statins

Muscle problems caused by statins: Can a genetic test reveal your risk?

One of the most dreaded side effects of cholesterol-lowering statins is myopathy, or severe muscle pains. A new test on the market can evaluate whether you’re genetically susceptible to myopathy. But true statin-induced myopathy is uncommon, and most muscle pain a person experiences while taking a statin likely isn’t caused by the statin. So, is this test really worth the (significant) price?

Do statins interfere with the flu vaccine?

John Ross, MD, FIDSA

Contributing Editor

The statin drugs are very effective at reducing LDL (“bad”) cholesterol and may also reduce inflammation throughout the body. Both of these properties can reduce the risk of cardiovascular problems. At the same time, research — some of it conflicting — suggests that statins may also affect the body’s immune system. In particular, they may dampen the response to vaccines.

Studies support broader use of cholesterol-lowering statins

The latest guidelines used to determine who should take a cholesterol-lowering statin to prevent heart disease appear to be more accurate and cost-efficient than the previous guidelines. That’s according to two studies led by Harvard researchers, both published in this week’s Journal of the American Medical Association. The new guidelines, published in 2013 by the American College of Cardiology and the American Heart Association, recommend a statin for men and women between the ages of 40 and 75 who have a 7.5% or higher risk of having a heart attack or stroke over the next 10 years. The JAMA studies show that the new guidelines provide a more accurate assessment of who would benefit from a statin and who wouldn’t, and are more cost-effective than the older guidelines. Statins aren’t a cure-all. Eating a healthier diet, exercising often, and not smoking will go a long way to preventing heart attack and stroke.

Cholesterol guidelines update: controversy over heart risk calculator

Howard LeWine, M.D.

Chief Medical Editor, Harvard Health Publishing

It’s been a topsy-turvy few days in the world of heart health and disease. Last week, the American Heart Association and American College of Cardiology released new guidelines that upended previous recommendations for who should take a cholesterol-lowering statin. A few days later, two Harvard physicians challenged the accuracy of the calculator included in the guidelines, saying it would cause many people to unnecessarily take a statin. The story made headlines in The New York Times and prompted a closed-door review by the guidelines committee. The controversy over the calculator should serve to improve this tool. Adoption of the guidelines should help prevent more heart attacks, strokes, and premature deaths. It’s important to keep in mind that guidelines are just that—information to guide a decision, not to mandate it. The best approach is to talk about what’s best for you with a trusted physician.

Cholesterol and statins: it’s no longer just about the numbers

Reena Pande, M.D.

Instructor in Medicine, Harvard Medical School

Updated cholesterol guidelines released yesterday by the American Heart Association and American College of Cardiology aim to prevent more heart attacks and strokes than ever before. How? By increasing the number of Americans who take a cholesterol-lowering statin. The previous guidelines, published in 2002, focused mainly on “the numbers”—starting cholesterol levels and post-treatment levels. The new guidelines focus instead on an individual’s risk of having a heart attack or stroke. The higher the risk, the greater the potential benefit from a statin. A statin is now recommended for anyone who has cardiovascular disease, anyone with a very high level of harmful LDL cholesterol, anyone with diabetes between the ages of 40 and 75 years, and anyone with a greater than 7.5% chance of having a heart attack or stroke or developing other form of cardiovascular disease in the next 10 years.