Do You Really Need a Statin to Lower Cholesterol?
Jennifer Robinson, MD
Your doctor says to take a statin to lower your cholesterol. You’re not convinced.
Maybe you don’t think your cholesterol levels are that bad. Or, that you can try harder to eat right and exercise. Perhaps you just don’t want to take another medicine every day.
High cholesterol levels have a direct impact on your risk of heart attack and stroke, so you don’t want to make a hasty decision. Make sure your concerns are valid before you reject a statin -- their benefits to your heart are noteworthy.
Can Exercise and Diet Lower Your Cholesterol Enough?
There’s no doubt that a healthy lifestyle helps lower cholesterol. The question is whether it can lower your levels enough – and that depends on how high your levels are and what your doctor has set as your goal.
- Eating a heart-healthy diet can lower LDL cholesterol at least 10%.
- If you lose 5% to 10% of your body weight, you can cut LDL cholesterol 15%, and reduce triglycerides 20%.
- If you exercise at a moderate intensity -- meaning you have enough breath to talk but not sing -- for at least 2 ½ hours a week, you can further cut triglycerides 20% to 30%. (Exercise can also increase your HDL, the “good” cholesterol.)
That’s a great start, says Michael Miller, MD, director of the Center for Preventive Cardiology at the University of Maryland Medical Center. "Lifestyle changes certainly are the cornerstone of cholesterol reduction."
To get your cholesterol down to lower your risk of cardiovascular disease your doctor may recommend, though, that you still need a statin. These powerful cholesterol-lowering medicines include atorvastatin (Lipitor), pravastatin (Pravachol), and simvastatin (Zocor), among others.
What a Statin Can Do
"Statins are very simple: You take them once a day, and their effects are quite profound," says Patrick McBride, MD, MPH, director of the cholesterol clinic at the University of Wisconsin School of Medicine and Public Health.
Statins quickly reduce LDL, the "bad," cholesterol by 50% or more.
- Statins boost HDL, the "good" cholesterol, by up to 15%.
You should see major changes in your cholesterol levels within two to four weeks after starting treatment.