Millions of Americans take these risk-reducing drugs for high cholesterol—here's a closer look at how they work.
In 2016, physicians in the U.S. prescribed more than 2.9 billion medications. The second largest category of most frequently prescribed drugs were antihyperlipidemic agents, a drug class that includes statins. Lipitor, the most popular brand-name statin medication, topped the list of 10 most commonly prescribed drugs in 2019.
We hear a lot about statin medications, and millions of people get prescriptions for them every year, but what exactly are statins, who should be taking them, and why do doctors prescribe them? Here, we break down the basics for you.
Statins are the most common medication prescribed to help lower bad cholesterol (LDL) and triglycerides and to increase good cholesterol (HDL) in the bloodstream. These medications are often prescribed in combination with a healthy diet and exercise, and are the only cholesterol-lowering medications that have been shown to reduce the risk of heart attack and stroke, according to the American Heart Association.
Statins, also known as HMG-CoA reductase inhibitors, work by blocking an enzyme in the liver which disrupts the production of LDL (bad) cholesterol and reduces the amount of LDL released into the blood. They can also raise HDL (good) cholesterol levels in the body, which makes them an effective tool for patients who need more than just diet and exercise to control their cholesterol levels.
The American College of Cardiology and the American Heart Association provide guidelines for who should use statins and how physicians should prescribe statin therapy. Below are their recommendations for four age groups. If you are pregnant or have active or chronic liver disease, you should not take statins.
Patients 20-75 years with LDL levels greater than 190 mg/dl: high-intensity statin
Patients age 40-75 with type 2 diabetes: moderate-intensity statin, or high-intensity if there are additional risk factors
Patients over 75 years of age should discuss risks and have a clinical assessment to determine the appropriate statin therapy
Patients age 40-75 whose LDL levels are between 70 and 189, and who do not have diabetes: moderate-intensity statin and have a discussion with your doctor about other risk factors; based on these factors your doctor may recommend a high-intensity statin
There are several types of prescription statins, grouped by low-, moderate-, and high-intensity based on their ability to lower LDL cholesterol. For each one, a higher or lower dosage changes its intensity level.
Atorvastatin (generic Lipitor) – high/moderate
Rosuvastatin (generic Crestor) – high/moderate
Fluvastatin (generic Lescol, Lescol XL) – moderate/low
Pravastatin (generic Pravachol) – moderate/low
Simvastatin (generic Zocor) – moderate/low
Lovastatin (generic Mevacor) – moderate/low
Pitavastatin (generic Livalo) – moderate/low
Atorvastatin and simvastatin statins are also available in many combination prescriptions, such as simvastatin and ezetimibe (generic Vytorin) and amlodipine and atorvastatin (generic Caduet). These drugs treat conditions like hypertension and high cholesterol simultaneously.
Since there are many statins to choose from (most of them generic), your doctor can help you decide which is right for you based on potential drug interactions, side effects, and risk factors such as a history of cardiovascular disease, type 2 diabetes, or hypertension.
As you and your doctor establish or revise your treatment plan, check to see if your prescription is available for less with Blink Health. If you’re running low on refills, Blink also offers online doctor consults for $5. You can renew your prescription from the convenience of home and get your refills delivered directly to your door.
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