussler says that anyone in a high-risk category for heart disease probably needs to be on a statin, including people:
- with a strong family history of heart disease
- who have diabetes
- who smoke
- who are obese
- who have an identified cardiac problem
- who have had a cardiac procedure
Side Effects & Staying Faithful
Though there are few side effects associated with statins, the most frequently reported is muscle aches and pain. Sometimes patients discontinue statins on their own if they experience side effects, which is a mistake according to Dr. Khetan.
Dosages can be adjusted and the brand of statin can be switched to manage side effects.
Dr. Khetan and Dr. Wiley also caution about the tendency for some patients to blame the drug for side effects, which are not supported by medical evidence.
It’s important to always take medications as prescribed consistently. Statins are no different. Dr. Schussler says that a new test called calcium scoring is helping in that regard.
A calcium score is obtained through a CT scan of the chest that shows buildup of hardened plaque (which is cholesterol) in and around the arteries of the heart. Patients who can actually see the blockages as they occur through the results of a calcium score test are more likely to take their statin consistently.
Besides calcium scores, another big incentive for patients in need of a statin to take them is the price. There are a number of statins on the market, including generics, some of which may be available for as little as $4 a month.
Between affordability, lack of side effects, and for having the ability to, as Dr. Schussler puts it, ‘turn the clock back on heart disease,’ our panel sees little reason for patients with high cholesterol not to take a statin.
I encourage you to watch the whole Hangout to learn more about statins.