How Second-Line Statins Slow ASCVD Progression

Untreated, atherosclerotic cardiovascular disease can have serious consequences.

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You might be used to hearing the term “heart disease,” but a more accurate term might be “heart diseases.” That’s because heart disease is actually a category of diseases with many different types. One of those types is atherosclerotic cardiovascular disease, or ASCVD.

What Is ASCVD?

ASCVD gets its name because it stems from atherosclerosis. This refers to plaque buildup in the artery walls that narrows the arteries. Plaque buildup typically occurs when someone has high cholesterol that goes untreated.

“When we think about atherosclerotic heart disease, we're specifically looking at the blood vessels that are supplying blood to the heart muscle,” says Lawrence Phillips, MD, cardiologist at NYU Langone Health. “The reason that's important is because when you have narrowing in those blood vessels, you're at an increased risk of having symptoms like chest pain or shortness of breath.” Furthermore, it increases the risk of a heart attack.

Treating ASCVD

The main treatment for high cholesterol—besides lifestyle changes—is statin therapy. Statins are medications that decrease the amount of cholesterol produced by the liver. They also help the liver remove more cholesterol. As a result, they reduce LDL (“bad”) cholesterol to improve cardiovascular health.

“By taking a statin, we know that it decreases the risk of progression or worsening of atherosclerotic heart disease and decreases your risk of having a heart attack,” says Dr. Phillips.

But sometimes, you may need a second-line statin. This means the first statin you try wasn’t the right fit, so you try an alternate option. Luckily, there are several types of statins that all work in slightly different ways. If one doesn’t help enough (or causes unwanted side effects), you have other options. Learn more about what second-line statins are here.

If your first statin isn’t the best fit, your second-line statin may help slow the progression of ASCVD. Finding the best statin for you and taking it as prescribed could help you reach your target cholesterol levels. This in turn can prevent ASCVD complications like heart attack and stroke.

“When a patient is not able to tolerate one medication and expresses frustration, the first thing to do is to reassure them that this is very common,” says Dr. Phillips. “We have many different options that we can use in medications, both within the statin class and others. [In] the great majority of patients, if we work together, we can reach our target.”