If your doctor has concerns about your cholesterol levels, you may be familiar with statins. This is a class of medications that can help reduce your body’s cholesterol production, lowering your risk of heart attack or stroke.
However, up to 30% of adults in the United States have some degree of statin intolerance, according to research published in the “Journal of Clinical Lipidology.” Possible signs or symptoms of statin intolerance are muscle aches and cramps, fatigue, weakness, elevated liver enzymes and the onset of diabetes or impaired glucose tolerance.
As a result, nearly one-third of patients (29%) discontinue their statin within the first year, according to findings published in the “American Journal of Cardiology.” Unfortunately, patients with statin intolerance are at an increased risk of cardiovascular disease, including higher rates of coronary heart disease and recurrent heart attack.
Lowering Bad Cholesterol
A diagnosis of high cholesterol involves measuring low-density lipoprotein (LDL) cholesterol, which is commonly referred to as “bad” cholesterol because it leads to the accumulation of plaque in your arteries. Plaque reduces your blood flow, which can cause damage to your cardiovascular system.
Bloodwork is the best indicator of your cholesterol levels, since you may not experience any symptoms of high cholesterol until you already have damage and buildup in your arteries.
To help create your treatment plan, talk to your doctor about your medical history, including whether you’ve had a heart attack or any heart procedures, such as a stent placement or bypass surgery. You’ll also review current medications, recent lab results and notes on any symptoms you may be experiencing.
Your doctor is likely to recommend a series of steps to reduce your cholesterol. Some common recommendations include a healthy diet low in saturated and trans fats and high in fiber, especially fruits, vegetables and whole grains.
It you’re not already getting regular physical activity, your doctor will likely encourage you to get at least 30 minutes of exercise daily, find ways to include more movement in your everyday lifestyle and, if necessary, work toward shedding extra weight.
Lifestyle changes can help but may not make a big enough impact to reduce cholesterol to a recommended level. In those cases, doctors rely on cholesterol-lowering medications such as statins. Statins can be highly effective at reducing bad cholesterol, making them a powerful tool to reduce the risks associated with heart disease.
When Statins Are Intolerable or Aren’t Enough
For a variety of reasons, including intolerance to the medication, other health conditions or interactions with other medications, statins may not be the right choice for everyone.
“While statins remain the gold standard for cholesterol lowering, I often see patients who either can’t or won’t take a statin, as well as patients who require further LDL cholesterol reduction,” said Guy L. Mintz, Director of Cardiovascular Health & Lipidolology at Northwell Health System. “For those patients, I prescribe non-statin medications, such as NEXLETOL (an oral prescription medication with the cholesterol lowering agent bempedoic acid) and NEXLIZET (a combination of cholesterol-lowering medicines bempedoic acid and ezetimibe). I am comfortable using NEXLETOL and NEXLIZET, along with a healthy diet and exercise, to reduce LDL cholesterol in adults with high blood cholesterol levels and to reduce risk of heart events. Non-statins are another important therapeutic tool in our lipid lowering toolbox.”
