Heart 411

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Statins are the best-selling cardiovascular drugs in the world, and experts estimate that 20 million Americans currently take them. Their development represents one of our greatest achievements in the fight against coronary heart disease. Acting at the level of the liver, statins reduce LDL (bad) cholesterol, and since their release in 1987, they’ve saved many lives.

Although we have solid scientific proof of statin benefits, lately these medicines have been the subject of intense controversy and clashes between experts. Let’s explore the battleground.

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Myth: Statins don’t work in women

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Pointing out that the majority of statin studies focus primarily on men, some claim that we don’t have sufficient evidence to support statin use in women.  Critics are correct in their assertion that statin studies enrolled more men than women. But we have data on the impact of statins in tens of thousands of women.

And when this data is analyzed, we find that statins do work in women. The drugs reduce their risks of heart attack, stroke and death. As one expert concluded, “…with respect to statin therapy, what is good for the gander is good for the goose.”

Myth: You don’t need a statin because you can always lower your LDL cholesterol with diet and lifestyle alone

When it comes to lowering LDL cholesterol and either treating or preventing coronary heart disease, we always prescribe a heart-healthy lifestyle that includes a Mediterranean-style diet and exercise. You can lower LDL cholesterol with calorie control and the right foods (limit saturated fat and dietary cholesterol while favoring fruits, vegetables, whole grain offerings and “good” fats). But because most cholesterol is manufactured in the liver, it is difficult to lower your LDL cholesterol by more than 20 percent through changes in diet alone.

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By all means pay close attention to diet and exercise as a means to control your LDL and raise your HDL cholesterol. But if LDL remains elevated despite your best efforts, don’t be afraid to try a statin.