JULIAN WILLETT'S COLUMN

What Are Statins?

Summary of a common medication preventing heart attacks and strokes.

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Heart and blood vessel diseases are serious problems, with one of the leading causes of death for individuals 65 and older being heart disease¹. While lifestyle plays an essential role in keeping individuals healthy, sometimes changes are not always possible, or people have a particularly high-risk profile. It is for these individuals that the class of medication called statins is considered.

What are statins?

Statins are medications that are used to control one’s cholesterol levels. They increase HDL and decrease LDL², the so-called good and bad cholesterol (refer to Points of Curiosity for more information).

What are they prescribed for?

Clinical trials have demonstrated that statins decrease one’s risk of having a heart attack or stroke². High total cholesterol or too much LDL cholesterol is problematic because they contribute to blood vessels’ blockage. Statins decrease the amount of cholesterol typically made in the body to better manage the excess deposits in less than ideal places.

What are the side effects of statins?

The vast majority of individuals who take statins have no adverse effects from the medication². The most common adverse effect is the muscles being sore². This adverse effect has a greater chance of occurring with higher doses of the medication². If you are experiencing such symptoms, you can talk with your doctor to discuss what to do next. Decreasing the dose may resolve the symptoms while continuing to protect against stroke and heart attack.

Rarely, those with affected muscles can develop rhabdomyolysis, where muscle cells die and release their contents into the blood². This can cause an acute kidney injury that may require hospitalization. It is best if statins are not taken with other medications that can cause muscle pathology as it increases the risk of this complication². Individuals may also rarely have evidence of liver injury². This is typically temporary and goes away without complications.

When should individuals not take statins?

Ultimately, this is often a question that requires consideration of an individual’s determined benefit of the medication compared to risk, as determined by their personal doctor. It is advised to avoid taking statins when one has active liver disease². They should also not be taken during pregnancy or while breast feeding².

What are the names of some statins?

The most commonly prescribed statins are atorvastatin, lovastatin, pravastatin, and simvastatin. Note how the end of the names of each of these medications is a statin.

Points of Curiosity

While HDL and LDL are known as good and bad cholesterol, it is more complicated than that. LDL plays a role in routine body maintenance. It can also cause problems if there is too much of it.

References

  1. https://www.cdc.gov/nchs/fastats/older-american-health.htm
  2. https://www.ncbi.nlm.nih.gov/books/NBK430940/

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JULIAN WILLETT, MD

Medika Columnist

M.D. trained in the US, now researching SARS-CoV-2 and COVID-19 in Canada for his Ph.D. After earning my Ph.D., I will be pursuing an Anatomic Pathology residency embracing my path towards being a physician-scientist. My academic interests are directed towards topics that provide the greatest net benefit for the greatest number of people. I love complicated, messy, and poorly understood topics.

I enjoy writing in my spare time, along with 3D printing and staying connected with my family. I have been a longstanding proponent for global health with projects ranging from supporting Doctors without Borders (MSF) to Syrian refugees (Syrian American Medical Society).

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