A cardiologist busts the biggest misconceptions and shares why statins are safer than you think.
Colleen Travers,Feb 6, 2020 • 4 min read
Cardiovascular disease (CVD) is the leading cause of death in the U.S., with coronary artery disease being the most common type of heart disease, which happens when fatty deposits build up in the walls of the arteries that surround the heart. That plaque buildup is primarily caused by too much cholesterol in the blood. For reference, among the 81 million people in the U.S. dealing with CVD approximately 17 million of those are dealing with coronary artery disease.
These numbers aren’t meant to scare you, but they do show what a serious issue high cholesterol (and its link to CVD) can become if not properly treated. This is where statins come in. “Statins target your natural pathway of making cholesterol,” explains Pilar Stevens-Haynes, MD, a cardiologist at Mount Sinai South Nassau in Oceanside, NY. “The drug acts as a competitive inhibitor of a natural enzyme that we all have, called HMG-CoA reductase [which is found in the liver and responsible for producing cholesterol]. Statins prevent the rate-limiting step [the slowest step] of how your body makes cholesterol.”
Whether taken alone or in combination with other cholesterol medications, statins—including atorvastatin, simvastatin, lovastatin, rosuvastatin, and pravastatin—can be highly effective. Not only will they lower LDL “bad” cholesterol levels by reducing how much cholesterol the liver is making, research published in Circulation found that statins also can reduce deaths related to coronary artery disease by 28% in men. Despite these benefits, there are many fears tied to statins, and this could lead to medication non-adherence (aka, you don’t take your prescription as directed) or choosing to stop taking a statin before you should or without discussing it with their doctor.
Here, Dr. Stevens-Haynes debunks the three biggest statin myths she regularly hears, so you can follow your heart-healthy therapy with peace of mind:
Myth #1: Statins Cause Liver Failure
“While some data suggest statins affect the liver, chances of a patient experiencing liver failure from a statin are very, very small,” says Dr. Stevens-Haynes. Statins may cause an increase in the level of enzymes in the liver, which can lead to inflammation. Again, the increase is typically so mild there are no negative impacts, but in the case of a substantial increase, the typical next course of action would be to try a different statin, not stop taking them all together.
Liver enzymes are monitored through regular blood tests. “I think that is where the fear may derive with many patients, because we do monitor liver enzyme levels,” says Dr. Stevens-Haynes. “In my practice, I have never seen a case of liver failure resulting from someone taking a statin.”
Myth #2: You Can’t Eat Grapefruit While on a Statin
As with everything in life, moderation is key here. The concern is that the citrus contains a chemical that has been found to hinder the body’s ability to metabolize certain statins. That could result in a higher level of the medication getting absorbed into the bloodstream, causing possible side effects like joint pain. But for most patients an occasional or moderate amount of grapefruit or grapefruit juice is completely fine, even if it happens daily. “Consuming grapefruit is not a contraindication, and you don’t have to give up your morning grapefruit if you don’t want to,” says Dr. Stevens-Haynes.
Cases where grapefruit and statins may interact are for specific statin drugs like atorvastatin (Lipitor), lovastatin, and simvastatin (Zocor), and even then it’s entirely dependent on the dosage. Talk to your doctor about your specific statin therapy if you have any concerns about your grapefruit consumption mixing with your meds.
Myth #3: Once You Start a Statin, You’ll Take it Forever
“A big part of the population may not need to take a statin indefinitely,” says Dr. Stevens-Haynes. “Some patients may also go back and forth between being on one for a period of time, and not being on one.” What this often comes down to is your doctor determining your actual risk for developing heart disease. “Depending on the patient, we may be able to tolerate a higher cholesterol level if their overall risk of heart disease is lower.” This means it’s important to keep up your doctor’s visits, so your provider can monitor your cholesterol (at least twice a year, sometimes more) and tweak your treatment plan appropriately.
If you’ve recently been prescribed a statin, check to see if you can get medication for less with Blink Health.