Why Are Women Less Likely to Take Statins?

Modern medicine has led to effective cholesterol medications that, along with exercise and a healthy diet, can significantly decrease the risk of stroke and heart attacks. Among the most powerful of these are statins—a type of medication to reduce cholesterol. 

The American Heart Association has shown that statins can reduce the risk of heart attack, stroke, and complications from atherosclerosis (blocked arteries) by as much as 60%.

Despite these benefits, research shows that women are less likely than men to take statins. Data published in JAMA shows that women in their 50s were 5% less likely than men to start a statin. Patients who took a statin achieved a healthy cholesterol level in just 1.5 years—about 3 years earlier than those who didn’t. 

Unfortunately, these findings aren’t surprising. Several studies have shown that women are more likely than men to delay care for heart symptoms or not take medication as recommended.

This happens, in part, because women often tie their symptoms to outside life factors, like chasing around kids or grandkids, or stress at work. Yet sometimes symptoms of heart disease in women are similar to signs of stress, including:

• Burning like indigestion   
• Chest discomfort or pain
• Lightheadedness or feeling tired
• Pain in the jaw, shoulders, or upper abdomen
• Shortness of breath

It’s inconvenient to take time out of your day, go to the doctor, and get checked out, especially if you learn it’s not your heart causing issues. But on the chance that it isn’t nothing—and that you have a chance to intervene with a simple, effective statin medication—you and your family will be happy you prioritized your health.

Taking statins, or any medication, is a personal choice. Your doctor should listen to you and have two-way discussion about your symptoms and what’s workable for your lifestyle. 

Benefits from statins start with open communication.

Medication only works if you are willing and able to take it. The doctor will make recommendations based on your health, lifestyle, lab work, and symptoms. More importantly, they’ll spend time talking with you to answer to your questions and address your concerns.

When I talk with patients about starting statins, we often cover these common topics.

Side effects.

Most patients can take statins with few, if any, challenges. However, there is a lot of misinformation online about potential side effects, including these common concerns:

• Muscle discomfort: In about 90% of patients, muscle aches after starting a statin are found to be unrelated to the medication. In the 1 in 15 patients who do have statin-related aches, pain is mild, manageable, and typically resolves within a year. 
• Liver damage: Research has shown that taking a statin can increase liver enzymes in about 3% of patients. Of these, only 0.5% of patients will need to stop the medication. In fact, recent studies have shown that statins an actually help reduce fibrosis and cirrhosis in patients with active liver disease. 
• Elevated blood sugar: While some research suggests that statins might increase blood sugar slightly, statin therapy is still recommended for many patients with diabetes or prediabetes and high cholesterol. 

Statin medications significantly reduce cholesterol levels, as well as the risk of heart attacks and strokes. In fact, certain statins may lead to a 25-50 percent reduction in LDL cholesterol. For most patients, that is an acceptable trade for the risk of rare, mild potential side effects of the medication. 

More benefits of statins.

Statins may also have an anti-inflammatory effect on the circulatory system, which can help reduce the risk of heart attacks and strokes. Importantly, statins also help protect the cardiovascular system by:

• Stabilizing plaque, which can interfere with blood flow to and from the heart
• Reducing oxidized cholesterol that can build up on the artery walls
• Lowering platelet activity, which can lead to reduced risk of blood clots 
  
  

Team approach.

At the end of the day, we’re a team working to treat you—and you should have the biggest say throughout your treatment process. Your cardiologist will communicate with you and your primary care doctor, endocrinologist, and other specialists to care for your holistic health.

One point of education with heart medications is that a lot of them, such as statins, might not feel like they are doing anything. You likely will not feel any different day to day, but know the medication is making significant change inside your blood vessels every step of the way. 

Here are a few discussion points we’ll talk through with you to ensure you’re getting a workable, effective treatment plan:

• Do you struggle to remember to take pills? We can see about once or twice a day options instead of three to four times a day like some meds. 
• Are you worried about the cost? Talk with your doctor. We can recommend community services to help cover medication costs or look at alternatives.
• Curious how a medication works? The better you understand the importance of a medication and why we recommended it, the more likely you are to prioritize your health. Many patients are more likely to try a new medication if they actively participate in the decision process.  
• Really don’t want to take a medication? If it is something you can feasibly change with diet/exercise or something different, we would love to talk with you about it. Let’s set goals that we can apply milestones to so we can come back in a month or two and check your progress.

Don’t shake off signs of a heart condition. See a cardiologist to discuss your symptoms and concerns. And if your treatment plan is difficult or confusing, talk with a MedStar Health cardiologist. Statins are a low-cost, highly effective way to significantly improve your future heart health—we want to help you find an effective solution to care for your heart in a way that works for you.