Is It Time to Start a Statin? Here’s What Your Primary Care Physician Considers

High cholesterol puts you at major risk for heart disease, the leading cause of death in the United States. Diet and lifestyle changes are the first line of defense, but may not be enough if your levels are very high or you have other risk factors. In such cases, you may need help from a cholesterol-lowering drug class known as statins.  

If your heart health is at risk from elevated cholesterol, you need an experienced provider like Bridgewater Primary Care & Cardiology to provide a thorough evaluation. Under the leadership of John Terzian, MD, FACC, our team specializes in diagnosing and managing chronic health issues, such as high cholesterol.

After a comprehensive evaluation, we can determine if statin therapy is the right approach and when. For some patients with significant risk factors, we may recommend statin therapy right away. For others, implementing diet and lifestyle changes and following up may be the most appropriate action.

Here’s what we consider before making this decision.

Reviewing your cholesterol profile

A complete lipid panel is the first step in determining whether it’s time to add a statin to your heart-health plan. A lipid panel measures various forms of fats and fat-like substances circulating in your bloodstream.

The test includes LDL (low-density lipoprotein), levels of which are harmful when elevated, HDL (high-density lipoprotein), a beneficial type of cholesterol, total cholesterol, and triglycerides. 

High LDL levels cause more plaque to accumulate in your arteries, which boosts heart attack and stroke risk. Ideally, the goal is to have an LDL below 100 mg/dL for most adults, and below 70 mg/dL for those with known heart disease or very high risk.

Our team also considers your HDL level, since higher HDL can help protect your heart, as well as triglycerides, the main form of stored fat in the body. Together, these numbers paint a clearer picture of your cardiovascular health.

Assessing your overall heart risk

Before recommending statin therapy, we use risk calculators that factor in age, blood pressure, smoking status, and other conditions like diabetes. For example, a 45-year-old nonsmoker with slightly high LDL may not need medication right away. 

But a 60-year-old with the same LDL level, high blood pressure, and diabetes may strongly benefit from starting a statin.

Family history is another critical piece. If close relatives experienced early heart disease, your risk goes up. We also consider lifestyle factors like activity level, weight, and diet, because these influence both cholesterol levels and long-term health.

Looking at existing conditions

People with specific health issues often need statins sooner, even if cholesterol levels are only moderately high. These include:

• Diabetes
• Chronic kidney disease
• Previous cardiovascular events 

For these patients, the goal is not only lowering cholesterol but also stabilizing existing plaque and reducing inflammation in the arteries.

Evaluating lifestyle and alternative options

Before starting a statin, we often recommend lifestyle modifications such as adopting a heart-healthy diet, exercising regularly, maintaining a healthy weight, and quitting smoking. These changes can lower LDL and triglycerides while raising HDL. If these steps fail to bring cholesterol into a safe range, medication becomes an important next step.

Following statin therapy, maintaining a heart-healthy lifestyle is still an essential part of promoting heart health. Our team may also discuss other options, such as non-statin cholesterol-lowering medications.

Monitoring safety and side effects

Statins are generally well-tolerated, but as with all medications, they come with potential side effects such as muscle aches or mild liver enzyme changes. Regular monitoring with follow-up visits and periodic blood tests helps to ensure that your treatment remains safe and effective.

Partner with us for your heart health

Deciding whether to start a statin isn’t a one-size-fits-all decision; our team works closely with you to create the most appropriate care plan. 

If you’re concerned about your cholesterol or heart health, contact our office today or book an appointment online with us at Bridgewater Primary Care in West Bridgewater, Massachusetts, to learn more about your options and take control of your cardiovascular wellness.