Peter Wehrwein

Statin use is up, cholesterol levels are down: Are Americans’ hearts benefiting?

Baseball fans have the Baseball Prospectus annual. Political junkies can get their fix from Nate Silver’s 538 blog.

For those of us with geeky interest in health and medicine statistics, graphs, and charts, the Health, United States, 2010 report from the National Center for Health Statistics is that kind of treat. The 41 charts and graphs and 148 trend tables in the 2010 report (it’s dated 2010 but was released earlier this year) could keep me happily occupied for hours.

One graph that really caught my eye shows the percentage of Americans that take a statin. Statins are prescribed mainly to lower “bad” LDL cholesterol, but they may have other benefits, too. The statins include atorvastatin (sold as Lipitor), rosuvastatin (sold as Crestor), and simvastatin (sold as Zocor but also available as a generic ).

Here is the graph I am talking about:

Many Americans take statins. No surprise there. But half of men, ages to 65 to 74, and 39% of women, ages 75 and older—that’s pretty stunning.

Combine the 45+ age groups and both genders, and it comes out that one in four Americans, ages 45 and older, are taking a statin. There are roughly 127 million Americans over age 45. Presuming that there hasn’t been a big drop off in use since 2005-2008 (the latest period for the government health survey upon which these statistics are based) almost 32 million Americans take a statin. That’s the equivalent of the entire populations of Florida and Illinois combined.

Here is another chart from Health, United States, 2010 that suggests that all those statins may be having the intended effect:

The trend lines for men and women between 20 and 44 aren’t so hot. But for other age groups, cholesterol levels are headed in the right direction. Sure, changes in diet may be a factor. But widespread use of statins has undoubtedly helped with the downward slope.

Now let’s cue up a couple of graphs that show the trends in death rates from heart disease (and other causes).

First, the one that shows the death rates for Americans 45 to 64:

And now the one for Americans ages 65 and over:

Of course, heart disease death rates have fallen for a whole host of reasons, some of them overlapping. Fewer Americans smoke. Treatment of heart disease has improved. Emergency treatment of heart attacks is swifter. The American diet is better for the heart than it used to be, at least in some respects. But lower cholesterol levels also belong on the list of positive influences and along with them, statins.
It’s hard to beat a statin if the goal is lowering your LDL. If you take the pills as prescribed, LDL levels typically decrease by about 30%.

But there are alternatives. My colleague, Pat Skerrett, editor of the Harvard Heart Letter, has written a great piece about the 11 foods that lower your cholesterol. And I wrote an article for the Health Letter a few years ago about ways to manage common problems, such as cholesterol, without taking medication.

Comments:

  1. Anonymous

    Today, we faced with this problem of our children due to inactive life and fast food, I think we have to control this first to prevent LDL and further health risks.

  2. Anonymous

    great post!

  3. mathew

    Thanks..,Good article..,my mother in-laws diet and exercice to lower cholesterol..but was unsuccessful, so doctors gave her a statin …, magic .., within one month,her cholesterol decreased sharply..,I believe that…

    [URL removed by moderator]

  4. Celiacs Disease

    A good diet can benefit many health issues. I find having Celiacs disease and being on a gluten free diet also help to keep my cholesterol well within the normal range.

    [URL removed by moderator]

  5. jdabb

    The statistics do show the decline in death rates for heart related disease. Whether or not there is a correlation between the decreased rate and statin use cannot be directly confirmed because of the many variables in lifestyle and diet that cannot be controlled. Please post your list of healthy foods which can lower cholesteral.

  6. Magazin Intim

    The most notable side effect for statin type therapy is that it interferes with CoQ10. This is an enzyme in the biochemical pathway for energy production in the cell, every cell in your body. That means every cell in your body will begin to have difficulty in energy production on a cellular level. Look up rhabdomyolysis.

  7. Richard Hanisits

    The following comment is based on hindsight: After I was put on Lipitor, I began to experience short term memory problems. I cannot tell you how many pots I burned on the stove because I forgot I was cooking something on the stove. Then one day while I was driving on a rural road in Michigan I had a frightening experience which I now identify as a bout of global amnesia. No evidence of a stroke. I have stopped taking my statim to the great alarm of my cardiologist I understand that when Lipitor was trial tested some subjects exerienced memory problems and a few had a bout of global amnesia. Extrapolate to the millions who are now taking Lipitor.

  8. PRiORA

    The reasoning in this article is sound, and it is presented in a way that acknowledges the difficulty of pinpointing causes and effects in relation to diseases for which multiple and sometimes overlapping risk factors influence both onset and treatment outcomes. Much appreciated amidst the considerable alarmism and conspiracy theory regarding the use of statin drugs.

  9. G

    I don’t think I’d be giving the statins the credit either. Researchers found that statins activate a gene signal in muscles called Atrogin-1. When this gene activates, it targets key muscle proteins for destruction. The activation of this gene drives the process of muscle wasting. It is induced in cardiac muscle in failing hearts. Since this initial discovery, Atrogin-1 has been found in every existing model of muscle wasting. Why on earth would any person want this gene activated by a drug?

  10. Deborah

    With statin use, Lipitor in particular, my husband has also been experiencing low testosterone levels, which have led to ED problems. He also has become moody and his short-term memory isn’t what it used to be, which has led me to fear Alzheimer’s.

  11. Jane

    Without any statistical dissection of the various factors lowering deaths from heart disease, there is no valid reason to pick statins as a significant cause of the decline, which I make out to be around 25% of the 65 and over population – almost exactly the same percentage as the rise in deaths from Alzheimer’s Disease in that same population. Could that also be attributed to statins?
    The dramatic decline in the use of hormone replacement therapy for post-menopausal women, the significant improvement in air quality over the period, and the promotion of exercise as a general health measure probably have far more to do with the improvement of the heart disease figures.

  12. Anderson Giraldo

    Totally agree with Thallab… Liver disease, muscle damage, even the beginnings of dementia and alzheimer’s for some people….many doctors do not even know it, but statins lower your body’s Coq10 levels, which can contribute to so many other problems…. Somehow this blog felt biased, or may be just too short, so it may mislead some people out there into thiinking that statins are great…..

  13. Thallab

    I am not a pro-chemicals. Isn’t s statin a chemical component. There must be a side-effect.

    • Robert T. Foy, DC

      The most notable side effect for statin type therapy is that it interferes with CoQ10. This is an enzyme in the biochemical pathway for energy production in the cell, every cell in your body. That means every cell in your body will begin to have difficulty in energy production on a cellular level. Look up rhabdomyolysis.