Statins 

  • Overview

Introduction 

Preventing and reducing high cholesterol

Too much cholesterol in the body causes coronary diseases such as angina, heart attack and stroke. Dr Jonathan Morrell explains who is at risk and the treatments that are available.

Media last reviewed: 21/02/2013

Next review due: 21/02/2015

Types of statin

There are five types of statin available via prescription in the UK:

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Statins are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood.

LDL cholesterol is often referred to as "bad cholesterol", and statins reduce the production of it inside the liver.

Why have I been offered statins?

Having a high level of LDL cholesterol is potentially dangerous, as it can lead to a hardening and narrowing of the arteries (atherosclerosis) and cardiovascular disease (CVD).

CVD is a general term that describes a disease of the heart or blood vessels. It is the most common cause of death in the UK. The main types of CVD are:

  • coronary heart disease – when the blood supply to the heart becomes restricted
  • angina – sharp chest pain, caused by coronary heart disease
  • heart attacks – when the supply of blood to the heart is suddenly blocked
  • stroke – when the supply of blood to the brain becomes blocked

Statins are usually offered to people who have been diagnosed with a form of CVD, or whose personal and family medical history suggests they are likely to develop CVD at some point over the next 10 years.

If you are offered statins, you will also be advised about lifestyle changes you can make to help reduce your cholesterol level. These include eating a healthy diet low in saturated fat, exercising regularly, stopping smoking and moderating your alcohol consumption.

Read more about when statins may be recommended.

Taking statins

Statins come as tablets that are taken once a day. The tablets should normally be taken at the same time each day  most people take them just before going to bed.

In most cases, treatment with statins will need to continue for life, as stopping the medication will cause your cholesterol to return to a high level within a few weeks.

If you ever forget to take your dose, do not take an extra one to make up for it. Just take your next dose as usual the following day.

If you accidentally take too many statin tablets (more than your usual daily dose), contact your doctor or pharmacist for advice, or call NHS 111.

Cautions and interactions

Statins can sometimes interact with other medicines, increasing the risk of unpleasant side effects, such as muscle damage. Some types of statin can also interact with grapefruit juice.

It is very important to read the information leaflet that comes with your medication, to check if there are any interactions you should be aware of. If in doubt, contact your GP or pharmacist for advice.

Read more about things to consider when taking statins.

Side effects of statins

Many people who take statins experience no or very few side effects. Others experience some troublesome  but usually minor  side effects, such as an upset stomach, headache or feeling sick.

Cases that involve more serious side effects, such as kidney failure, tend to get a great deal of media coverage, but these instances are rare. The British Heart Foundation states than just 1 in every 10,000 people who take statins will experience a potentially dangerous side effect.

The risks of any side effects also have to be balanced against the benefits of preventing serious problems. A review of scientific studies into the effectiveness of statins found that around 1 in every 50 people treated with a statin for five years would avoid a serious event, such as a heart attack or stroke.

Read more about the side effects of statins.

Alternatives to statins

Your doctor may offer statins as a treatment if you are believed to be at risk of CVD. However, it is up to you whether you take them.

Although statins are extremely effective at reducing high cholesterol, they are not the only option. Alternative measures to reduce your cholesterol level include:

  • eating a healthy diet low in saturated fats
  • increasing the amount of omega-3 fatty acids in your diet
  • taking another prescribed medication

Read more about treating high cholesterol.

Page last reviewed: 25/03/2014

Next review due: 25/03/2016

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Comments

The 10 comments posted are personal views. Any information they give has not been checked and may not be accurate.

P0ttsville said on 18 July 2014

Why write 'it is up to you whether you take them.' ? In modern medicine and modern ethics isn't it always up to the patient whether they take the medicine? Why not create a page stating patients rights and patients choices rather than having them occasionally doted within an article? The truth is that most Doctors would not take statins themselves, They realise the tiny risk improvement is unlikely to out-weigh the many side effects reported by patients.

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Rogerrocket said on 02 May 2014

ATORVASTATIN

I am a 66-year-old man. 2 years ago I was prescribed Simvastatin and subsequently Atorvastatin to reduce my triglyceride levels.
I have had severe shoulder pain in my right shoulder and to a lesser extent in my left one.
The other symptoms I have experienced are: -
Muscle cramps in legs and hands.
Sleep disturbance i.e. vivid dreams, nightmares and night frights. During the latter I wake up in the middle of the night feeling scared and don’t know why.
On waking my mind is racing and feeling fuzzy headed.

