Health Library

Statin Drugs: Not Just for High Cholesterol?

IMAGE Heart disease is the leading cause of death in the US, and cholesterol plays a major role in the development of heart disease.Cholesterol can be controlled with statin drugs, a common treatment for many people.

You may think of cholesterol as just a number, but using statins has other benefits to your cardiovascular system. Research has shown that statins may reduce the incidence of heart attack, stroke, and death in people without cardiovascular disease. In fact, statins have a primary role in cardiovascular disease prevention.

Like most medications, statins have a good and bad side. In most cases, the benefits outweigh the risks. Here is some information about statins that will make you think beyond your cholesterol number.

How Do Statins Work?

Statins have been used primarily to treat high cholesterol. High levels of low-density lipoproteins (LDL, the bad cholesterol) combined with low levels of high-density lipoproteins (HDL, the good cholesterol) can lead to a condition called atherosclerosis. Atherolsclerosis is a hardening of the arteries due to a build up of plaque on the inner walls. It is a condition that can lead to a heart attack or stroke.

Statin drugs, like atorvastatin (Lipitor), pravastatin (Pravachol), simvastatin (Zocor), work by inhibiting a liver enzyme that is involved in the production of cholesterol. They are most effective at lowering levels of LDL cholesterol and may also contribute to increasing levels of HDL cholesterol.

Statins have become a popular choice to treat cholesterol problems because they are effective and generally well-tolerated.

What Are the Health Benefits?

Researchers have investigated the potential health benefits of taking statins. There is evidence that statins may reduce the risk of:

  • Heart attack and death in people with heart disease in people with or without high cholesterol
  • Cardiovascular events and death in people who are at high risk of developing cardiovascular disease
  • Heart attack, stroke, and death in people with elevated levels of C-reactive protein, a sign of inflammation in the body
  • Cardiovascular events in women who have cardiovascular disease
  • Need for surgery to improve blood flow to the heart and unstable angina in women

Statins may also help lower blood pressure.

What Are the Risks?

If your doctor prescribes statins, some common side effects that you may have include:

Serious possible side effects include:

  • Memory loss and confusion.
  • Increased blood sugar levels.
  • Liver damage—Taking statins can lead to changes in liver enzymes and occasionally liver damage.
  • Muscle pain or weakness—Some people who take statins develop muscle damage. With severe cases, your body may release the protein myoglobin, which can damage the kidneys.
  • Cancer—There have been numerous scientific studies about the use of statins and the risk of cancer, but the evidence is conflicting.

If you have cholesterol problems, have coronary artery disease, or are at risk for coronary artery disease, your doctor may recommend that you take statins. Be sure to discuss your medical history and any concerns that you may have about taking this kind of medicine. Keep in mind, too, that a healthier lifestyle depends on more than just taking statins. Your doctor will most likely recommend that you make lifestyle changes that include eating a healthier diet and exercising more.

Resources

American Heart Association
http://www.heart.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

Canadian Resources

Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

Health Canada
http://www.hc-sc.gc.ca

References

Baigent C, Keech A, Kearney PM, et al. Cholesterol Treatment Trialists' (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267-1278.

Coronary artery disease (CAD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 4, 2013. Accessed April 5, 2013.

Douglas K, O'Malley PG, Jackson JL. Meta-analysis: the effect of statins on albuminuria. Ann Intern Med. 2006; 145:117.

Friis S, Poulsen AH, Johnsen SP, et al. Cancer risk among statin users: a population-based cohort study. Int J Cancer. 2005; 114:643.

Graaf MR, Beiderbeck AB, Egberts AC, et al. The risk of cancer in users of statins. J Clin Oncol. 2004; 22:2388.

Ichihara A, Hayashi M, Ryuzaki M, et al. Fluvastatin prevents development of arterial stiffness in haemodialysis patients with type 2 diabetes mellitus. Nephrol Dial Transplant. 2002; 17:1513.

Jick H, Zomberg GL, Jick SS, et al. Statins and the risk of dementia. Lancet. 2000;356:1627-1631.

Kshirsagar AV, Shoham DA, Bang H, et al. The effect of cholesterol reduction with cholestyramine on renal function. Am J Kidney Dis. 2005; 46:812.

Statins. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 5, 2013. Accessed April 5, 2013.

Statins and cancer risk. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated November 27, 2012. Accessed April 5, 2013.

Statins for prevention of cardiovascular disease: overview. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 25, 2011. Accessed April 19, 2011.

Wolozin B, Kellman W, Rousseau P, et al. Decreased prevalence of Alzheimer's disease associated with 3-hydroxy-3-methyglutaryl coenzyme A reductase inhibitors. Arch Neurol. 2000;57:1439-1443.

1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Mills EJ, Rachlis B, Wu P, Devereaux PJ, Arora P, Perri D. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65,000 patients. J Am Coll Cardiol. 2008;52:1769-1781.

3/6/2012 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: FDA announces safety changes in labeling for some cholesterol-lowering drugs. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm293623.htm. Published February 28, 2012. Accessed March 6, 2012.