Having high cholesterol, or hyperlipidemia, isn’t a disease in itself: It’s a risk factor for other serious diseases (such as heart disease) and cardiovascular problems (such as a heart attack). That’s because excess cholesterol deposits on artery walls and forms hard plaque, which narrows the arteries.
There are many lifestyle changes that can lower cholesterol naturally, but if someone is at a high risk of a heart attack or stroke, or lifestyle changes don’t lower cholesterol enough, their doctor may prescribe medications to lower cholesterol, such as statins.
“Statins as a class are so beneficial for lowering cardiovascular risk,” says Michelle W. Bloom, MD, cardio-oncologist at Stony Brook Medical Center. These medications lower cholesterol by reducing the amount produced by the liver.
“There is very clearly a role for using statins, both in the realm of primary prevention, as well as in the realm of secondary prevention,” says Dr. Bloom.
Primary Prevention of Cardiovascular Disease
“Primary prevention means preventing something from occurring for the first time,” says Dr. Bloom. In this case, it means preventing someone from developing heart disease, heart failure, or atrial fibrillation.
Doctors may prescribe statins as primary prevention for a patient with many risk factors for these heart diseases, such as:
Having high cholesterol
Having high blood pressure
Being over age 40
Or being physically inactive.
“In patients that have a high risk of developing a problem with the heart, such as a heart attack [or] a stroke, statins decrease an individual patient's risk by lowering inflammation and by lowering cholesterol levels,” says Dr. Bloom.
Secondary Prevention of Cardiovascular Disease
“Secondary prevention is the prevention that we use for a second or a third or a subsequent event,” says Dr. Bloom. “We know that there's a very clear role in using statins for patients who have already had a heart attack, already had a stroke, already developed heart failure from blockages in the arteries and a weakening of the heart.”
In other words, it’s not too late to get the benefits from statins once you’ve already been diagnosed with a heart problem: They play a role in both treatment and prevention. “We can decrease the risk of that patient developing another problem with the heart,” says Dr. Bloom.
While statins and other medications can make a big difference in an individual’s risk factor profile, lifestyle changes for a healthy heart are still recommended. Medications can only do so much to improve your overall health.
“We can give a patient any medication in the world, but if a person isn't empowered to change their lifestyle, then we're not doing the best we can for that individual patient to decrease the risk of a cardiovascular event,” says Dr. Bloom.