To Statin or Not Statin? Is That the Question?

By Melissa MacVenn, M.D. – WellcomeMD Naples

When I start to talk with a patient about optimizing heart health, the conversation will often turn to statin medications, prescribed to fight artery-damaging cholesterol.

It can seem like assembling a jigsaw puzzle together. There are lots of unique pieces to consider. Finding the right place for them can take extra time and careful thought. February is American Heart Health month, so that’s a good reason to focus a little more on statins — this powerful yet controversial class of medications.

There are several brands of them, each with subtle differences in action and side effects — Lipitor, Zocor, Pravachol, etc. — and tens of millions take them. I often counsel patients who have concerns that statin medications are over-prescribed. Those concerns have some foundation.

Risks, benefits, evidence
A recent study in the Annals of Internal Medicine found that half of those who take statins have too low a risk of cardiovascular disease to get much protection from them, and the side effects of the statin may outweigh the benefit.

But many other studies have concluded that the side effects are negligible, especially when weighed against the effectiveness of statins in preventing heart attacks and strokes in those at risk. One line of research, published in the Journal of the American Medical Association, even concludes that given the prevalence of heart disease and the drugs’ effectiveness, statins are heavily under-prescribed.

So, evidence-based research is extremely important for broad-scale public policy. But for individual patients who need to work out a plan for their heart health, it can be a confusing and frustrating discussion. My practice uses evidence medicine as a guideline, but I also listen to my patient’s individual medical history and future goals, in creating the best plan to treat their cholesterol concerns.

A different health focus
That takes time, some patience, a strong relationship with your doctor, and a sense of the alternatives available for you to solve the heart health puzzle. They go well beyond just “statin or no statin.” I also focus on how lifestyle changes can significantly reduce cholesterol, and therefore may limit the need for statin medication.

This is no secret. The American College of Cardiology’s guidelines emphasize that even for younger patients or those with no evident risk factors, “lifestyle optimization” is central. Medical practitioners can prescribe pills, but they can also prescribe, and help you achieve, a program of more physical activity, better nutrition, weight loss, blood pressure and cholesterol control.

When your risk factors have been carefully calculated by your doctor, and the most reasonable lifestyle alternatives are considered, then statins — their effectiveness and potential side-effects — may well be part of the picture. It is not the whole-medicine-cabinet picture, but the whole-health picture that I help my patients strive for.

Looking for Guidance on Making Healthy Choices?
I prioritize new research and healthy lifestyle changes into my prescriptions by allowing for longer office visits and physicals. The journey to optimal health looks different for everyone, and WellcomeMD can help!

We limit memberships so that each of my patients has far more access to time with me. Our certified health coaches help our members reach their goals and find their happiest, healthiest version of themselves.

WELLCOMEMD Naples
Membership medicine (sometimes called “con­cierge medicine”) re-establishes the kind of personal relationship with your physician that was once commonplace. We take advantage of the many advances in treatment and technology – treatment is more personal, pro-active, and effective.
• Consider the cost of avoiding a preventable disease, the value of early detection of serious health problems, and ready access to your doctor who knows you. You’ll even have my cellphone number.
• Unhurried, 30-minute consultations or video conference appointments — or just a quick call or text – you choose.

If you are ready to plan your healthcare for your specific needs, contact WellcomeMD today.

To schedule a tour of our practice and a free consultation with me, please call Tara Greenberg at (239) 451-5105 or visit WellcomeMD at wellcomemd.com/naples-florida.

Tara Greenberg
11181 Health Park Blvd Ste 2260
Naples, FL 34110
(239) 451-5105