For many people, the first steps to lowering your cholesterol start with a little TLC. That stands for Therapeutic Lifestyle Changes. TLC includes a diet low in fat, weight management and regular physical activity.
If you're not reaching your cholesterol goals with TLC alone, your doctor may want to talk with you about statins. Statins are a type of drug that can help lower your cholesterol. The drugs work by blocking the liver from making cholesterol.
A powerful weapon against heart disease
Statins have become a powerful weapon against heart disease. Studies have shown that statins can cut the risk of heart disease by about one third. Previously, statins were only for people with dangerously high cholesterol. Now they are often given to people who have moderately high cholesterol levels and other risk factors for heart disease.
Side effects: One consideration
Many people do well taking statins. Keep in mind they do have side effects. Some of the side effects will go away as your body adjusts to the medicine. Some of the less serious side effects may include nausea, muscle and joint aches, diarrhea and constipation. Always talk to your doctor about these symptoms.
Potentially serious side effects in the use of statins are monitored by the United States Food and Drug Administration (FDA). In February 2012, the FDA updated safety advice for statins to include:
- Liver injury is rare. Before you start the statin, your doctor may order liver function tests for baseline information. Your doctor will review with you the symptoms to watch for and report back.
- Memory loss reports have been noted by some statin users. Forgetfulness, memory loss and confusion or "fuzzy" thinking are examples. Report all changes to your doctor.
- Diabetes risks have been reported. A small increased risk of raised blood sugar levels and development of type 2 diabetes have been reported. Talk to you doctor about your concerns.
- Muscle damage potential. Some drugs can interact with statins and increase the risk of muscle injury. If you notice any new muscle pains when taking statins always report these changes to your doctor.
There are also some other medicines that can interact with statins. So be sure to tell your doctor about all other medicines or supplements that you are taking.
Are there other things to consider?
Generally, the higher your LDL, or "bad", cholesterol level and the more risk factors you have (other than LDL), the greater your chance of developing coronary heart disease (CHD) or having a heart attack.
The major factors that increase your risk of a heart attack are:
- Cigarette smoking
- High blood pressure
- Low HDL, or "good", cholesterol. The American Heart Association defines low HDL cholesterol as less than 40 mg/dL for men and less than 50 mg/dL for women.
- High LDL
- Family history of early heart disease (heart disease in father or brother before age 55; heart disease in mother or sister before age 65)
- Age (men 45 years or older; women 55 years or older)
- Physical inactivity
- Having diabetes
You can change some of your risk factors, such as cigarette smoking. You cannot change others - like your age. Your doctor will take all of these factors, including your LDL cholesterol level, into account when making your treatment plan.
Lifestyle is key to lowering cholesterol
Remember, lifestyle changes, or TLC, is important for lowering cholesterol even when taking statins. TLC includes a low fat diet, regular physical activity and weight management. Always check with your doctor first before you increase your activity level.
Even if your doctor feels a statin will be helpful to lower your cholesterol, lifestyle changes are still needed. Even if your cholesterol level goes down, you will probably need to keep taking the medication to keep it there. Talk to your doctor about whether statins are right for you.
Created on 08/14/2001
Updated on 08/07/2012
- Grundy SM, Cleeman JI, Bairey Merz CN, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation. 2004;110:227-239.
- National Heart, Lung and Blood Institute. High blood cholesterol: What you need to know.
- United States Food and Drug Administration. FDA drug safety communication: Important safety label changes to cholesterol-lowering statin drugs.
- United States Food and Drug Administration. Consumer health information: FDA expands advice on statin risks.