What is Cholesterol?
Cholesterol is a waxy, fat-like substance that is made by your liver to build healthy body cells, make certain hormones, and Vitamin D. Too much cholesterol can be harmful and lead to plaque formation in your body. Plaque is a sticky buildup that contains fatty deposits that can attach to blood vessel walls such as arteries. This is also known as atherosclerosis. Over time, plaque can narrow and clog blood vessels, which can lead to less blood flow to your heart and other organs. Blocking blood flow to the heart can cause chest pain or heart attack. It can also increase the chance of other heart diseases such as stroke and other heart problems.
Your body is made up of two main types of cholesterol: LDL (low-density lipoproteins) and HDL (high-density lipoproteins).
High LDL levels are often referred to as “bad cholesterol”, because it can lead to plaque buildup in the arteries, which increases your risk of heart disease and stroke. On the other hand, high HDL levels are considered “good cholesterol”. HDL helps to remove LDL from your body and reduces your risk of both heart disease and stroke.
Who may need to take cholesterol-lowering medicine?
To lower your chance of having heart problems, it is important to work closely with your doctor to control your cholesterol, blood sugar, and blood pressure by keeping a healthy lifestyle. However, this is sometimes not enough because as plaque builds up in the body, it can take a long time to remove them. Studies showed that the best way to dissolve and prevent plaque buildup in some people is to combine healthy habits with cholesterol medicine. People who benefit from cholesterol-lowering medicine include:
- Anyone with a history of heart disease, stroke, or blood flow problems, because they may already have narrowed arteries from too much plaque.
- Most adults aged 40 to 75 years old who have diabetes – chronic high blood sugar levels can damage blood vessels, making it easier for plaque to build up faster. That’s why people with diabetes are nearly twice as likely to have heart disease and stroke as people without diabetes, even if their cholesterol levels are normal.
- Most adults aged 40-75 years old whom their doctor assessed to have high risk of developing heart disease or stroke in the future.
- Anyone with high blood LDL cholesterol levels (LDL-C greater than or equal to 190mg/DL).
Which cholesterol-lowering medicine to take?
- Statins are a class of drugs commonly used to help lower “bad cholesterol” levels and reduce the risk of heart disease and stroke.
- It’s important to know that a statin drug only works if you take it regularly and don’t miss any doses.
- Statins have been used widely for more than 35 years.
- The most common side effect with statins is mild muscle aches or weakness. Over the years, statins have been safely used by many people without major harmful side-effects.
- Statins do not cause cancer or memory problems.
- It is very rare for statins to cause serious liver damage (less than 0.001%).
- Tell your doctor if you feel very tired or have muscle pain that does not go away.
- Your doctor may lower your dose or switch to a different statin drug that might not cause these side effects.
Common Statin Medications:
Atorvastatin (Lipitor)
Simvastatin (Zocor)
Rosuvastatin (Crestor)
Lovastatin (Mevacor, Altoprev)
Pravastatin (Pravachol)
Fluvastatin (Lescol, Lescol XL)
Pitavastatin (Livalo)
By: Vincent Luy, PharmD; CCHP Clinical Program Pharmacist
Disclaimer: This article is for informational purposes only and is not intended to substitute professional medical advice, diagnoses, or treatment. Always seek advice from your physicians or other qualified health provider
References:
- Centers for Disease Control and Prevention (CDC). May 2024. “Your Heart and Diabetes”.
- American Diabetes Association Professional Practice Committee. 2024. “Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2024”.
- American College of Cardiology (ACC)/American Heart Association (AHA). 2019. “ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease.”
- Foundation of the National Lipid Association (NLA). “Who would benefit from statin therapy.
- American Heart Association (AHA). ““What is Cholesterol?”
- Heart Foundation. “Diabetes and Heart Disease.”
- American College of Cardiology (ACC). 2020. “Management of Stable Coronary Artery Disease in Patients with Diabetes Mellitus.”
- American Heart Association Multi-Society Guideline. 2019. Guideline on the Management of Blood Cholesterol