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Tests and diagnosis (1)
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Treatments and drugs (4)
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Get StartedStatins: Are these cholesterol-lowering drugs right for you?
Should you be on a statin? These cholesterol-lowering drugs have benefits and risks. Find out whether your risk factors for heart disease make you a good candidate for statin therapy.
By Mayo Clinic staffStatins, drugs that are used to lower cholesterol, are being touted as one of the wonder drugs of the 21st century. They work by blocking a substance your body needs to make cholesterol. They may also help your body reabsorb cholesterol that has accumulated in plaques on your artery walls, helping prevent further blockage in your blood vessels. Statins include well-known medications such as atorvastatin (Lipitor), simvastatin (Zocor), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor) and others.
Already shown to be effective in lowering cholesterol, statins may have other potential benefits. But doctors are far from knowing everything about statins. Are they right for everybody with high cholesterol? What happens when you take a statin for decades? Can they help prevent other disease?
Here's some information to help you put information about statins into perspective as you weigh whether they're right for you.
Should I be on a statin?
Whether you need to be on a statin depends on your cholesterol level along with your other risk factors for cardiovascular disease. If you have high cholesterol, meaning your total cholesterol level is 240 milligrams per deciliter, or mg/dL, (6.22 millimoles per liter, or mmol/L) or higher, or your "bad" cholesterol (LDL) level is 130 mg/dL (3.68 mmol/L) or higher, the numbers alone won't tell you or your doctor the whole story.
High cholesterol is only one of a number of risk factors for heart attack and stroke. Before you're prescribed a statin, your cholesterol level is considered along with other factors including:
- Family history of high cholesterol or cardiovascular disease
- Lifestyle
- Blood pressure
- Age
- General health
- Presence of diabetes
- Excess weight
- Smoking
- Peripheral vascular disease — narrowing of the arteries in your neck, arms or legs
If the only risk factor you have is high cholesterol, you may not need medication because your risk of heart attack and stroke is probably already low.
If your doctor decides you should take a statin, you and your doctor will have to decide what dose to take. Statins come in varied doses — from as low as 5 milligrams to as much as 80 milligrams, depending on the medication. If you need to decrease your LDL cholesterol significantly — by 50 percent or more, it's likely you'll be prescribed a higher dose of statins. If your LDL cholesterol isn't as high, you'll likely need a lower dose. Talk to your doctor if you have concerns about the amount of statins you're taking.
Lifestyle is still key for lowering cholesterol
Lifestyle changes are essential for reducing your risk of heart disease, whether you take a statin or not. Quitting smoking, eating a healthy diet, getting daily activity and managing stress are examples of lifestyle changes that will improve cholesterol, and most all of the other risk factors for heart disease. In fact, lifestyle changes may have a greater impact on reducing risk of heart disease and stroke than does medication alone.
If you're following the recommended lifestyle behaviors but your cholesterol — particularly your low-density lipoprotein (LDL), or "bad" cholesterol — remains high, statins might be an option for you. Risk factors for heart disease and stroke are:
- High cholesterol
- High blood pressure
- Diabetes
- Excess weight
- Family history of heart disease
- Physical inactivity
- Heavy alcohol use
- Poor stress and anger management
- Age
- Smoking
- Peripheral vascular disease — narrowing of the arteries in your neck, arms or legs
Consider statins a lifelong commitment
You may think that once your cholesterol goes down, you can stop taking medication. But, if your cholesterol levels have decreased as a result of taking a statin, you'll likely need to stay on it indefinitely. If you stop taking it, your cholesterol levels will probably go back up.
The exception may be if you make significant changes to your diet or lose a lot of weight. Substantial lifestyle changes may allow you to maintain low cholesterol without continuing to take the medication, but do so under your doctor's supervision.
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