Statins: wonder drugs for heart disease?

Statins have been hailed as the wonder drugs against heart disease. Find out how they help and who should take them.
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Statins have been hailed as the wonder drugs against heart disease.

Heart disease is the biggest single cause of death in the UK, accounting for 4 in every 10 deaths.

Almost 2.6 million people are affected by heart and circulatory conditions in the UK, with someone dying from a heart attack every six minutes.

What are statins?

Statins are medicines that help lower cholesterol levels in the blood, which is one of the main causes of heart disease and stroke.

There are several different types of statin.

The most commonly used is simvastatin, which is effective for the majority of people who need to take statins.

Another type, rosuvastatin, is a potent statin – which is generally for people who have a family history of high cholesterol.

How do they help?

Cholesterol is a fatty substance made in the liver, and it's important for aiding vital cell functions.

Good cholesterol is known as high-density lipoprotein (HDL), while bad cholesterol is known as low-density lipoprotein (LDL).

Too much bad cholesterol in the blood can lead to a build-up of plaque, a hard deposit like substance, on the inner walls of the arteries – increasing your risk of a blockage and in turn the risk of a heart attack or stroke.

'Statins reduce the amount of cholesterol produced in the body, and they're particularly good at having an effect on bad cholesterol,' says Judy O’Sullivan, a cardiac nurse at the British Heart Foundation.

Several studies have shown that reducing bad cholesterol levels in the blood reduces the risk of heart disease and, in particular, heart attacks.

According to the British Heart Foundation, statins have been shown to:

  • reduce total cholesterol levels by 20 per cent
  • reduce bad cholesterol levels by 30 per cent
  • reduce the risk of heart attack and stroke by 25 per cent.

    Who should take them?

    Statins are prescribed to people who have a high risk of heart disease and those who may already have had a heart attack, stroke or peripheral artery disease.

    Whether or not you're considered at high risk is determined through a health check by your GP, which everyone over the age of 40 is eligible for.

    Your risk level is determined by taking into account a number of factors, including your family history, smoking history, age, sex, blood pressure and cholesterol levels.

    It's possible to have a relatively normal cholesterol level but still be high risk and prescribed statins.

    Typically, there are two causes of high blood cholesterol.

    The most common is due to a combination of factors, such as diet, and presents itself from late 40s onwards.

    The other is genetic in nature and particularly potent. It has a strong association with premature heart disease in those in their 30s and 40s and people can present with high cholesterol levels as early as the teenage years.

    Can anyone take statins?

    Statins are suitable for most people.

    But you shouldn't take them if you have active liver disease or are pregnant.

    There's no age limit on taking statins.

    Are there side-effects?

    Like many drugs, there's always a risk of side-effects when taking statins.

    Among possible side-effects: muscle pain is one that has been particularly reported.

    Other possible side-effects include: diarrhoea, nausea, headache and insomnia – with uncommon side-effects including a rash, vomiting, muscle damage and peripheral neuropathy.

    But the risk of side-effects has, according to many, been overplayed.

    'There are a large number of people taking statins and the majority don’t get side-effects,' says Judy O’Sullivan.

    Why has there been controversy?

    Reports of side-effects and claims by some experts that they are used too widely as a panacea, with patients popping a pill rather than making lifestyle changes, has created an air of controversy around statins.

    But Judy O’Sullivan points out that statins are one of the most trialled drugs on the market.

    'There has been a lot of over-reporting on the side-effects of statins,' says Judy O’Sullivan.

    'The important thing to remember is they can be of huge benefit. Survival rates for heart disease have improved. In particular, the survival rate for those who have already had a heart attack has improved, and statins have played a part in that,' she says.

    What should you avoid while taking statins?

    You can drink alcohol in moderation.

    But grapefruit should be avoided when taking simvastatin because it contains a compound that blocks its breakdown.

    Should you make other lifestyle changes?

    Yes, even when taking statins it's important to make other changes that can help improve your health.

    'Drugs are more effective at reducing blood cholesterol levels. But making lifestyle changes has an additive effect over and above reducing bad cholesterol,' says Professor Tom Sanders, Professor of Nutrition and Dietetics at Kings College, London.

    'You should swap saturated fats for unsaturated fats, such as olive oil, rather than cutting down on fat altogether. Eating things such as Flora and Benecol can help,' he says.

    An antioxidant thought to be beneficial in blocking bad cholesterol is lycopene – which is found in tomatoes. It can also be taken as the daily supplement, Lyc-O-Mato which, and it's available online or from health stores.

    'There's no point in taking statins unless you address other health factors,' says Judy O’Sullivan.

    'You need to eat healthily and exercise. Aerobic exercise is particularly good for increasing good cholesterol levels in your blood,' she says.

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