Statins are some of the most commonly prescribed heart drugs in the UK.
The British Heart Foundation says that around seven million of us take them to lower our cholesterol. But, like all medicines, they can have side effects.
Dr Sarah Jarvis GP 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.
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
- Being overweight
- Having a family history of heart disease or high cholesterol
- Having high blood pressure
- Having certain medical conditions, such as diabetes
- Your ethnicity – South Asians, for example, have an increased risk of developing heart disease, says the World Health Organization (WHO).
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 lower your ‘bad’ LDL cholesterol by anything up to about 50 per cent. They also increase your ‘good’ HDL cholesterol.
Dr Sarah Jarvis says, “It’s important to know your ratio of total HDL cholesterol as well as your total cholesterol. Your total cholesterol 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. Most people should also aim to have a total HDL cholesterol ratio as low as possible and definitely below 5.”
Even if you do not have high cholesterol, your doctor may still recommend that 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 people with diabetes are between two to four times more likely to develop cardiovascular disease than someone without diabetes, says Diabetes UK.
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.
Research shows statins can reduce rates of cardiovascular disease in people with diabetes, even amongst those considered to have a ‘low’ cholesterol level.
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 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.
And statins can occasionally cause muscle problems, which can be serious. You should speak to your doctor if you experience muscle pain, tenderness or weakness that cannot be explained, says The British Heart Foundation.
Is there anything else I can do to lower my cholesterol?
Even if you are taking a statin you should still think about the other ways you can help to 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 exercise
- Quitting smoking if you are a smoker
- Moderating how much alcohol you drink
Saturated fat is the kind of fat found in butter and lard, pies, cakes and biscuits, fatty cuts of meat, sausages and bacon, and 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.