So let’s talk about treatment for high cholesterol. I wrote about cholesterol and who may/may not need treatment based on cholesterol numbers. But I didn’t talk about treatment.
First step is always diet and lifestyle change. You can control this through your lifestyle and not need medication, though this requires discipline and dedication. You can do it, though may people choose not to/are not able to—WHICH IS OKAY!! If you are not able to control your cholesterol with lifestyle changes, where do we go from here?
Statins, yes I said the S word. Statins have gotten a pretty bad wrap over the years. People are always talking about how they can hurt you—but not often do they talk about how they can help. Statins have two main functions:
1. They lower your cholesterol, though their mechanism of action as an HMG-CoA
reductase inhibitor—well that was obvious.
2. They act as a protective seal over the plaques that you have in your arteries (and
yes, thanks to the typical American diet and McDonalds, we have been laying down
plaque in our arteries since about the age of 10). See these plaques break apart and
a piece travels downstream, gets stuck, causes a dam-like effect, and prevents
blood from flowing past—heart attack or stroke, depending on location.
Statins are also used if you have known vascular disease and diabetes. Our goal with these diagnosis is to try to prevent that heart attack or stroke. Did you know that being on a statin as a diabetic can reduce your risk of heart attack by as much as 30%?
I am a STRONG proponent of statins. They have relatively very little risk or side effects. They have great benefit. BUT, like all medications, you should only take them if you need them. Yes, they can cause muscle pains in people. No, they do not cause your knees or back to hurt, that would be your arthritis. No, they will likely not cause liver failure. Read this information from the Mayo Clinic about the risks and benefits of a statin.
There are other agents as well that are used when you either cannot tolerate statins or they aren’t working well enough for you. Though, all evidence, at this point, says that statins are still the best first line medication when you have high cholesterol.
One final note—if you have already had a heart attack or stroke, you just guaranteed yourself a statin for life. Taking one WILL absolutely allow you to live a longer healthier life than if you don’t
…until next time.