Dr. Morrow’s Show Notes on Statins
- Before talking about statins, we should talk about high cholesterol.
- What qualifies as high cholesterol?
- Has changed a lot over the years.
- Now, it is LDL > 130 or HDL < 40 if you have no family history of heart disease.
- It is an LDL > about 75 if you do have a family history.
- Hard to raise your HDL. No matter what you do.
- United States Preventive Services Task Force (USPSTF) recommends that adults without a history of cardiovascular disease (CVD) use a low to moderate dose statin for the prevention of CVD events and mortality when all the following criteria are met:
- (1) they are aged 40 to 75 years;
- (2) they have 1 or more risk factors (i.e., high cholesterol, diabetes, high blood pressure, or smoking) ; and
- (3) they have a calculated 10-year risk of a cardiovascular event of 10% or greater
- So, to determine whether a patient is a candidate for medical treatment, clinicians must first determine the patient’s risk of having a future cardiovascular event.
- Task Force found adequate evidence that the risk of statins in adults aged 40 to 75 years is small
What are “Statins”?
- Statins are prescription medications that lower cholesterol to prevent cardiovascular disease (heart attack or stroke), which is the leading cause of death in the United States.
- These are medicines you have probably heard of, or more likely Googled, like Zocor, Lipitor or Crestor.
- First line of therapy should be lifestyle changes. Try lifestyle changes for a few months, then on to the meds.
- Statins can reduce the risk of stroke, heart attack and even death by 25 percent or more.
- There are two side effects that actually happen from statins.
- Myalgia (muscle aches or weakness) is a commonly reported adverse effect of statins,
- Liver irritation or inflammation can occur. Need to have lab work before starting and then regularly when taking them. Not smart to give a year’s supply.
Myths about statins
- Myth #1: Taking Statin Drugs Leads to Diabetes Out of the Blue
- Truth: In clinical trials, statins appear to accelerate a diagnosis of adult-onset diabetes because they cause a slight elevation in blood sugar.
- However, people impacted by this side effect already have higher than normal blood sugar.
- For those who are borderline diabetic, the mild increase in blood sugar can lead to a diabetes diagnosis about five weeks earlier than it would be otherwise.
- Fact: Research indicates that statin drugs do not induce diabetes in someone who isn’t already nearing a diabetes diagnosis.
- Additionally, the benefits of reducing cardiac events in someone who has prediabetes or is a diabetic greatly outweigh the mild increase that might occur in their blood sugar.
- Myth #2: Statins Frequently Cause Memory Loss
- Truth: In 2012, the FDA changed statin drug labels to include information that some people had experienced memory loss and confusion while taking the medications.
- Unfortunately, that change was based on some poor-quality studies and evidence. People became seriously concerned that lower cholesterol levels could affect the brain’s function. But in fact, the brain makes its own cholesterol. It doesn’t depend on the cholesterol in the blood.
- The most rigorous studies show that statins do not commonly cause memory loss. If anything, long-term use of statins might have a beneficial effect on the brain since they help prevent strokes and protect the health of arteries in the brain.
- Myth #3: You Could Get Cataracts from Taking Statin Drugs
- Truth: Some studies have indicated that there may be a relationship between statin drugs and an increased risk for developing cataracts. However, these investigations have been either conducted in animals or in less-than-rigorous studies.
- The best evidence we have comes from high-quality clinical trials in humans, which showed that statin drugs do not increase risk of cataract formation. In fact, some studies even performed eye exams in people over time and showed no difference in eye health between those taking and not taking statins.
The Truth About Statins
- Statins are safe
- Statins save lives
- Statins are affordable
- If you do get side effects, there is a good chance that you can tolerate a different statin or a different dose
- If all else fails and you are in a high-risk group due to your cholesterol, there are alternatives
- Red yeast rice – less effective and still could cause same side effects
- Fish oil or krill oil, etc. – less effective
- Diet and exercise
- Praluent or Repatha –monoclonal antibodies that promotes removal of LDL cholesterol from circulation, thereby lowering cholesterol in the blood
If your statin does what we want it to do, you will never know it. It’s one of the mysteries of medicines. People who have benefited from statins are not sitting at home posting online about side effects that in most cases are not even related to statin therapy.
So… You can take cholesterol medicine, or you can wait and take heart attack medicine – but the ironic thing is: they are the SAME MEDICINE!
About Morrow Family Medicine and Dr. Jim Morrow
Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be. At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!” Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.
Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce. He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.