People with pre-diabetes should only be treated with statins if they have a markedly elevated risk of heart attack and stroke. Emphasize to patients that even those who develop diabetes after starting statin therapy derive the same or even greater benefits in terms of reducing their cardiovascular risk.
Statins and memory. Reassure patients that there is very little evidence — most of it unconvincing — that statins impair memory function. In fact, research suggests that statins may help preserve memory by warding off strokes. Statins and muscles.
Assure patients that severe muscle damage from statin use is exceedingly rare, but that minor aches and pains are common yet often benign. Reassess muscle function within three months after statin initiation and urge patients to report any new or worsening muscle pain.
Aim for the highest tolerable dose. To obtain maximum benefit, aim for the highest dose tolerable in those without predisposition for side effects.
Use lower doses in people predisposed to side effects or taking medications that could interact with statins. Pay attention to news media. Periodically scan major news headlines about statins and heart disease. For the Media Contacts: Ekaterina Pesheva epeshev1 jhmi. Find Physicians Specializing In Previous Next.
Show me more Cardiovascular disease risk assessment and management for primary care. Safety and efficacy of statin therapy. Nat Rev Cardiol ;— J Am Coll Cardiol ;e— Statins for primary prevention of cardiovascular disease. Review of evidence and recommendations for clinical practice. Med Clin N Am ;— Strandberg TE. Curr Atheroscler Rep ; Drugs Aging ;— Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials.
The Lancet ;— Primary prevention of cardiovascular disease: Updated review of contemporary guidance and literature. Cardiovascular disease risk assessment and management.
Cardiovascular disease: risk assessment and reduction, including lipid modification. Available from: www. Can Med Assoc J ;E— Int J Cardiovasc Sci ; [Epub ahead of print]. Circulation ; Cleve Clin J Med ;—9. Worldwide Dyslipidemia Guidelines. Curr Cardiovasc Risk Rep ; Familial hypercholesterolaemia: identification and management. Eur Heart J ;— Key takeaways comparing lipid guidelines across the pond: the hot off the press ESC vs.
Simons LA. Med J Aust ;— Interpretation of the evidence for the efficacy and safety of statin therapy. Circulation ;— Saeed A, Mehta LS. Statin therapy in older adults for primary prevention of atherosclerotic cardiovascular disease: the balancing act. Accessed Dec, J Am Geriatr Soc ;— Safety and benefit of discontinuing statin therapy in the setting of advanced, life-limiting illness: a randomized clinical trial.
Evidence-based deprescribing of statins in patients with advanced illness. Efficacy and safety of lowering LDL cholesterol in older patients: a systematic review and meta-analysis of randomised controlled trials. NZF v Effects of morning vs evening statin administration on lipid profile: A systematic review and meta-analysis.
J Clin Lipidol ;— Laufs U, Isermann B. Statin intolerance: myths and facts. Eur Heart J ;—5. Circ Res ;— Practical aspects in the management of stain-associated muscle symptoms SAMS.
Atheroscler Suppl ;— Diagnosis and Management of Statin Intolerance. J Atheroscler Thromb ;— Statin-associated muscle symptoms - Managing the highly intolerant. The Lancet ; [Epub ahead of print]. New onset diabetes mellitus induced by statins: current evidence. The more risk factors you have, the more likely it is that you will get CVD. We came to this conclusion because of the strong evidence showing that statins can reduce the risk of CVD.
They might decide that taking a statin is not right for them. Armed with this information, it is then down to the person and their healthcare professional to discuss whether statins are the best option for them.
No, that depends on your individual circumstances and how you feel about all the pros and cons of taking a statin. For most people the first steps you should take to reduce your risk of CVD are lifestyle changes , including:. We recommend that most people try doing these things before they think about taking statins.
And you should be able to access support through your GP practice. After you have tried to change your lifestyle, you should be offered another assessment to see if your CVD risk has changed. Your choice is then between continuing to change your lifestyle plus taking a statin, or continuing with the lifestyle changes without taking a statin.
You should think carefully about taking a statin at the same time as starting those lifestyle changes. Statins are generally recommended for people who have CVD such as people with angina or who have had a heart attack.
But ultimately, the choice is yours. Understanding the potential benefits from statin treatment means crunching some numbers…. No one can say with certainty whether you will be in the group of 10 or the group of And if you turn out to be one of the people who gets CVD, we cannot predict when in the next 10 years this will happen. In this circumstance we would predict the same 90 members of the group will still be CVD free after 10 years. Six members will still develop CVD, but four members of the group who previously would have developed CVD now no longer will.
What we do know is that the greater your risk of CVD, the more likely you are to benefit from taking a statin.
If all people take a statin, over 10 years on average:.
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