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Is the Risk of Statin Medications Greater than the Reward?

Is the Risk of Statin Medications Greater than the Reward?

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When I start talking with patients about optimizing their heart health, the conversation will often turn to statin medications, prescribed to fight artery-damaging cholesterol. It almost feels like assembling a jigsaw puzzle together—there are lots of unique pieces to consider, and finding the right place for them can take extra time and careful thought. 

Heart disease is the leading cause of death for adults across all genders and most racial and ethnic groups in the United States. That’s a good reason to focus a little more on statins—this powerful yet controversial class of medications. There are several brands, each with subtle differences in action and side effects—Lipitor, Zocor, Pravachol, etc.—and tens of millions of people take them. I often counsel patients who have concerns that statin medications are overprescribed. Those concerns have some foundation.

Risks, Benefits, Evidence
A recent study in the Annals of Internal Medicine found that half of those who take statins have too low a risk of cardiovascular disease to get much protection from them, and the side effects of the statin may outweigh the benefit. While side effects are rare—the most common being muscle pain, digestive issues, headaches, and sleep problems, which often go away if medication is changed or reduced—the rarer side effects, such as an increased risk of developing diabetes, can be harder to reverse.

But many other studies have concluded that the side effects are negligible, especially when weighed against the effectiveness of statins in preventing heart attacks and strokes in those at risk. One line of research, published in the Journal of the American Medical Association, even concludes that given the prevalence of heart disease and the drugs’ effectiveness, statins are heavily underprescribed. The study suggests that most side effects can be dealt with by having a thorough conversation with your doctor, so the right drug and the right dose is prescribed based on an individual’s lifestyle and medical background.

Evidence-based research is extremely important for broad-scale public policy. But for individual patients who need to work out a plan for their heart health, it can be a confusing and frustrating discussion. There is no one-size-fits-all solution when it comes to statins. There is one important aspect the latest studies agree on: Doctors and patients need to spend more time discussing the benefits and risks of statin drugs, paying particular attention to a patient’s individual health concerns.

A Different Health Focus
Diving into those risks and benefits takes time, patience, a strong relationship with your doctor, and a sense of the alternatives available for you to solve the heart health puzzle—alternatives that go well beyond simply whether to take statins. There must also be a focus on how lifestyle changes can significantly reduce cholesterol and therefore may limit the need for statin medication.

This healthy lifestyle/heart health connection is no secret. The American College of Cardiology’s guidelines emphasize that even for younger patients or those with no evident risk factors, lifestyle optimization is central. Medical practitioners can prescribe pills, but they can also prescribe, and help you achieve, a program of more physical activity, better nutrition, weight loss, and blood pressure and cholesterol control.

When your risk factors have been carefully calculated by your doctor and the most reasonable lifestyle alternatives are considered, then statins—their effectiveness and potential side effects—may well be part of the picture. It is not the whole-medicine-cabinet picture, but the whole-health picture that I help my patients strive for.

Looking for Guidance on Making Healthy Choices?
My practice uses evidence medicine as a guideline, but I also listen to patients’ individual medical histories and future goals when creating the best plan to treat their cholesterol concerns. I prioritize new research and healthy lifestyle changes into my prescriptions by allowing for longer office visits and physicals. The journey to optimal health looks different for everyone, and WellcomeMD can help!

Membership medicine (sometimes called “concierge medicine”) re-establishes the kind of personal relationship with your physician that was once commonplace. We take advantage of the many advances in treatment and technology—treatment is more personal, proactive, and effective. We limit memberships so that each of my patients has far more access to time with me. Our certified health coaches help our members reach their goals and find their happiest, healthiest version of themselves.

  • Consider the cost of avoiding a preventable disease, the value of early detection of serious health problems, and ready access to your doctor who knows you.
  • Unhurried, 30-minute consultations or video conference appointments—or just a quick call or text— you choose.

If you are ready to plan your healthcare for your specific needs, contact WellcomeMD today.

Melissa MacVenn, MD, of WellcomeMD Naples, is a board-certified family concierge medical physician with over 10 years of experience treating patients with complex medical conditions. She and her team offer complimentary consultations to answer any questions you may have on how Dr. MacVenn can help you achieve your optimal health. To schedule a tour of our practice and a free consultation with me, please call Tara Greenberg at 239.451.5105 or visit WellcomeMD at: wellcomemd.com/naples-florida. 11181 Health Park Blvd., Naples.