This is what you should know about statins, according to science.
(Case study: https://docs.google.com/presentation/d/1ekcyPxP5j8Q17UPmZemy9KFOAChvCJif/edit?usp=drivesdk&ouid=114283541351980723334&rtpof=true&sd=true)
According to the World Heart Federation, there’s about half a billion people(1) in the world who have heart disease.
If the statistic calls for 1 in 13 people (2) to have a heart disease, it’s no surprise that it tops as the number 1 killer disease in the world.
Among types of heart disease, coronary artery disease (CAD) or ischaemic heart disease contributed the largest portion of deaths: 9.1 million deaths (1) in 2019.
One of the biggest risk factors for coronary artery disease is obesity, and obesity increases the risk of having high cholesterol.
Statins, the gold standard for treating high cholesterol, has been prescribed mostly to people that have heart failure and obesity - find out why in this article.
So, What Are Statins?
Statins are a group of drugs that work by inhibiting hydroxymethylglutaryl-CoA reductase enzyme (3) - which is the enzyme responsible for producing cholesterol in the body.
Because it reduces hepatic cholesterol synthesis, it lowers total cholesterol, low-density lipoprotein (LDL), and triglyceride concentrations while increasing high-density lipoprotein (HDL) concentrations (3).
The drugs in this group includes:
Atorvastatin (Lipitor),
Rosuvastatin (Crestor),
Simvastatin (Zocor),
Pravastatin (Pravachol),
Fluvastatin (Lescol),
Lovastatin (Mevacor), and
Pitavastatin (Livalo, Zypitamag)
The common side effects are as follows (4):
Myopathy (muscle weakness),
Hepatotoxicity (liver damage), and
Diabetes.
In a few cases, you can have elevated liver enzyme levels and muscle damage (rhabdomyolysis).
Some people have reported insomnia, loss of memory, and dizziness - but if you find that the side effects have disturbed your normal daily activities, you should consult about changing your medications.
What is Coronary Artery Disease (CAD)?
Coronary artery disease (CAD) or ischaemic heart disease is a condition where the heart didn’t get enough oxygen supply, because of cholesterol plaque build up in the arteries of the heart (5).
The risk for CAD is higher in people with abdominal fat (or belly fat), regardless of whether they have a high cholesterol or not (6).
In What Conditions Should You Consume Statins?
Statins serve as a drug to lower your cholesterol, specifically LDL and triglyceride levels in your body.
If you have a high LDL or VLDL levels, regardless of whether you’ve had a history of heart disease or not, the doctor would always recommend it.
LDL levels are normally less than 100 mg/dL, and fasting triglyceride levels are less than 150 mg/dL. (7)
Do statins really help with heart disease?
This study (8) has concluded that, although statins do not directly heal your heart, it certainly increases your life expectancy.
The recent guideline (9) also states that it’s important for people suffering from coronary artery disease to take care of their cholesterol levels.
Besides lowering cholesterol, statins have also been found to reduce the occurrence of heart related diseases via cholesterol-lowering mechanisms (10).
Bottom Line
If your doctor prescribed you statins, don’t be confused. It might have something to do with your cholesterol levels, and you can always ask the reason behind the use of it.
Although statins are the gold standard, it's just a medication - each person might react differently to it.
If you experience any bothersome side effects or you feel like the medication isn’t working, you can always ask for other alternatives.
FAQ
I don’t want to consume statins. Is there another way to lower cholesterol?
Keeping a healthy lifestyle could always help, as well as losing weight.
But if your problem comes genetically, you may need to consult your doctor.
There are herbals, like herbal tea or green tea - but they may work differently for each individual
(reading references: https://www.sciencedirect.com/science/article/pii/S2666154323001564 (herbal tea) and https://link.springer.com/article/10.1186/s12937-020-00557-5 (green tea).
What should I do if I’m intolerant of statins?
This study has concluded that statin intolerant accounts at 9.1% (11), meaning 1 in 10 - 12 patients can have it worse.
There is no one-size-fits-all approach to medications, you should consult your doctor about it, because there’s always alternatives.
Can being overweight cause a heart attack?
For adults: overweight is a BMI greater than or equal to 25; and obesity is a BMI greater than or equal to 30.
Overweight is not the same as obesity, but the higher the BMI, the higher the chance you have cholesterol plaque in your arteries.
References:
World Heart Federation. (2023). World Heart Report 2023: Confronting The World’s Number One Killer. Geneva, Switzerland: World Heart Federation. Available from: https://world-heart-federation.org/wp-content/uploads/World-Heart-Report-2023.pdf
British Heart Foundation (2024). Global Heart and Circulatory Diseases Factsheet. Birmingham, England: British Heart Foundation. Available from: https://bhf.org.uk/-/media/files/for-professionals/research/heart-statistics/bhf-cvd-statistics-global-factsheet.pdf?rev=e61c05db17e9439a8c2e4720f6ca0a19&hash=6350DE1B2A19D939431D876311077C7B
(3) Sizar O, Khare S, Patel P, et al. (2024). Statin Medications. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430940/
(4) Bansal AB, Cassagnol M. (2023). HMG-CoA Reductase Inhibitors. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542212/
(5) Shahjehan RD, Bhutta BS. (2023). Coronary Artery Disease. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK564304/
(6) Powell-Wiley, T. M., Poirier, P., Burke, L. E., Després, J., Gordon-Larsen, P., Lavie, C. J., Lear, S. A., Ndumele, C. E., Neeland, I. J., Sanders, P., & St-Onge, M. (2021). Obesity and cardiovascular Disease: A scientific statement from the American Heart Association. Circulation, 143(21). doi: 10.1161/cir.0000000000000973
(7) Lee Y, Siddiqui WJ. Cholesterol Levels. (2023). Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542294/
(8) Rodriguez F, Maron DJ, Knowles JW, Virani SS, Lin S, Heidenreich PA. (2019). Association of Statin Adherence With Mortality in Patients With Atherosclerotic Cardiovascular Disease. JAMA Cardiology, 4(3):206–213. doi:10.1001/jamacardio.2018.4936
(9) Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., De Ferranti, S., Faiella-Tommasino, J., Forman, D. E., Goldberg, R., Heidenreich, P. A., Hlatky, M. A., Jones, D. W., Lloyd-Jones, D., Lopez-Pajares, N., Ndumele, C. E., Orringer, C. E., Peralta, C. A., . . . Yeboah, J. (2019). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APHA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. Journal of the American College of Cardiology, 73(24), e285–e350. doi: 10.1016/j.jacc.2018.11.003
(10) Agrawal, H., Choy, H. K., Liu, J., Auyoung, M., & Albert, M. A. (2020). Coronary artery disease. Arteriosclerosis Thrombosis and Vascular Biology, 40(7). doi: 10.1161/atvbaha.120.313608
(11) Bytyçi I, Penson PE, Mikhailidis DP, Wong ND, Hernandez AV, Sahebkar A, Thompson PD, Mazidi M, Rysz J, Pella D, Reiner Ž, Toth PP, Banach M. (2022). Prevalence of statin intolerance: a meta-analysis. Eur Heart J., 43(34):3213-3223. doi: 10.1093/eurheartj/ehac015.
(Btw, this article is not intended to diagnose, treat, or heal your disease. Consult your doctor for individual circumstances.)