Reviewed by Robert Ehrman, MD
A‘statin’ a day can keep a heart attack away. Heart disease is often thought of as a silent killer because you can have it without any warning signs. This makes it hard to diagnose until something happens. People with diabetes are at high risk for developing heart disease. There is new evidence showing that taking a statin drug to lower LDL (bad) cholesterol reduces the risk of developing heart disease.
Statins are a group of medicines that lower blood cholesterol by decreasing the body’s ability to make it.
According to new studies, lowering LDL cholesterol as much as possible reduces the risk of heart attack and stroke. More than ever, health care providers want to help people with diabetes lower their cholesterol levels. One reason for this relates to the outcome of the recent Heart Protection Study.
Details of the Heart Protection Study
The purpose of the Heart Protection Study was to understand whether lowering cholesterol would help reduce the risk of heart disease, including heart attack and stroke. It was the largest research study of its kind and was done over a period of five years with 20,000 people. It was also the largest study of people with diabetes at risk for heart disease. One of the strongest findings was that regardless of the person’s cholesterol level (whether above or below 100 mg/dL), the use of a statin was proved to significantly reduce the risk of heart attack and stroke. Most people in the study started with an LDL higher than 100 mg/dL. But there were some people who started with an LDL lower than 100 mg/dL, and they still had a reduction in their risk of heart disease.
What this study means for you is that a statin can help save your life by reducing your chances of having a heart attack or a stroke If you have diabetes, talk with your health care provider about your cholesterol level and the ways you can reduce your risk of heart disease.
Why does diabetes increase the risk of heart disease?
High blood glucose levels alone can damage blood vessels. The blood vessel walls can become thicker, so blood has a harder time passing through. Also, people with diabetes often have high levels of cholesterol and triglycerides. These can clog blood vessels, making them very narrow. This condition, known as atherosclerosis (also called “hardening of the arteries”), can lead to a heart attack or stroke. Today, the belief among diabetes experts is that it is as important to decrease your risk for heart attack and stroke as it is to control your blood glucose.
If you have diabetes, your LDL cholesterol should be as low as possible. Your health care provider can determine your cholesterol levels with a simple blood test that will show both the LDL cholesterol and HDL (good) cholesterol. The LDL cholesterol is bad because it builds up on the wall of your arteries, forming plaque. The HDL cholesterol is good because it helps your body get rid of the bad cholesterol. Triglycerides are another type of fat that can also lead to hardening of the arteries. Statins have been found to lower your LDL and triglycerides while raising the level of HDL in your blood. The benefits of using statins are that they will reduce the risk of heart attack and stroke in people who have heart disease or diabetes.
If you have diabetes, your LDL should be lower than 100 mg/dL. There are some experts who suggest going as low as 70 mg/dL to further reduce the risk of developing heart disease. This advice is particularly true for people with diabetes. It is important to talk with your health care provider about your specific risk for developing heart disease.
Other risks include having diabetes, your age, family history, food choices, physical activity, high blood pressure, obesity and smoking.
What you can do
Ask your health care provider if you are at high risk for heart disease. If so, find out how you can lower your LDL cholesterol to help reduce your risk. Ask your health care provider for help and guidance about how to live a healthy lifestyle. This includes eating healthy, being active and not smoking. Ask your health care provider if you also could benefit from a statin medicine. Some or all of these steps can help you lower your risk of heart disease.
Understanding Heart Disease
Heart disease is the number-one killer of both men and women in the United States. The numbers are far greater than the number of deaths from all cancers combined.
Most heart disease is caused by narrowing of the arteries that feed the heart—these are the coronary arteries Like any muscle, the heart needs a constant supply of oxygen and nutrients, which are carried to it by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits, they cannot supply enough blood to the heart. The result is coronary heart disease (CHD).
If not enough oxygen-carrying blood reaches the heart, a person may have chest pain. This is called angina. Angina typically occurs when you exercise and it goes away when you stop. A heart attack happens if the blood supply to a portion of the heart is completely cut off by total blockage of a coronary artery. A heart attack is usually caused by a sudden closure of an artery from a blood clot.
Some people are more likely than others to develop heart disease because of their risk factors. Risk factors are behaviors or conditions that increase the chance of heart disease. Some of the risk factors for heart disease, like our genes, are beyond our control.
However, most can be managed to help lower the risk of getting the disease.
Because each risk factor multiplies the effect of the other risk factors, it is very important to prevent or control the ones that you can change. If you have one or more risk factors, talk to your health care provider or your pharmacist about what you can do to decrease your risk. Work with them to find out how to most reduce your heart disease risk and keep it from getting worse.