Heart Health: About Cholesterol and Statins

Every February there’s plenty of talk about hearts – loving hearts, broken hearts, chocolate hearts and tiny candy hearts with heart emoticons and goofy sayings like “text me”– but there’s rarely talk about healthy hearts, and the things we can be doing to help keep them that way.

Coincidentally, February is American Heart Month and a perfect time to remind people of one of the major contributors to cardiovascular disease: Too much bad cholesterol, or not enough good cholesterol. It’s also important to talk about one of the primary medicines millions of Americans consume to help their bodies regulate or offset the negative effects of cholesterol – a widely prescribed class of drugs called statins.

A brief primer on cholesterol

Cholesterol is a waxy substance found in all parts of the body. It is critical to the normal function of all cells. The body needs cholesterol for making hormones, digesting dietary fats, building cell walls, and other important processes. Our body makes all the cholesterol it needs, but cholesterol is also in some of the foods we eat.

When there is too much cholesterol in our blood, it can build up on the walls of the arteries (blood vessels that carry blood from the heart to other parts of the body). This buildup is called plaque. Over time, plaques can cause narrowing or hardening of the arteries – a condition called atherosclerosis – which can clog our arteries and keep our heart from getting the blood it needs.

Keeping our cholesterol levels in check is one of the best ways to keep our hearts healthy, and to lower our chances of getting heart disease or having a stroke. The American Heart Association recommends all adults age 20 or older have their cholesterol, and other traditional risk factors, checked every four to six years. It typically only requires a simple blood test. Our total cholesterol and HDL (good) cholesterol are among numerous factors our doctors can use to predict our lifetime or 10-year risk for a heart attack or stroke. Other risks include family history, if you are a smoker, your diet, the amount you exercise, and if you have high blood pressure.

With HDL (or “good”) cholesterol, higher levels are better. Low HDL cholesterol puts us at higher risk for heart disease. People with high blood triglycerides usually also have lower HDL cholesterol. Genetic factors, type 2 diabetes, smoking, being overweight and being sedentary can all result in lower HDL cholesterol. A low LDL (“bad”) cholesterol level is considered good for our heart health.

Statin drugs work by blocking the action of the liver enzyme that is responsible for producing cholesterol. Statins lower LDL cholesterol and total cholesterol levels. At the same time, they lower triglycerides and raise HDL cholesterol levels. Triglycerides are another type of fat, and they’re used to store excess energy from our diet. High levels of triglycerides in the blood, which are associated with atherosclerosis, can be caused by being overweight or obese, physical inactivity, cigarette smoking, excess alcohol consumption and a diet very high in carbohydrates (more than 60 percent of total calories).

People with high triglycerides often have a high total cholesterol level, including a high LDL cholesterol (bad) level and a low HDL cholesterol (good) level. Many people with heart disease or diabetes also have high triglyceride levels.

Statins help stabilize plaques in the arteries. Since their arrival on the market, statins have been among the most prescribed drugs in the United States, with about 17 million users. The statin medications that are approved for use in the U.S. include Lipitor, Livalo, Mevacor (or Altocor), Zocor, Pravachol, Lescol and Crestor. There also are generic versions available.

The down side to statins

Most people who take statin drugs tolerate them very well. But some people experience side effects. The most common statin side effects include:

  • Headache
  • Difficulty sleeping
  • Flushing of the skin
  • Muscle aches, tenderness, or weakness
  • Drowsiness or dizziness
  • Nausea or vomiting
  • Abdominal cramping, pain, bloating or gas
  • Diarrhea or constipation

Statins also carry warnings that memory loss, mental confusion, high blood sugar, and type 2 diabetes are possible side effects. Due to the possibility of side effects that can damage the liver, patients taking statins are required to have periodic blood tests. It’s important to remember that statins may also interact with other medications.

If you experience any unexplained joint or muscle pain, tenderness, or weakness while taking statins, you should call your doctor immediately. Pregnant women or those with active or chronic liver disease should not use statins. Also, if you take a statin drug, tell your doctor about any over-the-counter or prescription drugs, herbal supplements, and vitamins you are currently taking or plan on taking.

Give yourself the best Valentine’s Day gift possible by keeping your heart and body healthy. Even if your physician recommends you take a statin, maintaining a healthy lifestyle while taking one of these drugs can improve its effectiveness. Be sure to eat a balanced, heart-healthy diet; get regular physical activity; limit alcohol intake; and avoid smoking. Over time – and with sustained healthy weight loss and regular exercise – some patients are able to go off statins, but always speak with your physician before stopping any prescribed medication.

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Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!