I am considered very fit and a onetime long distance runner and over the last few years regularly swim 5 days a week to keep fit.

5 months ago I stopped swimming due to shoulder pain. Medical examinations were unable to find the cause
(x ray and an ultrasound scan).
Physiotherapy and acupuncture did not improve it.
The ultrasound specialist suggested that I had “pinged my biceps ligament/tendon” and to go back swimming.

A few weeks ago I woke up one morning and every part of my body was aching. The day before I had done a lot of DIY involving fairly heavy lifting.
I am a retired research chemist and have done a few simple tests to determine if statins are the cause.
In summary –
1.Stopped taking statins for 2 weeks. Result – all symptoms gone.
2.Started taking statins again. Results – 1week later the symptoms returned.
3. Repeated the test (stopped taking statins)to validate the result. Results – all symptoms gone.
4. Started taking statins again. Results - symptoms returned after about a week.
5. Stopped medication
Summary
I have been taking statins for 2 years and have experienced the side affects as described. On stopping the medication for two weeks all symptoms have gone and I have my life back.
This week I swam over a mile each day for 5 days and no pain. I will live with the knowledge that I have a 27% chance of a heart attack in the next 10 years and enjoy my life.

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Richard_John said on 12 February 2014

Where's the evidence? How effective are they really and for what conditions? Has negative trial data been suppresssed? Are reports of side effects ignored?

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TURNERO said on 24 November 2013

Statins may lower cholesterol but there is a very big question over whether high cholesterol is what causes heart disease. After you are 50 higher cholesterol is actually protective against heart disease.

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ailsa craig said on 12 September 2012

the jury is out on statins - and on cholesterol levels.
cholesterol is found in arterial wall deposits, thus, we've been led to believe, high cholesterol is to blame, but
arterial calcification could be linked to lack of vitamin d, rather than to high cholesterol levels.

i.e. the french population eats high amounts of animal fat and has higher cholesterol levels than the british population, but has far fewer incidents of cardiovascular disease.
a recent study claims that statins act on vitamin d receptors in the body, as they are or contain components that mimic vitamin d in the body.

the pharmaceutical industry, for obvious reasons, isn't happy regarding these findings.
vitamin d3 can't be patented so the industry and their shareholders won't be able to make any money.
but, if these findings turn ou to be correct, we could all take vitamin d3 supplements (no side effects), rather than statins.
food (low or high cholesterol) for thought?????

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MatthewMcKendree said on 08 May 2012

Statins are known currently to be by far the most effective medications for the lowering of high blood cholesterol levels. However this comes with a price. The usage of statins may be accompanied by statin side effects such as muscle damage, liver damage and gastrointestinal symptoms. The degree of damage, however is usually mild and reversible by discontinuation of the drug.<a href="http://www.aitkin.k12.mn.us/nurse/links.html">Blood Cholesterol</a>

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User626030 said on 19 December 2011

Having used statins for many years I finally gave up on them insofar as the side effects (very severe muscle aches) worked against the primary alternative treatment of taking vigorous exercise.
Since then I have noticed a massive increase in their use and frankly, left to their own devices, I believe the drug companies would have babes in arms on these dangerous drugs.
The prognosis to the story: Since dumping statins my exercise has increased dramatically - cholesterol down to within normal range - angina a thing of the past.

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vernon39 said on 20 January 2011

Doesn't yet note contents of Choice News item News 19/1/2011

http://www.nhs.uk/news/2011/01January/Pages/cholesterol-lowering-statin-drugs-examined.aspx

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brianfromenfield said on 01 December 2009

I am surprised that no reference is made to the risks of statins (I actually wanted to find out about these).

Also it is notable that Mr Parker (and most of the literature concerning cholesterol reducing foods/drugs/exercises) does not quantify the benefits - i.e. how much can I expect to reduce my cholesterol by doing various things? I believe I read once that diet can give a maximum reduction of only about half a micromole whereas my cholesterol needs reducing by several micromoles so special diets may well be an unpleasant waste of effort! But no one tells you.

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laryparker said on 01 October 2009

Some changes in your diet that may reduce your cholesterol. Oats, in the unprocessed form have been proven to reduce cholesterol. Using soy products such as soymilk can reduce your cholesterol. Exercise, as little as half an hour; thrice a a week, has been shown results of lower cholesterol. Ateronon, is a one a day food supplement, which contains 7mg of Lycopene.It is proven to reduce ‘bad cholesterol’ which causes fatty deposits and blocks arteries.

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