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The “right” level of cholesterol depends on what your risk of having a heart attack or stroke is. The higher your risk, the lower the levels of cholesterol that are needed. Sometimes people who have a blocked artery or have a health event like a stroke or heart attack may be started on a statin. This is because their risk is now higher to have another stroke or heart attack, even though their cholesterol may be “normal”. The overall goal is to lower your risk of having a heart attack or stroke.
A heart healthy diet is very important and a great way to help prevent a heart attack or stroke. However, statins will lower your risk and your cholesterol more than just changing your diet. Few diets have been proven to lower your risk of heart attack or stroke.
Statins also affect your body in other ways. If you have blockages or build-up of cholesterol in your blood vessels, even small ones that you can’t feel, statins can prevent them from getting bigger or from breaking open and causing a heart attack or stroke.
Most side effects are mild (such as stomach upset) and go away over time. Less than 10 out of every 100 people who take a statin have side effects. In fact, in studies where people didn’t know if they were taking a statin or “sugar pill” (placebo), the rates of statin side effects were similar to those of the “sugar pill”.
It is very rare to have serious muscle problems from taking a statin (about 1 out of every 10,000 people). It is also uncommon to have minor muscle problems, such as aching, when taking a statin. Less than 10 out of every 100 people who take a statin have this side effect.
If it does happen, it usually affects large muscles (such as the arms or legs) on both sides of the body. It can usually be managed by lowering the dose or changing to another type of statin. It doesn’t cause any long-term muscle damage.
Statins can cause a mild increase in liver enzymes. This usually doesn’t cause symptoms. It affects up to 3 out of every 100 people who take a statin. This mild side effect doesn’t cause permanent liver damage. It can usually be managed by lowering the dose or changing to another type of statin.
It’s rare that statins will cause a serious liver problem. In fact, it’s so low—1 out of every 1 or 2 million people—that doing a blood test to check the liver every year is no longer recommended.
Yes, in most cases. High cholesterol and heart disease can’t be cured. Statins work by protecting against heart attacks and strokes over many years. If you’re on a statin and your cholesterol is normal, it’s usually because of the medicine. If you stop it, your cholesterol and risk will go up. This is just like medicine for diabetes and high blood pressure.
A recent study compared fish oils, garlic, cinnamon, turmeric, plant sterols, and red yeast rice against low dose rosuvastatin or a "sugar pill" (placebo). This study showed that none of these supplements lowered cholesterol significantly. None of these supplements have been proven to prevent heart attacks or strokes.
Originally, it was thought that coenzyme Q10 may help prevent muscle aches in people who take a statin. However, most studies show that coenzyme Q10 doesn’t have any benefit in preventing muscle aches. Ask your healthcare provider before starting to take coenzyme Q10. It’s expensive and usually not needed.
Both atorvastatin (Lipitor®) and rosuvastatin (Crestor®) can be taken anytime during the day. For example, a healthcare provider may ask you to take your statin in the morning with your other heart medicine. Other statins (such as simvastatin/Zocor®) should be taken at bedtime or with the evening meal.
No. Atorvastatin (Lipitor®) is just as safe as other statins.
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Current as of: February 6, 2023
Author: Cardiovascular Health and Stroke, SCN, Alberta Health Services
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