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You know high cholesterol is not a good thing. But just how dangerous it can be was driven home in a 2019 study in the Journal of the American Heart Association. Scientists following 3,875 adults for 35 years found that those with long exposure to high LDL cholesterol — often called “bad” cholesterol — had five times the rate of cardiovascular disease and four times the mortality of individuals with optimal LDL levels.
While the best way to lower LDL, which clogs arteries and is a significant cause of heart attack and stroke, is through diet and exercise, statins are the accepted second line of defense. And with good reason, says Nihar Desai, M.D., associate professor of medicine at the Yale School of Medicine in New Haven, Connecticut. “The data to support their use is overwhelming,” he says. “They’re highly effective at reducing the risk of cardiac disease and cardiac events like a heart attack.”
Yet only about 60 percent of people with coronary artery disease and peripheral artery disease, or who have had a stroke, are being prescribed the recommended statin therapy, according to a 2020 study in JAMA Network Open. And only slightly more than half (or 47 million) the adults who could benefit from cholesterol medication are currently taking it, according to the Centers for Disease Control and Prevention.
Some of the hesitation comes from concerns about potential side effects, which many doctors say have been overblown. Here’s a closer look at common concerns with statins like atorvastatin (Lipitor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor) — and when you need to worry, or not.
CONCERN: Statins can have a lot of side effects, including muscle pain, digestive problems and liver damage.
REALITY: Patients who take statins are often told by their doctors to report back if they have muscle problems, which appear in about 5 percent of patients. But awareness of the potential for this symptom and others, like digestive problems, can have its own effect, says Roger S. Blumenthal, M.D., professor of medicine at the Johns Hopkins University School of Medicine and director of the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease in Baltimore, who explains that what may be at play is a kind of twist on the placebo effect, called the nocebo effect.
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