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Statin Risks Outweighed by Statin Benefits

Cholesterol-Lowering Statin Drugs: A WebMD FAQ
By
WebMD Health News
Reviewed by Laura J. Martin, MD

March 1, 2012 -- Are the benefits of cholesterol-lowering statin drugs worth their risks?

It seems that every week there's news about statins. One week there's a scare about possible new or underappreciated risks. The next week, you hear they are the best thing ever.

What's the truth? To answer commonly asked questions, WebMD turned to Steven Nissen, MD, chair of cardiovascular medicine at the Cleveland Clinic, and to recent medical literature reviewing the latest research.

What Are Statin Drugs?

The first statin drug, mevastatin, was isolated from a fungus. Red yeast rice contains mevastatin, although different batches of this natural product contain different amounts of mevastatin.

Several other statin drugs were derived from this fungal compound. Others are fully synthetic. All of them block an enzyme the body needs to create cholesterol. This lowers the amount of bad LDL cholesterol in the body.

Statin drugs include:

Clinical trials show that all of these cholesterol-lowering drugs cut the risk of heart disease by 25% to 30%, Nissen says.

In the U.S., an estimated 33 million adults are taking a statin drug.

Are Statin Drugs Too Risky?

"If you have heart disease, or are at very high risk of heart disease with high cholesterol, statins are one of the best classes of drugs we ever had," Nissen says. "When used thoughtfully and with good monitoring, they are safe and effective."

We all need to watch our cholesterol levels. But statin treatment is not for everyone.

"Some people are running around saying we should put statins in the water supply, and that is wrong. These are serious drugs," Nissen says. "Statins should be coupled with good diet and exercise. They are not a substitute for a healthy lifestyle."

Who Should Take Statin Drugs?

Statin drugs are for people who are at risk of heart disease.

Risk is defined by your age, your total cholesterol level, your good HDL cholesterol level, your blood pressure, and whether you are a smoker. Your blood level of C-reactive protein (CRP) and whether either of your parents had an early heart attack also are factors.

But the decision on whether or not to take a statin drug should be made in consultation with your doctor, who can take all your individual risk factors into account.

Statin drugs are not a cure-all. They should be used only along with proper exercise and a healthy diet.

And some people definitely should not take statins. Pregnant women, or women of childbearing age not using contraception, should not take statin drugs. And certain other drugs can have dangerous interactions with statins.

What Are the Risks of Statin Drugs?

Even the very best drugs carry risks. Statins are no exception.

Is This Normal? Get the Facts Fast!

Is Your Cholesterol Level Heart Healthy?
What is your LDL (low-density lipoprotein) level?

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Answer:
Desirable
0-199
Borderline
200-239
High
240+

Your level is currently

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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