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Home > Nutrition > Statins: How They Work and Who Should Take Them

Statins: How They Work and Who Should Take Them

March 11, 2021 - Updated on August 24, 2021
6 min read
By David Filsoof, MD | Cardiologist

In this article:

  • A Drug by Many Names
  • A Simple Goal
  • Candidates for a Statin Prescription
  • Attempting to Prevent Negative Outcomes
  • The Potential for Side Effects
  • An Extremely Common Solution
  • Final Word

If you have recently discovered that you have high cholesterol, you may have become aware of a group of drugs known as statins or HMG-CoA reductase inhibitors. This medication works by reducing the production of bad cholesterol or low-density lipoprotein (LDL) inside the liver to maintain healthy blood cholesterol levels. (1)

statins for lowering cholesterol levels

When a patient is discovered to have elevated cholesterol levels, statins are often the first medication a doctor will prescribe for a solution. While it is possible to be prescribed a statin for reasons other than high cholesterol levels, this is the most common use for this type of drug. (2)

A Drug by Many Names

The word “statin” is used to describe this category of medications, but there are many different options for what specific drug will be prescribed. You may have seen names such as atorvastatin, fluvastatin, or simvastatin, drugs that go by the brand names Lipitor, Lescol, and Zocor, respectively.

If you are prescribed a statin, your doctor will choose the appropriate drug based on your diagnosis and a long list of other factors.

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A Simple Goal

mechanism of statins

Developing any kind of new drug is an incredibly complicated process, but the goal of statins is really quite simple. These drugs aim to lower your cholesterol level through a couple of possible methods.

For one thing, statins can discourage your body from producing cholesterol by blocking an enzyme that is responsible for new cholesterol production. (3) Naturally, if your body is prevented from creating new cholesterol, your overall levels should go down.

The other way statins can work is by helping your body to reabsorb cholesterol. This cholesterol can be found as plaque in your arteries, which is particularly dangerous as it can lead to a heart attack.

Without freshly produced cholesterol to access, the body will look for the cholesterol it needs in these built-up stores. This process could help improve your overall heart health in time.

Candidates for a Statin Prescription

As you might imagine, you will need to work directly with your healthcare professional to determine whether or not a statin is right for you.

There are some general categories of individuals who may be good candidates for this kind of drug:

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  • For starters, those who have high LDL cholesterol levels are often recommended to take a statin drug. LDL is what you may have heard referred to as the “bad” type of cholesterol. Elevated LDL cholesterol can be dangerous in terms of elevating your risk of stroke or heart attack.
  • Another group that may benefit from statin use is anyone who has cardiovascular disease associated with hardening arteries. (4)
  • If you have already had a heart attack or you have had surgery to open a coronary artery, you may be a candidate for a statin.
  • Also, even if you don’t have heart disease currently, you might be encouraged to take a statin if you have one or more risk factors for developing cardiovascular disease in the coming years.
  • Finally, individuals with diabetes are also potential candidates for statin use. (5) Diabetic adults with an LDL cholesterol level in a specific range could benefit from a statin. This is particularly true for those who also have another risk factor present, such as a smoking habit.

Attempting to Prevent Negative Outcomes

how to avoid possible negative outcomes when using statins?

Lowering your levels of bad cholesterol is a good start when using a statin, but that outcome alone doesn’t really mean much. What you want to accomplish is a lowering of your risk for negative health outcomes.

So, what are the negative outcomes that you are trying to avoid by using a statin?

Heart attack is the one that gets much of the attention, and for obvious reasons. A heart attack can be a fatal event, and even if it is not, it can have a profound impact on your health and well-being for the rest of your life.

Strokes are another potential outcome that statins aim to help patients avoid, as they can be fatal as well. With such high stakes, it’s easy to see why statins are such a popular drug to help patients deal with high cholesterol levels.

The Potential for Side Effects

As is the case with many prescription drugs, there are possible side effects associated with using statins. The exact set of side effects that any given patient experiences will depend on countless variables, some of which are:

  • The patient’s health history and conditions
  • Other drugs that are in use
  • The specific statin prescribed

Always talk to your doctor about possible side effects before starting any new drug, including a statin.

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The good news is that most of the side effects associated with using statins are relatively minor. Symptoms such as headaches and nausea are reported as possible side effects, along with other issues such as diarrhea, constipation, or vomiting. (6)

Side effects should always be closely monitored when using a new drug and they should be reported to a medical professional if there is any concern about their severity.

An Extremely Common Solution

statins are a common solution for lowering cholesterol levels

If you are looking at starting a statin prescription, you might take some comfort in knowing that you are far from alone. Millions of people across the United States use medication to lower their cholesterol levels. (7)  

Elevated LDL levels are very common in the United States, and a statin prescription is a common option used to improve those numbers and reduce the patient’s risk for negative health outcomes.

Final Word

With regard to statins, the advice is just the same as it is for so many other medical situations – speak directly with your doctor. Yes, statins are an extremely common type of drug, and they are prescribed to huge numbers of people each year, but that doesn’t mean they will be right for you in the end.

Only by working directly with your healthcare provider can you determine whether or not a statin is the right choice. By asking questions about what statins can do for you and what kinds of risks and benefits you are looking at, you should be able to work together with your doctor to find a treatment plan that makes everyone comfortable.

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References
  1. Feingold KR. Cholesterol Lowering Drugs. Endotext [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK395573/. Published March 29, 2020.
  2. Pahan K. Lipid-lowering drugs. Cellular and molecular life sciences: CMLS. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1986656/. Published May 2006.
  3. Schonewille M, de Boer JF, Mele L, et al. Statins increase hepatic cholesterol synthesis and stimulate fecal cholesterol elimination in mice. Journal of lipid research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959861/. Published August 2016.
  4. Diamantis E, Kyriakos G, Quiles-Sanchez LV, Farmaki P, Troupis T. The Anti-Inflammatory Effects of Statins on Coronary Artery Disease: An Updated Review of the Literature. Current cardiology reviews. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633715/. Published 2017.
  5. Elnaem MH, Mohamed MHN, Huri HZ, Azarisman SM, Elkalmi RM. Statin Therapy Prescribing for Patients with Type 2 Diabetes Mellitus: A Review of Current Evidence and Challenges. Journal of pharmacy & bioallied sciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508420/. Published 2017.
  6. Spence JD, Dresser GK. Overcoming Challenges With Statin Therapy. Journal of the American Heart Association. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859367/. Published January 27, 2016.
  7. Menon AS, Kotwal N, Singh Y, Girish R. Statins: Cholesterol guidelines and Indian perspective. Indian journal of endocrinology and metabolism. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566333/. Published 2015.
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