You are here:

Ask the doctor: Do I really need a statin, and which kind should I take?

Q. I’m 71 and have no sign of heart disease, but my doctor thinks I should take a generic statin drug. Will I really benefit from a statin, and is a generic as good as the brand-name drug?

A. I can understand why you ask. You’re probably thinking, like the old adage says: “If it ain’t broke, don’t fix it!” While I can’t comment on your particular case, I can tell you why I advise a lot of patients in their 70s and without signs of heart disease to take a statin.

Even if you have no signs, you still could have heart disease. In fact, many people who have a heart attack never knew they had heart disease—until the heart attack. And statins can reduce the risk of heart attack, even in people your age.

For example, a recent study looked at over 24,000 people in randomized trials of statin drugs. They were people like you: over age 65 and without known heart disease. The risk of a heart attack was 39% lower, and the risk of a stroke was 24% lower, in the people who took statin drugs, compared with those who took a placebo (inactive pill). The study was published in 2013 in the Journal of the American College of Cardiology.

Image: Thinkstock

Generic statins are chemically identical to brand-name versions.

That surely doesn’t mean that everyone your age and without known heart disease should take statins. Generally speaking, only people with a risk of heart attack or stroke in the next 10 years that is 7.5% or greater should consider statins, as the Harvard Health Letter wrote about in June 2014. Ask your doctor if you fall into that group.

As for generic statin drugs, they are chemically identical to the brand-name version. The only difference is in the filler materials that are part of the pill. As with the brand-name drugs, the generics are tested by the FDA for potency. In addition, the generic drugs lower cholesterol levels just as surely as their brand-name equivalents.

A recent study in the Sept. 16, 2014, Annals ofInternal Medicine highlighted another virtue of generic statin drugs. Of over 90,000 older patients, 93% were taking generic statin drugs and 7% the brand-name drugs. People who were prescribed the generic statins were more likely to take them; probably the lower cost of the generic drugs made people more likely to fill the prescription and take the medicine. The bottom line: people taking the generic drugs had an 8% lower rate of heart disease, stroke, and death than people taking the brand-name drugs.

So if you’re at somewhat higher risk of developing heart disease, a generic statin is probably a good idea. 

—Anthony L. Komaroff, M.D.
Editor in Chief
Harvard Health Letter

Posted by: Dr.Health

Back to Top