The Grapevine

Cholesterol-Lowering Medication Works Differently On Different People

There are many changes one can make to their diet and lifestyle to reduce cholesterol and improve heart health. But in some cases, doctors may also choose to prescribe medication — known as statin — to regulate cholesterol levels.

In simple terms, these drugs do their job by targeting a liver enzyme and reducing the production of cholesterol in your blood. For certain people, statins are estimated to help reduce the risk of various heart problems by 25 to 40 percent.

Since the turn of the millennium, the use of statins by adults in the United States has experienced a significant rise. But there has been much debate on whether their benefits outweigh the risks. In a new study, experts discuss the subject and suggest that current medical guidelines should do more to adequately reflect their potential health effects which tend to vary based on factors such as age, sex, and statin type.

For example, the study supported statin use for only 15 to 20 percent of older adults — this is nearly half the figure suggested by current medical guidelines, which is somewhere around 30 to 40 percent.

"The elderly do not benefit as much as previous studies might have thought," said senior author Milo Puhan, a physician and epidemiologist at the University of Zurich. "One size doesn't fit it all. That's a very important message."

Consuming grape juice is not advised while you are on statins since the mix of these two can trigger some harmful effects on health. But otherwise, in most cases, the risks and side effects of taking statins are not too severe, involving nothing more than muscle aches and dizziness.

"Statins are very safe. For patients with prior heart attacks or strokes, statins lead to overwhelming cardiovascular benefit," said Dr. Michael Blaha, an associate professor, and director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.

"However, in primary prevention, the margin of benefit of these drugs can be small," he cautioned. "In lower risk primary prevention patients, statins may not lead to a net benefit."

This means statins work best for those who are in the high-risk category, including individuals who have experienced a heart attack in the past. Doctors use tools to predict your likelihood of suffering a heart attack over the next decade or so.

Patient preferences are taken into account to determine whether the benefits are worth the risks. Factors such as race, family history, smoking habit, blood pressure, diabetes, etc. also need to be considered.

In other words, it is crucial to weigh the pros and cons with your doctor before starting statin therapy. As much as guidelines may need to improve, they can only do so much to account for individual circumstances.