Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
Tags: statin | cholesterol | risk

Should I Take Statins?

Monday, 29 October 2012 09:01 AM

Question: My doctor has been suggesting I take a statin for high cholesterol, which runs in my family. But I have stubbornly refused because I’m worried about potential side effects. What do you recommend?

Dr. Hibberd’s answer:

Welcome to the club. We all have the same concerns about potential side effects of any medications or supplements. But on the other hand, we really do not want diseases to advance and progress while we try out alternatives that may or may not be effective, or may interact negatively with other medications you may use.

Understand that side effects on statin drugs are far less common than Internet discussions would have you believe. The trick is to have a doctor who selects the right drug or combination for you. This is not just a numbers game, but should involve a risk-factor analysis. There are some people who need aggressive cholesterol management, and others who should never use statins.

Here’s what happens when high cholesterol is left untreated:
• Elevated lipids contribute to blocked arterial vessels, and early treatment will actually reverse this process, as long as the arteries have not calcified and the fatty buildup (plaque) will stabilize.
• You may have just age-related plaques without narrowing or your arteries, and even a small plaque can destabilize and create a sudden unexpected blockage. We know that elevated lipids are associated with unstable plaque and unfortunately no lifestyle or natural remedies will help or change this condition.
• Elevated lipids may take years to pose a health risk for most people, but those with familial lipid disorders may suffer heart attacks as young as 17-18 years of age and sometimes even earlier.
• Elevated lipids attach to arterial walls and can damage the blood vessel linings underneath plaque, creating inflammation that can lead to bloodstream blockages.

The problem is that there is often little or no warning before plaque destabilizes, resulting in inflammation and an acute bleed into the inside lining of the blood vessel wall that suddenly blocks the artery. Once the plaque is there, you are at risk even if you normalize your lipid values.

That’s why plaque regression and stabilization are the keys to good cholesterol management, and that’s why we are aggressive with management. We know that low levels of LDL cholesterol — values of 80 or less — will induce plaque regression, which reduces the likelihood of plaque disruption, inflammation, blockages, and health risks. Unfortunately, no non-drug agents have been proven to work as effectively, or we would be all using them.

Additionally, statins stabilize plaque, and some have a potent antinflammatory effects that provide further protection from the plaque disrupting and blocking our affected arteries.

© HealthDay

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Monday, 29 October 2012 09:01 AM
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