Statins are drugs that lower lipids in the blood. Doctors commonly prescribe them to reduce cholesterol. Lowering high cholesterol reduces the risk of serious conditions, such as heart disease and stroke.
This article will look at the pros and cons of statins, their potential side effects, and their risks. It will also explore some alternatives to statins, factors to consider, and other ways to reduce cholesterol.
Statins are drugs that reduce cholesterol. Cholesterol is a fatty substance that the liver makes.
Cholesterol has a few important roles in the body, but having too much of it can cause plaques to stick to the inside of blood vessels. This causes atherosclerosis and increases the risk of cardiovascular disease, stroke, and other conditions.
Statins work by blocking an enzyme that tells the liver to produce more cholesterol. By blocking this enzyme, statins reduce the amount of cholesterol in the body.
There are a few different kinds of statin. Although they all have a similar function, doctors may recommend trying a few different options to see which works best for someone.
The benefits of statins include:
Cholesterol reduction
Statins help lower low-density lipoprotein (LDL), or “bad,” cholesterol. Depending on the specific drug, statins may lead to a
Cardiovascular function
Statins also help protect the cardiovascular system in other ways. According to the same research article, statins can:
- help stabilize existing plaque, which can prevent it from increasing in size
- reduce cholesterol oxidation, which could prevent it from building up on the walls of arteries
- reduce dysfunction in the blood vessels on the surface of the heart
- reduce platelet activity
Inflammation reduction
According to the article in Medicina Clínica, statins may have an anti-inflammatory effect on the circulatory system. Evidence suggests that taking them can lower inflammation markers.
This is a separate function of statins, independent of their impact on cholesterol. This may mean that they are beneficial for people with elevated inflammation and normal LDL cholesterol levels.
Statins can be a beneficial treatment for many people. However, some people do experience side effects from them.
The overall risk of side effects may be low. According to the research article in the journal Medicina Clínica, over the course of 5 years, about
A survey in the Journal of Clinical Lipidology found that the most common side effects among respondents were:
- muscle aches and pain
- cramps and stiffness
- muscle weakness
- joint or bone pain
- memory problems
- tiring easily
Muscle aches and pains are common while taking statins. These symptoms may be more likely to occur in people who:
- have low muscle mass
- have hypothyroidism
- have vitamin D deficiency
- drink alcohol
- take certain medications, such as tricyclic antidepressants, azole antifungals, or mycin antibiotics
- drink grapefruit, starfruit, or pomegranate juice
However, some studies have found no causal link between statins and muscle pain, suggesting that there may be other causes of this side effect.
Managing or eliminating risk factors, where possible, may help reduce muscle pain. People can also speak with a doctor about lowering their dosage, trying a different statin, or trying an alternative medication.
Do not stop or change the dosage of any medication without first seeking medical advice.
In rare cases, statin use can cause complications or raise the risk of other health conditions in people who are susceptible. These include:
Type 2 diabetes
There may be an increased risk of developing type 2 diabetes while taking statins. One meta-analysis found that people taking statins had a 44% increased risk of developing new cases of diabetes compared with people who did not take them.
Frequent monitoring in people taking statins can help detect high blood sugar levels. People at high risk of diabetes may need to try other approaches to lower their cholesterol.
Liver problems
According to a study in the Journal of the American College of Cardiology, people taking statins sometimes have abnormal liver function test results — particularly when they first begin taking them. It is unclear if statins cause this.
Very few cases of liver failure are directly associated with statin use. The study authors suggest that statins may cause problems for people with liver conditions that doctors have not detected before they begin statin treatment.
Doctors regularly check liver and kidney function in people taking statins. This allows them to monitor for signs of adverse effects.
Rhabdomyolysis
Rarely, statin use causes rhabdomyolysis. This is a severe syndrome caused by the death of muscle tissue. When this occurs, the muscles release their contents into the bloodstream. This can damage the kidneys and may cause kidney failure.
Rhabdomyolysis only occurs in around
Drug interactions
Drug interactions are possible with any medication. Before beginning statins, it is important to discuss any prescription medications or supplements a person takes with a doctor.
In many cases, the benefits of taking statins outweigh the risks. A doctor can help with deciding if they are the right option for a person based on:
- their current cholesterol levels
- their risk of developing other health conditions due to high cholesterol
- whether or not dietary or lifestyle changes have helped lower cholesterol sufficiently
- any risk factors that could make side effects or complications more likely
People may need to consider options other than statins if they have prediabetes, have impaired liver or kidney function, or take medications that interact with statins.
Sometimes, taking statins is a lifelong commitment. Statins may only reduce cholesterol for as long as the person takes them. However, doctors will often recommend other approaches before reaching this stage.
Making certain dietary and lifestyle changes can sometimes prevent people from needing to take statins or make lower dosages of statins more effective.
Dietary changes
A person’s diet may contribute to their cholesterol levels. The
This means reducing the intake of foods that are high in these fats, which include:
- red meat
- full fat dairy products
- fried foods
- packaged goods with hydrogenated oils and trans fats
Instead, the AHA suggest focusing on eating a heart-healthy diet that is high in:
- vegetables
- fruits
- whole grains
- nuts
- poultry
- fish
- nontropical vegetable oils, such as olive and sunflower oil
Many diets for general health, such as the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet, have these qualities.
Lifestyle changes
Some lifestyle changes a person can make that may help lower cholesterol include:
- quitting smoking, vaping, and tobacco use, as this lowers high-density lipoprotein, or “good,” cholesterol
- exercising for at least
150 minutes per week - reaching or maintaining a moderate weight
- reducing or eliminating alcohol use
There are some medications besides statins that doctors may offer to help lower cholesterol. These include:
- PCSK9 inhibitors, which suppress some enzymes that regulate how much LDL cholesterol gets into the bloodstream
- bile acid sequestrants, which bind to bile, forcing the liver to use up more cholesterol to make more bile
- cholesterol absorption inhibitors, which help limit the amount of cholesterol the small intestine can absorb
These medications do not directly replace statins, as they do not work in the same way. However, they may be a sufficient alternative for people who have difficulty taking statins.
The pros and cons of statins are important considerations when thinking about treatment for high cholesterol. Sometimes, making dietary and lifestyle changes is effective for lowering cholesterol. However, some people may need statins to quickly and effectively lower LDL cholesterol.
Reducing high cholesterol lowers the risk of high blood pressure, cardiovascular disease, stroke, and heart attack. Side effects are uncommon, and most people tolerate statins well.
Doctors can advise on how people can lower the risk of adverse effects from statins. If necessary, they can also suggest some alternatives for those who cannot take statins.