High cholesterol? Shall we talk about these statins?

Many of us have a problem with high cholesterol. It is normal to feel a little scared and worried when you get your blood test results and see that your LDL level is above three digits. So, has your doctor told you to start taking a medication called statins to control your cholesterol? You may already be taking this medication. So, you probably have a lot of questions about this medication, its effectiveness, and its pros and cons. Let's clear up all the questions you have about it today.

Simply put, what are these statins?

Statins are a class of drugs that can only be taken with a doctor's prescription. Their main function is to normalize your cholesterol levels. In particular, some statins can reduce your LDL (Low-Density Lipoprotein) cholesterol, also known as the "bad" cholesterol, by 50% or more.

Doctors call LDL "bad" cholesterol for a reason. Think of the arteries that carry blood throughout your body as water pipes. What this LDL cholesterol does is deposit itself on the walls of those water pipes like moss. Over time, these deposits (we call them plaque) build up and reduce the space inside your blood vessels. This makes the heart work harder to pump blood, and it also obstructs blood flow.

Statins don't just lower LDL. They also lower another type of fat in your blood called triglycerides. They also help your liver get rid of unwanted cholesterol. Sometimes these drugs can also increase your levels of HDL (High-Density Lipoprotein), which is known as the "good" cholesterol . HDL is "good" because it collects unwanted cholesterol from all over the body and delivers it to the liver. The liver then removes it from the body.

These medications come in the form of tablets or capsules. They are taken once a day. They can be taken with or without food. The most important thing is to take them at the same time every day. The label on your medicine bottle will tell you what time of day to take them. Usually, short-acting statins are taken at night because our bodies produce more cholesterol at night when we are sleeping. However, long-acting statins are not as effective at any time of day.

Okay, now let's see how this medicine works inside the body.

This is very simple to understand. Imagine that your liver is the main factory that makes cholesterol. 75% of the cholesterol our body needs is produced by this liver. The rest comes from the food we eat.

So, for this cholesterol-making factory to work, it needs an essential worker. That's an enzyme called HMG-CoA reductase. It's like needing a master mechanic to build a car.

Statins do a very subtle job. It's like a security guard at the gate of a factory. Statins stop the HMG-CoA reductase enzyme from entering the factory. That is, they block it. What happens then? Because the main "worker" that makes cholesterol is gone, the liver's cholesterol production is greatly reduced. This is how statins control the cholesterol levels in your blood.

Why do we need these statins?

The main reason is to reduce the risk of heart attack and stroke.

Cholesterol is essential for our bodies to make vitamin D, hormones, and acids that help digest food. But the problem is, too much cholesterol builds up in the blood.

As I mentioned earlier, this extra cholesterol starts to build up inside the blood vessels. We call this atherosclerosis. Over time, these deposits (plaque) cause the blood vessels to narrow. Then there is less room for the blood to flow. It's like a traffic jam on a busy road.

The situation can be even worse. Sometimes, the cholesterol deposits that have built up inside those blood vessels can become unstable and suddenly burst. If a blood clot forms there, it can completely block the blood vessel. If this blockage occurs in an artery that supplies blood to the heart, it causes a heart attack . If it occurs in an artery that supplies blood to the brain, it causes a stroke . Statins lower cholesterol and protect us from these serious conditions.

What types of statins are available on the market?

There are several types of statins. Your doctor will assess your condition and determine the type and dose that is best for you.

In some cases, a statin drug is given in a combination pill with another drug.

• Simvastatin with ezetimibe or niacin
• Atorvastatin with ezetimibe or amlodipine
• Lovastatin with niacin

Who should take statins?

This is a very important question. Statins are not a one-size-fits-all drug. A doctor will prescribe this drug based on your overall risk of developing heart and blood vessel disease.

Typically, statins are recommended for:

• For those who cannot control their cholesterol levels through diet and exercise .
• For some people, due to genetic reasons (genes), that is, hereditary, the body produces more cholesterol than necessary. For those people.
• For those with risk factors for heart disease, such as diabetes, high blood pressure, and tobacco use.

When deciding whether you need statins, your doctor will consider many factors, including your age, gender, and family history. Statins may be prescribed for adults and, in some cases, young children.

Here are some situations in which doctors typically recommend statins:

• For those whose bad cholesterol (LDL) levels are very high, above 190 mg/dL, and cannot be controlled by lifestyle changes.
• People between the ages of 40-75 with diabetes and LDL levels greater than 70 mg/dL.
• For those who have had a previous heart attack, stroke, or peripheral artery disease (PAD).
• For those aged 40-75 years, with LDL levels greater than 70 mg/dL and a high risk of developing heart disease.

Do statins have side effects?

Like any medication, statins can cause side effects. But the important thing is that most people don't experience any side effects. Even if they do, most of them are minor.

However, it is very important that you are aware of this. If you experience any side effects, you should inform your doctor. He or she can then adjust your dosage or switch you to a different statin.

Frequently asked questions about statins

What happens if you stop taking statins suddenly?

This is very dangerous. If you stop taking statins without your doctor's advice, your cholesterol levels will start to rise again. That means your risk of heart attack and stroke will increase again. This is like taking an umbrella off the hook in the rain. The protection provided by the medication will be lost. So do not stop taking the medication for any reason without asking your doctor.

Do statins cause weight gain?

Some studies have found that statins can cause a small amount of weight gain. Another thing is that when some people start taking the medication, because their cholesterol levels are good, they think, "Now I'm fine," and neglect to control their diet and exercise. Even then, they can gain weight. Remember, even if you take statins, it is essential to maintain a healthy lifestyle.

When should I see a doctor while taking this medication?

If you experience any of the following symptoms while taking statins, tell your doctor immediately:

• Unbearable muscle or joint pain
• Weakness
• Fever
• Yellowing of the eyes or skin (Jaundice)
• Dark urine

Are there people who should not take statins?

Yes. Statins are not suitable for some people.

• For pregnant women
• For nursing mothers
• For people with certain severe liver diseases

If you have diabetes, tell your doctor. For someone who is already at risk of developing diabetes, statins may slightly increase that risk. However, because people with diabetes are at a much higher risk of developing heart disease, the benefits of statins far outweigh the small risk. Your doctor is the best person to make this decision.