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Q: When are statins effective? And what are the side effects?
Recently (November of 2013), the American Heart Association and American College of Cardiology published the new national guidelines on the treatment of blood cholesterol to reduce the risk of atherosclerotic cardiovascular disease (ASCVD) in adults. They identified four groups at risk for ASCVD events – heart attack, stroke, and death – who warrant treatment with a statin:
- Diagnosis of ASCVD (primarily coronary artery disease or stroke)
- LDL cholesterol > 190 mg/dl
- Diabetes with LDL >70 mg/dl
- Estimated 10 year risk of having a heart attack or stroke >7.5%
These groups have demonstrated major benefits from statins to the extent that the benefits outweigh the risks. But it is important to understand the side effects. For a minority of patients, these may include muscle aches and pains and a very small increased risk of diabetes in individuals already at risk. Again, in individuals who belong to one of the four benefit groups, the number of heart attacks and strokes that are prevented is much greater than the incidence of side effects with statins.
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Michael Shapiro, D.O., is the medical director of the Heart Disease Prevention program at the OHSU Knight Cardiovascular Institute and is a board certified cardiologist with sub-specialty board certifications in Lipidology (cholesterol) and Cardiovascular Computed Tomography (CT).