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Blood Cholesterol Statin Medication Guidelines

  • Date: 2013/11/15 (Rev. 2019/01/15)
  • Thomas C. Weiss - Disabled World
  • Synopsis : Information about new statin guidelines regarding the administration of a statin medication when blood cholesterol levels reach a certain point.

Main Document


Statins are a class of medications many times prescribed to help lower cholesterol levels in a person's blood. By doing this statins help to prevent heart attacks and stroke. Studies have shown that in certain people, statins reduce the risk of heart attack, stroke, and death due to heart disease by 25-35%. Studies have also shown that statins may reduce the chances of recurrent heart attacks or strokes by around 40%.

It is estimated that in addition to the people who are already taking them, another 15-20 million people should be taking statin medications based upon their factors for heart disease. A doctor may order a blood test to determine the amount of cholesterol in a person's blood. If a person has high levels of LDL or, 'bad cholesterol,' they also have a greater chance of heart disease.

On the other hand, it is good to have high levels of HDL or, 'good cholesterol.' HDL cholesterol prevents plaque buildup in a person's arteries by transporting the bad cholesterol out of their blood to their liver. In the person's liver it is eliminated from their body.

Cholesterol is defined as a waxy, fat-like substance that's found in all cells of the body. Cholesterol travels through your bloodstream in small packages called lipoproteins (lip-o-PRO-teens). These packages are made of fat (lipid) on the inside and proteins on the outside. Two kinds of lipoproteins carry cholesterol throughout your body: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Having healthy levels of both types of lipoproteins is important.

  • LDL cholesterol sometimes is called "bad" cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. (Arteries are blood vessels that carry blood from your heart to your body.)
  • HDL cholesterol sometimes is called "good" cholesterol. This is because it carries cholesterol from other parts of your body back to your liver. Your liver removes the cholesterol from your body.

Cholesterol Level Chart - Find out what your blood cholesterol level should be.

How Statin Medications Work

Statin medications work by blocking the action of the liver enzyme that is responsible for producing cholesterol. Too much cholesterol in a person's blood may cause a buildup of plaque on the walls of their arteries. The buildup may eventually cause a person's arteries to harden or narrow. Sudden blood clots in narrowed arteries can cause a stroke or a heart attack.

Statin medications lower LDL cholesterol and total cholesterol levels. Statins also lower triglycerides and raise HDL cholesterol levels. The medications might also tend to stabilize plaques in a person's arteries, making heart attacks less likely. To improve the effectiveness of statin medications it is important to maintain a healthy lifestyle by making sure to:

  • Avoid smoking
  • Limit the intake of alcohol
  • Pursue regular physical activity
  • Eat a diet that is balanced and heart-healthy

Statin Medication Side-Effects

Chart showing potential side-effects of statin medications
Chart showing potential side-effects of statin medications

The majority of people who take statin medications tolerate them well. There are some people who experience side-effects from taking this type of medication however. The more common side-effects of statin medications include the following:

  • Rash
  • Diarrhea
  • Dizziness
  • Headache
  • Drowsiness
  • Constipation
  • Gas/bloating
  • Skin flushing
  • Nausea/vomiting
  • Difficulty sleeping
  • Abdominal cramping/pain
  • Muscle tenderness, weakness, or aches

Additional side-effects of statin medications may include mental confusion, memory loss, high blood sugar, and type 2 diabetes. Statin medications may interact with other medications a person takes. Statin medications are also associated with a few rare but potentially serious side-effects:

  • Elevated Levels of CPK: CPK or, 'creatine kinase,' is a muscle-enzyme that, when elevated,' may cause mild inflammation, muscle pain and muscle weakness. The condition might take a long time to resolve.
  • Myositis: Myositis involves inflammation of a person's muscles. The risk of muscle injury increases when certain other medications are taken along with statins. For example, if a person takes a combination of a statin and a fibrate, which is another cholesterol-reducing medication, their risk of muscle damage increases when compared to someone who takes only the statin medication.
  • Rhabdomyolysis: Rhabdomyolysis involves extreme muscle inflammation and damage. The muscles all over a person's body become weak and painful. The severely damaged muscles release proteins into the person's blood that collect in their kidneys. The person's kidneys may become damaged as they attempt to eliminate a large amount of muscle breakdown caused by the statin medication. The condition may lead to kidney failure or death. Rhabdomyolysis is rare, occurring in less than 1 in 10,000 people who take statins.

People who take statin medications and experience unexplained muscle or joint pain, weakness or tenderness need to contact their doctor immediately. Women who are pregnant, or people with active or chronic liver disease, should not use statins. People who take statin medications need to inform their doctor of any over-the-counter or prescription drugs, vitamins, or herbal supplements they take or plan on taking.

New Statin Guidelines

Chart showing new statin guidelines
Chart showing new statin guidelines

New statin guidelines, introduced by America's leading heart experts, might greatly expand the numbers of people who take statins. Doctors are being told to no longer adhere to rigid clinical guidelines that prompt the administration of a statin medication when a person's cholesterol levels reach a certain point. Instead, people will be advised to take a statin if their LDL cholesterol is extremely high, if they already have heart disease, or if they are middle-aged with type 2 diabetes.

People who are between the ages of 40 and 75 with an estimated 10 year risk of heart disease of 7.5% or greater will also be advised to take a statin medication. Experts are saying the new rule could greatly change the numbers of people who will be advised to take a statin. Experts from the American Heart Association and American College of Cardiology studied data over a 4 year period of time related to heart disease care. The new criteria for who should take a statin also now factors in a person's risk of experiencing a stroke, something experts think might also boost the numbers of those who will be deemed eligible for statin use.

Dr. Neil Stone, Professor of Medicine at the Northwestern University Feinberg School of Medicine stated, "We focused specifically on the use of cholesterol-lowering therapy to determine what works best to reduce the risk of heart attack and stroke." Dr. Hector Medina, Cardiologist at Scott & White Healthcare in Round Rock, Texas stated the revised cholesterol policy, "suggests treatment should be individualized and that, depending on your risk, you may need a higher dose of a more potent statin than if your risk is lower."

Statin medications such as Zocor, Crestor, and Lipitor are the most effective medications for reducing cholesterol and should be combined with changes in a person's lifestyle for best results. The approach is better than attempting to get cholesterol as low as possible by combining statin medications with other types of drugs. Matching people with the appropriate level of statin therapy is more important than achieving a specific target number as formerly pursued.

Assessing a Person's Risk

Approximately one-third of adults who are at risk of a stroke or heart attack have not received a diagnosis and might benefit from primary intervention, to include taking a statin. Doctors should use known risk factors such as cholesterol levels, age, blood pressure, diabetes and smoking to assess a person's cardiovascular risk. Dr. Donald Lloyd-Jones, Professor of Preventative Medicine at the Northwestern University Feinberg School of Medicine said, "These are the strongest predictors of 10-year risk for cardiovascular disease."

Dr. Lloyd-Jones also stated that people at risk of a stroke or heart attack within the next 10 months should receive immediate drug therapy and be encouraged to make changes in their lifestyle. People who experience a lower risk of stroke or heart attack should receive counseling, he said, and make changes in their lifestyles; they most likely do not need statin therapy.

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