High cholesterol: Is it dangerous to suddenly stop taking statins?

High cholesterol has become one of the most common and concerning ‘silent killers’ of all time. Not only does it increase your chance of developing heart disease, but it even puts you at a greater risk of a heart attack or a stroke.

Statins on the other hand are medications that help lower low-density lipoprotein (LDL) cholesterol, which are often referred to as ‘bad’ cholesterol. Besides stopping the production of cholesterol in the body, statins also help reabsorb the waxy substance that builds plaques in the artery walls.

Dr Shivali Ahlawat – Lab Director, Oncquest Laboratories Ltd, says statins belong to a class of lipid-lowering drugs that lower mortality and sickness in people with a high risk of cardiovascular disease.

According to her, although part of the cholesterol in the blood is derived from foods, one’s liver produces the majority of it. It is then that statins function by lowering the amount of cholesterol the liver produces and assisting the liver in removing cholesterol from the blood, she explains.

But as helpful as medications like statins are in reducing the risk of heart disease, many are as concerned about the side effects it can cause. Given that statins are an indefinite treatment solution for lowering blood cholesterol, many who start on this medication, do not continue taking it over a period of time.

Dr Nishith Chandra, Principal Director, Interventional Cardiology, Fortis Escorts Heart Institute, is of the opinion that statins are very well tolerated. However, in 5-10% of cases certain side effects can occur.

“The commonest side effect is generalised body and muscle pains. These side effects occur especially in persons with hypothyroidism, or alcohol abuse. Feeling tired, headache, or some digestive problems are some other side effects,” he says.

Furthermore, some people may experience dizziness, nausea, feeling weak, muscle discomfort, sleep issues, and low blood platelet count, adds Dr Ahlawat.

But should you stop taking statins suddenly?

Several studies in the past have recommended against stopping cholesterol-lowering statins therapy. Many researchers have gone as far as to link it with an increased risk of death associated with heart disease.

According to Dr Chandra, if a person stops taking statins, their cholesterol could most likely go up again, putting them at risk of developing atherosclerotic heart disease, which is why, he believes, one should never stop statins on their own, rather must consult their doctor before stopping statins. In case of serious side effects, doctors may recommend stopping statins.

What happens when you stop?

“Statins increase lifespan and improve health. They also reduce mortality rates among those with excessive cholesterol. Well, stopping your statin suddenly is risky and can increase your risk of developing heart disease and other high cholesterol-related health issues such as stroke and heart attack,” Dr Ahlawat shares.

She further explains that the liver naturally produces cholesterol that is transported throughout the body by proteins in the blood. The cholesterol produced is then used by the body to build healthy cells. However, depending on a person’s lifestyle and genetics, there could be an excessive cholesterol production in the body. To stop that from happening, statins are crucial. Hence, stopping the intake of this drug suddenly can cause these levels to spike, resulting in coronary heart disease, heart attacks, or strokes.

How to stop statins safely?

From the fear of the side effects to negligence to the belief that they no longer need the medication, most doctors believe that there are several reasons why patients want to stop taking statins.

However, it is in the best interest of the patient to consult with the doctor when it comes to stopping statins.

“If they [statins] need to be stopped, because of intolerance or side effects, the doctor at first might reduce the dose, or change to a different statin. Even if the side effects persist, then the physician may suggest some alternative cholesterol reducing medicines, like Ezetimibe, Bempedoic acid or PCSK9 inhibitor medicines,” says Dr Chandra.

Dr Ahlawat advises that patients consult with their cardiologists before taking any decision regarding the consumption, potency change, or discontinuance of statins.

“The doctor might advise to lower the dosage, using a statin along with another medication that lowers cholesterol, or switching to a different medication altogether,” she adds.