Jorgeana Lass, Pharmacist in our Health at Hand team

Statins – do the benefits outweigh the risks?

20 September 2019

Statins are some of the most commonly prescribed heart drugs in the UK.

The British Heart Foundation says that around eight million of us take them to lower our cholesterol. But, like all medicines, they can have side effects.

Jorgeana Lass, a pharmacist in our Health at Hand team explains why some people need these tablets and how to weigh up the merits of taking statins against the risks.

Why take a statin?

Statins are used to keep cholesterol levels in check. 

Cholesterol is a type of fat produced by the liver. We also get a small amount from our diet. We all need and have some cholesterol in our blood, but some people can have too much.

High cholesterol is bad because it can clog up your arteries, increasing your risk of a heart attack and stroke.

Doctors will prescribe a statin if they believe you’re at increased risk of cardiovascular disease and can benefit from using this medicine.

They’ll make this call based on a number of factors, including your age – heart disease risk increases as you get older. 

Other factors that can raise your heart risk include:

  • If you have already had a heart attack or stroke
  • Smoking
  • Being overweight
  • Having a family history of heart disease or high cholesterol
  • Having high blood pressure
  • Having certain medical conditions, such as diabetes
  • Ethnicity

You can ask your doctor for a health check to find out if you are at risk.

What are the benefits of taking a statin?

Statins can reduce your 'bad' LDL cholesterol by around 30%, sometimes even 50% with high doses.

Jorgeana says, “It’s important to know your cholesterol ratio as well as your total cholesterol. Your total cholesterol includes your 'good' HDL cholesterol and gives a basic guide to your risk – most people should aim for a total cholesterol level below 5mmol/l, or below 4mmol/l if you’re in one of the high risk categories listed above. Your cholesterol ratio shows what proportion of your total cholesterol is made up of 'good' HDL. It's calculated by dividing total cholesteral by HDL. Most people should also aim to have a cholesterol ratio as low as possible.” 

Even if you don't have high cholesterol, your doctor may still recommend you take a statin to reduce your risk of cardiovascular disease.

It’s widely recommended that anyone who has had a heart attack or stroke, or who suffers from a condition called peripheral vascular disease, should take a statin regularly regardless of cholesterol levels.

If you have diabetes, your doctor may also advise you to take a statin. This is because when you have diabetes, you're more at risk of heart disease than someone without. 

Many of the risk factors for type 2 diabetes, such as carrying too much weight around your tummy, also raise your risk of heart disease. What’s more, high levels of blood sugar can also damage your arteries, making you more prone to heart attack and stroke. This is because your body can't use all of this sugar properly, so more of it sticks to your red blood cells and builds up in your blood. This build-up can block and damage the vessels carrying blood to and from your heart, starving the heart of oxygen and nutrients.

Research shows statins can reduce rates of cardiovascular disease in people with diabetes, even amongst those considered to have a ‘low’ cholesterol level.

You can find out more about the link between heart disease and diabetes at the Diabetes UK website.

What about side effects?

It’s important to remember that all medicines have side effects, and statins are no exception. 

However, for the majority of people taking statins, the benefits in terms of reduced risk of heart attack or stroke will outweigh the risk of side effects.

Your doctor or pharmacist will carefully consider these relative merits and risks.

Some people who take statins may experience minor side effects such as nausea, difficulties sleeping, cold-like symptoms or nosebleeds. There are many makes of statin and switching to a different one may help.

More rarely, statins can affect the function of your liver. Your doctor will be checking for this, starting with performing baseline blood tests and clinical assessment that will be reviewed periodically.

Statins can occasionally cause muscle problems, which can be serious. The British Heart Foundation says you should speak to your doctor or pharmacist if you experience muscle pain, tenderness or weakness that cannot be explained.

Is there anything else I can do to lower my cholesterol?

The good news is that yes, there are several things you can do reduce your cholesterol and delay the need to take cholesterol lowering medication or remove it altogether. In fact, according to NICE guidelines, lifestyle changes such as the ones described below should be tried first before considering starting taking statins.

Even if you're taking a statin already it's a good idea try to incorporate  some or all of these behaviours, if possible, to help keep your cholesterol down.

Some simple lifestyle changes that can make a big difference include:

  • Eating a healthy diet low in saturated fat*
  • Taking regular light to moderate exercise, in whatever form suits you best 
  • Quitting smoking if you're a smoker 
  • Moderating how much alcohol you drink
  • Controlling diabetes and blood sugar levels adequately – remember, sugar will also turn into fat in the body once the level of sugar is higher than required, which is one of the roles of the hormone insulin.

*Saturated fat is the kind of fat found in butter and lard, pies, cakes and biscuits, fatty cuts of meat, sausages and bacon, cheese and cream. Try switching to healthier options, such as low fat spreads and olive oil. Nutrition labels on packets will tell you how much saturated fat is in your food. Those that are high in saturated fat contain more than 5g saturates per 100g and are often colour-coded red. Our article gives more detail on the differences between dietary fats, which to choose, and why it's important not to eliminate healthy fats from your diet.

Next steps

The suggestions above don't just apply to managing your cholesterol and improving your heart health; they're changes that can help all of us improve our overall health and wellbeing, as well as reducing the risk of a range of serious, life limiting illnesses as we get older. And we've got lots of expert information, tips and inspiration in our health and wellbeing pages to help support you along the way. Take a look and start your journey today.

Or, if you have a question about any aspect of your or your family's health, our Health at Hand team are here to support you, whenever you need us, wherever you are in the world and whether you're an AXA PPP healthcare customer or not.

Available around the clock, 365 days a year, our free Ask the expert information service allows you to ask the team of friendly and experienced nurses, midwives and pharmacists about any health concerns you may have. Simply submit your question online and we’ll get back to you with an answer as soon as we can – usually within a couple of hours.

Resources

Diabetes UK

British Heart Foundation

The World Health Organisation

British Heart Foundation patient information sheet on statins

Further reading

Diet and nutrition hub - AXA PPP healthcare

Fitness and exercise hub - AXA PPP healthcare

Quit smoking - AXA PPP healthcare

How to develop healthy eating habits - AXA PPP healthcare

How to cut down the amount of alcohol you drink - AXA PPP healthcare