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A Clearer Look at Statins and Cholesterol
Omar P. Haqqani, MD
Midland Daily News
October 9, 2016
Possibly more than any other class of drug, statins have been shown unequivocally to help in reducing your cardiac and vascular risks. It is my personal practice to minimize the medications a patient has to take, however, statin therapy is the cornerstone of my medical therapy – so much so that I take a statin myself.
Statins are a class of drug initially intended to help in reducing “bad cholesterol,” otherwise known as low-density lipoprotein (LDL) cholesterol. Statins are used by over 70 million people in the US. In fact, approximately one in four adults in the US receive statin therapy.
When “bad cholesterol” levels are high, your risk for heart attack, stroke, and vascular disease increases significantly. Statins work by blocking your body’s ability to produce “bad cholesterol” by affecting the enzyme responsible for its production.
High cholesterol levels contribute to 2.6 million deaths worldwide annually. With the clear link between elevated cholesterol and death from cardiovascular illness, one might think that statin use would be common. However, only one in three adults with high “bad cholesterol” have it under control, and less than half are getting adequate medical treatment.
Statins were initially developed to lower “bad cholesterol.” Since then, however, statins have been found to have many other benefits. For one, statins act as a “glue” to keep plaque in place and prevent it from moving to untoward areas. This is a very important feature in carotid disease as plaque and debris showering to the brain can cause a devastating stroke.
A second benefit is that statins have been shown to decrease the rate at which aneurysms grow. This is very useful in patients that have aneurysms, which are a bulging of the blood vessel that can rupture if it enlarges beyond a certain point.
A third benefit of statins is their ability to improve levels of “good cholesterol,” which are important in proper functioning of cells and organs.
Statins have a very safe pharmacological profile. There are many different types of statin drugs that all work in the same manner with varying side effect profiles. In rare instances patients may develop muscle pains.
Even though any medication may produce an untoward side effect, the benefits of statins far outweighs the risks. Research findings, including a recently published study in The Lancet, have been decidedly and unequivocally in favor of their use.
A few key findings in the Lancet study support this. One finding focused on the daily use of 40 mg of atorvastatin by 10,000 patients for five years. Among these 10,000 patients, it was determined the drug would prevent 1,000 people with a pre-existing heart conditions from having life-threatening events such as a heart attack or stroke. This translates into one in ten users benefiting from statin therapy.
For those at increased risk of cardiovascular events due to conditions such as diabetes and hypertension, but have no previous heart condition, the same regimen would prevent 500 catastrophic events. This translates into one in twenty users benefiting from statin therapy.
Given that every year over 1.5 million Americans suffer from a heart attack or stroke, statin therapy has the potential to prevent tens-of-thousands of life-threatening events annually.
Another finding revealed that by decreasing “bad cholesterol” through statin therapy, risk of stroke and heart attack is reduced by around 25 percent for each year the drugs are taken following the first year.
The study also examined whether the controversies surrounding the use of statins are merited. Findings did reveal an occurrence of side effects, such as muscle pain, hemorrhagic stroke and diabetes; however, the rate of occurrence was rare. In fact, these side effects occur at less than one percent.
Harms should certainly be acknowledged and communicated to patients, but the attributed harms are miniscule in comparison to the potential health benefits.
Simply put, if you have high cholesterol and have been diagnosed with cardiovascular disease, or had a previous stroke or heart attack, statin therapy could significantly reduce your risk of a life-threatening event.
As with any medication or decision concerning your health, you should discuss the matter with your healthcare provider to ensure that you make an informed decision.
Dr. Omar P. Haqqani, MD is the Chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.
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