Most people have heard of cholesterol, and many will know someone who takes medication to help lower cholesterol. Perhaps you are trying to decide if taking cholesterol tablets is the right decision for you. If a heath-care professional has offered you medication to manage your cholesterol, but you are unsure why, or if you should take them, then hopefully there will be some useful information for you in this post.
So what actually is cholesterol?
Cholesterol is a fatty substance in the blood. We need it to stay healthy, but our modern life can sometimes lead to us developing high levels of cholesterol and this can lead to health problems such as heart disease and strokes. The healthcare service is very keen to avoid people having heart attacks and strokes as these are very expensive and difficult to treat. Any survivors can be left with long term problems, which again are very expensive and difficult to treat. More importantly, for the person and their families the impact can be huge, and so everybody agrees - heart attacks and strokes are very, very bad. Lots of research has gone into trying to prevent these terrible conditions, because everybody knows - prevention is better than cure. This is where statins come into play.
What are statins?
There are 5 types of statin on the market in the UK:
Atorvastatin
Simvastatin
Rosuvastatin
Fluvastatin
Pravastatin
They work in the liver (where our bodies process cholesterol) to interfere with how cholesterol is produced, in particular the bad cholesterol.
Wait - what is bad cholesterol?
When you get a cholesterol blood test at your GP surgery they usually look at 3 main things:
Good cholesterol - HDL
Bad cholesterol - LDL
Triglycerides
LDL cholesterol can lead to hardening and narrowing of the arteries. If it builds up in the heart it can lead to heart attacks and if it builds up in the arteries in the brain it can lead to a stroke.
HDL cholesterol is the good guy. This can make you less likely to have heart problems or a stroke.
Triglycerides are another substance in the blood that consists of 3 molecules of fat joined to one molecule of sugar. These are a source of energy, and are essential for good health, but too much = big problems, similar to LDL cholesterol.
The GP/nurse/pharmacist will also look at other factors such as age, family history, blood pressure, blood sugars, smoking status, height, weight, and other medical conditions, and enter the details into a magic calculator called the QRISK3 calculator. This magic calculator is the closest thing we have to a crystal ball, to determine what your risk of having a heart attack or stroke will be over the next 10 years. If it is over 10% you will be offered a statin.
Do I really have to take it?
The easy answer to this is - no. Nobody will force you to take it. If you are a grown up human who is otherwise able to make decisions for yourself, then you are free to choose. The GP is offered an incentive from NHS England to offer a statin to anyone who is at risk, but they still get their points even if you decline. NHS England just want to make sure that people who may benefit, and may want it, know that they have access to this potentially life saving treatment if they want to. The GP will not be offended if you say no - however as they will have seen the devastating effects of heart problems and strokes in many other patients before you they may try to persuade you that it is a good idea to take it, because it is a good idea to take it.
But what about side effects?
All medicines have the risk of side effects, and statins are no different. There is not a single medication out in the world that doesn't have the potential to cause side effects (and that includes herbal supplements!). Most people don't do much research before taking a cough mixture, or an antihistamine, yet if you read the leaflet of these or medication there will be a list as long as your arm of terrible sounding ailments. For some reason when it comes to statins, because they have been in the news a lot, people do a lot of research and get scared, or overwhelmed. It is totally natural to get scared of something that you have read can make you feel bad. What I always advise people to do is just to try it and see how you get on. Yes your best friends, golf partners, auntie got a terrible headache from her statin, but that doesn't mean that you will too. Plus I bet your best friends, golf partners, auntie also got a terrible headache from a glass of wine or two on the odd occasion, but that never stopped anyone else from giving it a try. If you do try a statin, and you do get a side effect then you could always try a different one. They all work in a similar way, but some people are more suited to one than another for reasons that we just can't predict. Try it, if you don't get on with it then try another. There are 5 to choose from (and some other treatments too) so if at first you don't succeed try and try and try and try and try again. They don't guarantee a heart attack free life, but it's the best we have.
But what about lifestyle?
Statins are not a get out of jail free card. They reduce your chances of bad things happening, but to really maximise your chances of a long healthy life is wise to look at your lifestyle and diet too. You probably know what to do already as it has been very well documented, but just in case you missed the memo:
Do some physical activity - aim for 150 minutes a week of moderate intensity exercise.
Reduce the amount of processed food in your diet - particularly those high in added sugar.
Reduce the amount of saturated fat in your diet, by switching to foods that are naturally lower in fat such as legumes, and vegetables, or to things that contain a healthier fat such as oily fish.
Limit your intake of alcohol, preferably avoid it all together, but if that isn't possible keep below 14 units a week. Well below.
Stop smoking.
If you are over-weight, try and lose some weight (but if you are following steps 1-4, and you weren't doing them before, then this will probably happen naturally).
That's all folks
So, this post is already quite long, think of this as a beginner guide. If you wish to do further research then please follow the link below:
I hope this was helpful!
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