If you take a statin medication to lower unhealthy levels of cholesterol, yet continue to fill your plate with foods that are high in saturated fat, you are still at increased risk for heart disease.

Heart disease kills nearly 600,000 people every year in the United States. That’s one in every four deaths. Every year, about 715,000 Americans suffer a heart attack. Health care services, medications and lost productivity related to heart disease cost the United States over $100 billion annually.

Statins have proven to be effective in warding off heart disease. These drugs work by blocking chemical production in the liver that is necessary in the making of cholesterol. However, getting the most out of these medications usually requires some dietary modification. Research published in JAMA Internal Medicine indicates this often doesn’t happen.

Researchers at the University of California, Los Angeles (UCLA) found that people who took statins in 2009-2010 ate considerably more foods high in saturated fat than those who took the medications 10 years ago. This same effect was not observed in people who did not take statins.

According to researchers, today’s typical statin user is not as focused on reducing caloric intake and losing excess weight and continues to eat whatever he or she wants. Even when they are vigilant about taking their medication (and most are not), their risk for a heart attack or stroke remains high. In a press release, Study author Takehiro Sugiyama said this is because they are not changing their food habits.

“[E]ating more fat, especially saturated fat, will lead to higher cholesterol levels, which will undermine the effect of statins and may lead to unnecessary cost of medications. Being overweight also increases the risk of diabetes and [high blood pressure], which also are risk factors for heart disease and stroke,” Sugiyama said.

He also noted that doctors may be more likely today to prescribe statins to patients who have not modified their diets and who weigh more than they should. Ten years ago, they would have stressed that lifestyle changes should be the first resort in lowering cholesterol and reducing the likelihood for heart disease.

“We believe that, when physicians prescribe statins, the goal is to decrease patients’ cardiovascular risks that cannot be achieved without medications, not to empower them to put butter on steaks,” Sugiyama said. “We may need to re-emphasize the importance of dietary modification for those who are taking these medications, now that obesity and diabetes are important problems in society.”

Who Takes Statins

Approximately 43 million Americans are currently taking statins. However, under new guidelines developed by the American Heart Association (AHA) and the American College of Cardiology at the request of the federal government, as many as 56 million Americans – some of whom do not have high levels of cholesterol – are also eligible.

The guidelines recommend statin therapy for the following groups:

• People without cardiovascular disease who are 40 to 75 years old and have a 7.5 percent or higher risk for having a heart attack or stroke within 10 years. (Learn your risk using the AHA Heart Attack Risk Assessment Calculator.)
• People with a history of a cardiovascular event (heart attack, stroke, stable or unstable angina, peripheral artery disease, transient ischemic attack or coronary or other arterial revascularization).
• People 21 and older who have a very high level of bad cholesterol (190 mg/dL or higher).
• People with type 1 or type 2 diabetes who are 40 to 75 years old.

Despite the benefits of statins, side effects can sometimes make the medications difficult to take. Muscle pain is the most common side effect, but statins can also cause digestive problems, liver damage and memory loss. And while the new guidelines recommend statin therapy for diabetics beginning at middle age, there is a very small risk that statin use can cause some people to develop type 2 diabetes.

If you have been prescribed a statin, get the most out of your medication by taking it as directed, by losing excess weight and by reducing your consumption of foods that are high in saturated fats. Let your health care provider know if you are experiencing side effects as measures can be taken to relieve them.

The LHSFNA has a variety of brochures and Health Alerts pertaining to high blood pressure, heart disease and general wellness. They can be ordered through the Fund’s Publications Catalogue.

[Janet Lubman Rathner]