Understanding Cholesterol Targets After Starting Statins
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Cholesterol management is a key part of preventing heart disease, especially for people at risk but who haven’t yet had a heart attack or stroke. Statins are medications commonly used to lower bad cholesterol and reduce this risk. But after starting a statin, how do we know if it’s really working? A recent Canadian study looked at this question and offered some helpful insights.
What is cholesterol and why does it matter?
Cholesterol is a fatty substance in your blood. Your body needs it to function, but too much can clog your arteries and lead to heart disease. There are different types:
- LDL-C (low-density lipoprotein cholesterol) is often called "bad cholesterol" because it contributes to plaque buildup in arteries.
- HDL-C (high-density lipoprotein cholesterol) is "good cholesterol" that helps remove LDL-C from your bloodstream.
- Non-HDL-C includes all the bad types of cholesterol and is becoming more widely used by doctors as a risk marker.
What did the study look at?
The study included over 125,000 people in Ontario, all aged 66 and above, who started a statin for the first time between 2012 and 2019. Researchers tracked their cholesterol levels after a year and checked if they experienced heart problems or died over the next few years.
They divided participants into groups based on whether their LDL-C and non-HDL-C levels were below or above the targets suggested by Canadian guidelines.
Key findings
- Most people had cholesterol levels below target after a year on statins.
- But about 20 to 30 percent were still above recommended levels, even while taking their medication.
- People who were above both the LDL-C and non-HDL-C targets had a higher risk of serious problems like heart attacks or strokes.
- Among people with diabetes or chronic kidney disease, having non-HDL-C above target—even when LDL-C was okay—was also linked to higher risk.
What this means for you
If you’ve started a statin, it’s important to check your cholesterol levels again after a few months to see if the medication is working as expected. Here are some tips:
Get your cholesterol retested
Many people take a statin and never check their cholesterol again. But this study shows that follow-up tests can spot people who still have higher risk despite taking medicine.
Don’t ignore non-HDL cholesterol
Most people are familiar with LDL-C, but non-HDL-C gives a fuller picture of heart disease risk. If your doctor checks only LDL-C, ask if they can also look at non-HDL-C. This is especially important if you have diabetes or kidney problems.
Ask about adjusting your medication
If your cholesterol levels are still high after a year on a statin, you might need a stronger dose or an added medicine. Don’t assume that just starting a statin is enough. Talk to your doctor about your follow-up results.
Stay consistent with your medication
Statins work best when taken every day. If you’re skipping doses or stopping due to side effects, tell your doctor. They may adjust the dose or switch to another option that works better for you.
Focus on the big picture
Cholesterol is just one part of heart health. Managing blood pressure, avoiding smoking, staying active, and eating a healthy diet also matter. But this study makes it clear that knowing your cholesterol numbers after starting treatment is a key step in preventing future heart problems.
Final thoughts
This research reminds us that heart disease prevention isn’t a one-time decision. Even after starting medication, it’s important to follow up, understand your numbers, and work with your doctor to keep your risk as low as possible. If you or a loved one is taking statins, make sure cholesterol levels are being checked and discussed. A simple blood test could make a big difference.