If a blood test reveals that you have high cholesterol levels, the first thing your doctor might recommend is lifestyle changes to lower cholesterol naturally. Many patients are able to improve their cholesterol levels without medication—but some may need more help. This is where medications come in, and the most commonly prescribed medication is statins.
Statins are a class of cholesterol-lowering medications that decrease the amount of cholesterol produced by the body. By lowering LDL (bad) cholesterol levels and raising HDL (good) cholesterol levels, they can help reduce the risk of cardiovascular events, such as a heart attack.
Who Benefits From Statins?
“Individual risk is what plays the most into how we decide whether a person needs a statin, and if they do need a statin, what dose of that statin to use,” says Michelle W. Bloom, MD, cardio-oncologist at Stony Brook Medical Center.
Risk factors that make someone a good candidate for statins include:
Having a previous cardiovascular event, such as a heart attack or stroke
Having a family history of cardiovascular disease
Having high blood pressure
And living an inactive lifestyle.
You can also be given a different dose of a statin depending on your risk factors. “In patients that are a lower risk, those are patients where we will typically start with a low dose of a statin,” says Dr. Bloom. Those with a higher risk, on the other hand, may benefit from a high-dose statin.
Alternatives to Statins to Lower Cholesterol
Sometimes, statins aren’t the best option for a patient. “In patients that either cannot tolerate a statin, or in patients [who] still need to lower their cholesterol further [despite a high dose of statins], there are newer medications called PCSK9 inhibitors,” says Dr. Bloom.
PCSK9 lower cholesterol by switching off a protein in the liver. It can be used in combination with, or instead of, a statin. Instead of a pill, PCSK9 inhibitors are administered via injection, which is given every few weeks (depending on the type).
Other alternatives to statins include resins and lipid-lowering therapies. Learn more about medications to treat high cholesterol here.
“Millions and millions of patients take statins and you would never know, and the reason why is because they are generally so well tolerated, you're not going to run into any major side effects,” says Dr. Bloom. “If you do, you can always talk to your doctor about it, and things can be adjusted.”