Statin medications are used to lower cholesterol levels and also to improve coronary function in patients with a history of cardiovascular disease or high risk factors such as diabetes. They work primarily by blocking the production of cholesterol in the liver, and include atorvastatin (Lipitor), lovastatin (Mevacor), simvastatin (Zocor), and rosuvastatin (Crestor).
Statins can help correct dyslipidemia, an imbalance between healthy high-density lipoproteins and damaging low-density lipoproteins, but these medications are not safe for everyone. Women cannot safely take statins during pregnancy and people with liver damage cannot tolerate the elevation in liver enzymes that statins cause.
Step 1
Determine if taking a statin could benefit your health. Statin medications are approved by the U.S. Food and Drug Administration to lower the dangerous form of cholesterol, low-density lipoprotein or LDL, and this is their primary action. In addition, they raise levels of the healthy form of cholesterol, high-density lipoprotein, or HDL. Look at your latest lipid profile, a blood test done while fasting. Statins may be advised if your LDL cholesterol is over 100 mg per deciliter, although a lower target of 70 mg per deciliter may be beneficial if you have several other risk factors for heart disease. Statins can also help men with HDL levels below 40 mg per deciliter or women with levels below 50 mg per deciliter.
Step 2
Compare statins based on their ability to lower your level of LDL. The Oregon Resouces Commission 2006 Recommendations for statin medications found that all statins are equally effective when you need to lower your LDL by only 40 percent or less. But if you must reduce your LDL by more than 50 percent, only Lipitor and Crestor were proven effective in a study published in the June 2006 American Heart Journal.
Step 3
Have a hemoglobin A1C blood test to rule out diabetes. If this number is greater than 6.5, diabetes will be diagnosed and a statin may be prescribed even if your LDL is not extremely elevated. In the Collaborative Atorvastatin Diabetes Study, men and women with diabetes who had an average LDL of just 107 mg per deciliter lowered their risk of cardiovascular disease by up to 95 percent over four years by taking Lipitor.
Step 4
Consider whether you need to raise your HDL cholesterol with niacin, a prescription medication. High-density lipoprotein in sufficient quantity is capable of safely storing large amounts of LDL. Lifestyle changes such as losing weight, exercise and smoking cessation can raise HDL for many people, but if this number remains too low, your doctor may prescribe niacin. Combining niacin with most of the statins can, however, cause a condition called myopathy, a neuromuscular disorder that results in muscular weakness. The statin that is not known to interact with niacin in this way is Zocor.
Tips and Warnings
- Decide whether you are ready to invest the time and effort required to correct your weight to a healthy BMI of 18.5 to 24.9 and reduce your waist measurement to less than 35 inches (if you are a woman) and 40 inches (if you are a man). Consider engaging a health coach to help you establish a safe and effective plan for meeting those heart-healthy goals, and aim for a weight loss of one to two pounds a week.
- Always rely on the opinion of a physician who has recently examined you, reviewed your lab work and other tests, and knows your personal and family medical history. A primary care provider in either traditional or osteopathic medicine can provide comprehensive care to prevent or diagnose and treat dyslipidemia and related health issues.
Things You'll Need
- Paper
- Pen
- A copy of your latest lipid profile
References
- Food and Drug Administratation: Statins
- Oregon Health Resource: HMG-CoA Reductase Inhibitors (Statins): Subcommittee Report (2006 update)
- "American Heart Journal"; Effects of Rosuvastatin and Atorvastatin Compared; A. Olsson et al; June 2006
