To statin or not to statin -- is that the question?
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Dr. Melissa MacVenn of WellcomeMD Naples
Published in Napes Daily News - February 10, 2022
[Excerpt]
When I start to talk with a patient about optimizing heart health, the conversation will often turn to statin medications, which are prescribed to fight artery-damaging cholesterol.
It can seem like we're assembling a jigsaw puzzle with lots of unique pieces to consider. Finding the right place for each can take extra time and careful thought. February is American Heart Health month. That's a good reason to focus 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 of people take them. I often counsel patients who have concerns that statin medications are over-prescribed. Those concerns do 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.
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, that's the wrong puzzle. 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
The planning process takes time, some patience, a strong relationship with your doctor and a sense of the alternatives available to solve the heart health puzzle. The options 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.
DR. MELISSA MACVENN
Dr. MacVenn is a physician at WellcomeMD’s medical concierge clinic in Naples, Florida. She has been practicing as a supervising physician in a Naples medical clinic for the past four years, often for mature patients with complex medical conditions that require acute attention. Dr. MacVenn’s mission is to provide personal and proactive care for members. She understands that creating an effective wellness plan is a team effort, and helping members optimize their health requires face-to-face conversations and trust.
