HEALTHY LIVING


Lifestyle Change vs. Statins


Which should you try first if your cholesterol is high? ::


BY CHRIS ILIADES, M.D. Y


ou just found out your cholesterol is too high. Should you try a better diet and other lifestyle


changes first, or should you go right to a statin drug? Statins have been around for 30


years, and are the most prescribed drugs in the world, so there has been enough time and research to answer this question. “We prescribe statin drugs to lower


cholesterol, prevent cardiovascular disease, and to help people live longer,” says Seth Martin, M.D., professor of medicine in the division of cardiology at Johns Hopkins University School of Medicine, specializing in preventive cardiology, including cholesterol management. “Mountains of evidence from well-


controlled trials involving hundreds of thousands of people show these drugs lower the risk of heart disease, heart attacks, strokes, and early death.”


HOW STATINS WORK When cardiologists talk about lowering cholesterol, they mean low- density lipoprotein (LDL), the bad cholesterol. Statins block your liver from


making LDL, and they trigger liver cells to remove LDL from your blood. “In the simplest terms, statins tell


your liver to make less LDL and to clean up what’s left,” says Martin. LDL cholesterol leads to the


fatty deposits inside your arteries called plaque that can cause a


96 NEWSMAX MAXLIFE | DECEMBER 2025


We prescribe statin drugs to lower cholesterol, prevent cardiovascular disease, and to help people live longer.”


stroke or heart attack. If your LDL number is 130 mg/dL


or higher, your cholesterol is too high. “Studies show that lowering the


LDL number by 40 reduces your cardiovascular disease risk by about 25%. If someone has a high number like 160, and they can reduce it by 80 points, the risk is cut in half,” explains Martin.


LIFESTYLE CHANGES If you have been healthy and your cardiovascular disease risk is not too high, you could start with lifestyle changes, such as a healthier diet and increased exercise, for about six months to see if your number comes down, explains Martin. “But if lifestyle changes can’t


get your LDL back to normal, your healthcare provider may start you on a statin along with your changes.” Key lifestyle measures


recommended by the American Heart Association to improve cardiovascular health can be found at heart.org. Search “Life’s Essential 8.”


WHEN TO START STATIN If you have already been diagnosed with cardiovascular disease, or your


— Seth Martin, M.D.


LDL is 190 or higher, you would start a statin in addition to making lifestyle changes, says Martin. Other reasons to start a statin right


away are having diabetes or a high cardiac risk score, which is a number calculated by your doctor that predicts your 10-year risk of developing cardiovascular disease, he explains. If you know your blood pressure


and cholesterol numbers, you can calculate your own risk by going to the American Academy of Cardiology website at acc.org. Search “ASCVD risk estimator.”


SIDE EFFECTS A recent review of 176 trials involving more than 4 million people found the rate of statin intolerance is low, between 6% and 10%. The most common complaint is


muscle aches. For most people, side effects are mild and go away over time. In some cases, lowering the dose or changing to a different statin helps. If side effects persist, the drug can


be stopped to see if the symptoms go away and restarted to see if they come back. If someone truly can’t tolerate a statin, other drugs are available, says Martin.


APOMARES©ISTOCK


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