If You Have Heart Disease or Diabetes, Statins Can Help

What if there was a medication that could reduce your risk of having a heart attack or a stroke by as much as 50 percent and help your diabetes?

Luckily, there is: statins.  

Introduced in the 1980s, statins are designed to lower your LDL “bad” cholesterol by blocking the substance that your body needs in order to make it.

With less cholesterol, your arteries have less plaque, your blood flows more smoothly, and your chance of having a heart attack—and dying from a cardiovascular event—goes way down. In fact, statins have cut deaths from coronary heart disease by 28 percent among men, according to a long-term study in the UK. And research shows they have lots of other benefits too, from lowering your risk of glaucoma to cutting the rate of breast cancer.

“Statins reduce the amount of plaque already formed in your arteries, and lowers the risk that these plaques will rupture suddenly,” explains Dr. Anuj Shah, M.D., a cardiologist in private practice in New Jersey. 

Dr. Shah notes that statins can help both people who have heart disease and those who might be at risk for getting it in the future. And they’re even more effective when you combine them with a healthy Mediterranean-style diet, which includes plenty of fruits, vegetables, whole-grains, and legumes, while cutting back on red meat.

They’re also an enormously popular drug. As of 2013, almost 40 million Americans had statin prescriptions. But there are many people who’d benefit from statins who aren’t taking them. A 2019 study from the Intermountain Healthcare Network found that only about six percent of patients were taking their statins as prescribed, and many doctors aren’t offering them to patients who could use them.

Are statins right for you? Here’s how to get started.

Find Your Risk for Cardiovascular Disease (CVD)

You doctor can assess your risk for having a heart attack or stroke. However, you can get a rough idea just by asking yourself these questions.

• Am I a smoker? Even second-hand smoke is a concern.
• Has my doctor told me that my cholesterol is high?
• Do I have high blood pressure?
• Am I overweight or obese? Avoid stepping on the scale, as that number is not always accurate when it comes to representing your health. Your waistline is the best indicator of proper weight. Women should have a waist size less than 35 inches, and men should have one less than 40.
• Do I have diabetes?
• Do I seldom exercise and am generally sedentary? 

Diabetes and Statins

When you have diabetes, your body produces less of the "good" cholesterol (HDL) and raises levels of "bad" cholesterol (LDL). This puts individuals with diabetes at a higher risk for heart attack and stroke. According to recent guidelines from the American College of Cardiology, when individuals with diabetes have an LDL of 70 mg or higher, statins can help lower their risk. 

Despite these recommendations, people often worry that statins can worsen diabetes. But they’re safe to use. “It can be monitored,” says Dr. Shah. "The cardiovascular benefits of statins are strong, even for those with diabetes, especially since they’re already at [a] high risk for heart disease.”

Talk to Your Doctor

If you answered yes to one or more of those questions, ask your care team about statins. If you fall into one of the below categories, your doctor may also consider you to be a good candidate.

• If you’re between the ages of 20 and 75, with an LDL greater than 190
• If you’re between the ages of 40 and 75, with Type 2 diabetes
• If you’re between the ages of 40 and 75, with an estimated 10-year risk of a heart attack or stroke greater than 7.5 percent.

Your doctor can inform you if you fall into any of these categories.

Don’t Fear Side Effects  

Statins are remarkably safe drugs. But the American Heart Association found that more than 10 percent of patients who could benefit from statins, weren’t taking them because they were worried about side effects. However, the actual side effects of taking statins are fairly minor—and usually simple to address.

One possible side effect that scares people away from statins is muscle pain. But that can be easily alleviated when your doctor switches you to a different brand or another dose. If you're experiencing muscle pain, talk to your doctor. 

Another concern is that statins cause a decline in memory, though extensive studies have not found a link.

Are statins right for you? Get the facts before deciding. “Statins often get bad press,” says Dr. Shah, “but the benefits outweigh the risks. Definitely talk to your doctor—in some cases, it may [be] the best decision you ever make.”