What Is a Statin?
Statins, medications that lower cholesterol, are a relatively new class of drugs that are already being widely prescribed. Statins work by inhibiting a substance the human body uses to produce cholesterol. Statins also may help clear up blood vessels that are already partially blocked by accumulated cholesterol deposits. Statins include medications such as atorvastatin (Lipitor), rosuvastatin (Crestor), simvastatin (Zocor), lovastatin (Mevacor) and others.
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Who Benefits from Statins?
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Health care professionals decide if statins should be prescribed. Analysis of a patient's blood determines levels of both "good" cholesterol, high-density lipoprotein (HDL), and "bad" cholesterol, low-density lipoprotein (LDL). An HDL level above 60 mg/dL is considered ideal for men or women. The optimal limit of bad cholesterol is less defined. Generally, LDL levels below 70 mg/dL are considered optimal for people who have a very high risk of heart disease.
Factors to Consider
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There is some risk of side effects from statins, and health care providers should take into account multiple factors before prescribing them. Age, general health, weight, smoking, family history, as well as other health conditions such as diabetes, vascular disease and high blood pressure should be considered. If the only risk factor a patient has is high cholesterol, statins may not be prescribed since the risk of heart attack and stroke is probably low.
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Which Statin?
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Finding the right statin and correct dosage for each patient can take time. Some patients experience side effects with one statin, and not others. Combinations of statins may be indicated. Dosage levels may be as low as 5 mg or as high as 80. Blood work will probably be done every three months until optimal results are achieved. Once a patient's cholesterol levels are considered to be under control, lab work is usually done every six months.
Tips
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Lifestyle changes are essential to reduce the risk of heart disease, whether statins are prescribed to reduce cholesterol or not. Quitting smoking, eating a healthy diet, getting daily exercise and reducing and managing stress are some examples of lifestyle changes that will improve cholesterol levels. Unless a patient makes these essential lifestyle changes, statins will need to be prescribed indefinitely, or cholesterol levels will probably return to pre-medicated levels.
Warnings
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Statins can cause an increase in liver enzymes, which may eventually result in permanent liver damage. Certain other cholesterol-lowering drugs, such as gemfibrozil (Lopid) and niacin, increase the risk in people who take statins. Liver problems may develop without noticeable symptoms and periodic liver function tests should be required. The higher the dose of statin, the more likely muscle pain may develop. In severe cases, muscle cells can break down and eventually cause kidney damage. Certain drugs in combination with statins can increase the risk, including gemfibrozil, erythromycin, antifungal medications, nefazodone (Serzone), cyclosporine and niacin. Consult a physician if new muscle aches or tenderness is noted.
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