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How Statins Help Your Heart, And What You Need to Know about Them

separator Statins have become the leading medication doctors prescribe to lower the levels of cholesterol in the blood. The medications are safe and effective for the vast majority of people who take them. In the past year, experts have recommended that statins be prescribed for even more people than they had previously thought would benefit. The current statins on the market today are Lipitor, Mevacor, Zocor, Pravachol and Lescol.

How statins work
Cholesterol is a hard, waxy substance that the liver produces naturally. The body needs cholesterol in order to synthesize testosterone, estrogen and adrenal hormones, to provide the body with vitamin D, to aid in the digestion of fats and to ensure that cell membranes remain flexible and relaxed.

But sometimes cholesterol levels can get too high, increasing the risk of blockages in the arteries, which can lead to heart disease, heart attack and death. Statins work by stopping the action of a liver enzyme that’s essential to the production of cholesterol. When the enzyme can’t produce cholesterol, the liver will remove cholesterol from the blood, using it to perform those essential body functions.

Many experts believe that statins are also effective in reducing arterial inflammation, which studies have recently shown probably plays an important role in heart attacks and strokes. Statins also seem to reduce that chance that pieces of cholesterol will break free of the artery walls and block important blood vessels. And they help keep vessels relaxed and flexible, which keeps them functioning well.

Most people take one statin pill per day, usually with their evening meal or at bedtime. Nighttime is the most effective time to take statins because that’s when the body produces the most cholesterol.

Side effects to be aware of
For the majority of people, statins cause no serious side effects. Side effects that people do experience are usually mild to moderate, and they usually go away as your body adjusts to the medication. These effects include

  • Upset stomach
  • Gas
  • Constipation
  • Abdominal pain or cramps

In some rare cases, statins can cause muscle aches or joint pains. Even more rare are elevated levels of an enzyme called creatine kinase. Initially, this causes muscles aches, soreness or weakness. But if statins are not discontinued, these elevated levels of creatine kinase can cause complete muscle breakdown, kidney failure and death.

This type of reaction is more likely when a patient is taking certain other drugs as well, such as cyclosporine (an immunosuppressant commonly taken by people who have had organ transplants), antifungal drugs and protease inhibitors for HIV. Drinking more than a quart per day of grapefruit juice also increases the risk, as does being over 80 years old, having chronic kidney disease.

What you can do to lower your risk of serious side effects
If you’re taking statins and you experience muscle pain for an unknown reason, be sure to tell your doctor about it right away. You should also have your blood tested regularly to test for liver damage.

Remember, most people who take statins have little or no trouble at all. Statins are a highly effective tool in the managing your risk of heart disease and stroke. It’s always a good idea, though, to be aware of possible complications, so that you can call your doctor right away and nip any problems in the bud.

The National Heart, Lung, and Blood Institute; The New York Times, “Statins: Miracles for Some, Menace for a Few,” 16 December 2002.
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