Help Reduce Cardiovascular Events by Encouraging Statin Use
The first statin medication, lovastatin, was initially approved in 19871. Since then, we’ve witnessed the development of other statin medications and decades of research providing efficacy and safety. There are now many different statin medications, most of which are available as a generic at a low cost to patients.
Statin medications decrease cholesterol and are indicated to reduce both primary and secondary risk of cardiovascular events (including heart attack and stroke). Over the years, however, statin medications have built up a reputation of hesitation in the patient community, with concerns about muscle pain and pill burden overriding the benefits of cardiovascular prevention and risk reduction.
At LifeWise, we work directly with providers and patients to better understand statin hesitancy. Here are a few common statin use concerns from our patient-facing teams:
| Do statins always cause muscle pain? | Statin medications only cause muscle pain in approximately 10% of patients2.
Using certain medications in combination can increase the risk of muscle-related injury because of drug interactions (fibrates) or reduced metabolism of the statin medication. |
| If my patient has an intolerance to one statin, could they tolerate a different statin without any issues? | Each statin medication has different characteristics. Some statins are lipophilic or hydrophilic, and certain statins are metabolized differently than others.
The American College of Cardiology has a statin intolerance tool to help navigate next steps after an intolerance. This tool can also support clinician-patient discussions about balancing the benefits and risks of reinitiating a statin after a potential intolerance or side effect. It can help highlight how intolerance to one statin does not necessarily mean that they will have intolerance to all statins, and that the characteristics of each statin can impact how well tolerated they are. |
| Do statin medications cause an increased risk of dementia? | Current research shows that the benefits of statins outweigh the risks for patients who need them. In a large-volume study published by the Journal of the American College of Cardiology, statin users were not more likely than non-users to have dementia (or other changes in cognition and memory). |
| Why treat patients with a statin when the true benefit may appear to be small3? | Large scale trials have demonstrated atherosclerotic cardiovascular disease (ASCVD) risk reduction with statin initiation that have outweighed the risks when compared to placebo. These studies have shown a statistically significant reduction in cardiovascular events, as well as associated reduction in total cost of care and improvement in long-term outcomes. |
Please take the time to review your patients for appropriateness of statin prescribing. If you have a patient who has been resistant to statin prescribing in the past, consider taking a few minutes to address some of the common questions about statin medications and connect that patient to resources that support their effectiveness in cardiovascular event prevention.
References:
1 Hajar R. Statins: past and present. Heart Views. 2011 Jul;12(3):121-7. doi: 10.4103/1995-705X.95070. PMID: 22567201; PMCID: PMC3345145.
2Arteriosclerosis, Thrombosis, and Vascular Biology. Statin Safety and Associated Adverse Events: A Scientific Statement From the American Heart Association. Volume 39, Number 2. Read more.
3Arnett, D, Blumenthal, R, Albert, M. et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. JACC. 2019 Sep, 74 (10) e177–e232. Read more.