Statin Guide

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Are Statins Overprescribed?

Critics charge that too many doctors are whipping out their prescription pads when they should first be talking about how diet and exercise can lower LDL.

Janet Brill, Ph.D, R.D., author of the book Cholesterol Down: 10 Simple Steps to Lower Your Cholesterol in 4 Weeks—Without Prescription Drugs (Three Rivers Press, 2006), says doctors are instructed to treat high cholesterol (in people not at high-risk for heart disease) with diet and exercise first. If that’s unsuccessful, statins should be prescribed. High risk individuals should take a statin and make lifestyle changes. The guidelines appear in the National Heart, Lung, and Blood Institute’s National Cholesterol Education Program for health professionals.

“We just can’t put a whole society on these drugs,” Brill says. “They are lifetime drugs and have to be taken every day."

Brill lowered her own cholesterol through diet. In three months, her LDL dropped from 160 to less than 100.

Cardiologist Melissa Walton-Shirley, M.D., co-director of the cardiovascular lab at TJ Samson Community Hospital in Glasgow, Kentucky, says doctors did lean on statins too much in the past. “I’ve been a cardiologist for 19 years, and I spent the first 10 years prescribing statins without ever discussing diet and exercise,” she says. “In four years of medical school, we had five days of nutrition science. Now things are changing."

Today, she talks with patients about the importance of diet and exercise. Paul D. Thompson, M.D., does too, but he says the reality is that many people don’t make the needed lifestyle changes.

“They should start with diet and exercise, but let’s face it, we are not a puritanical country,” Thompson says. “A lot of people don’t move, so what do you do?”