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How Long Does It Take for Statins To Reduce Plaque?

You may notice a decrease in your LDL ‘bad’ cholesterol in about four weeks

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If you have high cholesterol, your healthcare provider may prescribe a statin. This type of medication works by blocking certain enzymes your liver needs to make cholesterol. They can be an effective way to reduce plaque buildup in your arteries and lower your LDL (low-density lipoprotein or “bad”) cholesterol.

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But how long does it take for statins to reduce plaque? Cardiologist Ashish Sarraju, MD, shares more about how statins work.

How statins work over time

Statins are available as a tablet or capsule that you’ll need to take daily.

“Statins work by inhibiting an enzyme called HMG CoA reductase, which plays a role in cholesterol synthesis in the liver,” explains Dr. Sarraju. “And that, ultimately, leads to the production of cholesterol particles, including LDL cholesterol, that float around in your blood.”

By lowering your LDL, statins can stop the progression of plaque or even reduce the amount in your arteries. If plaque builds up over time, it can cause heart attacks and stroke. Statins also reduce high-sensitivity C-reactive proteins (hsCRP), which can help reduce inflammation.

“All of that can lead to a decrease of cardiovascular events,” adds Dr. Sarraju. “Studies show that controlling LDL cholesterol to very low levels has led to a decrease or stabilization of heart plaque.”

How long does it take for a statin to work?

Dr. Sarraju says that it can take only a few weeks after that first dose of statin to notice a difference.

“You can see changes to your LDL levels within four weeks of taking a statin medication. Within one to three months, you’ll see noticeable improvement. By the time you’re at the three-month mark, you’re seeing more or less the full effect of the statin, regardless of which type of statin you’re taking.”

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Statins are typically divided into three categories:

  • Low intensity: Reduces LDL by less than 30%
  • Moderate intensity: Reduces LDL by 30% to 50%
  • High intensity: Reduces LDL by 50%

“In general, your doctor can make treatment decisions by checking your cholesterol levels about four to six weeks after starting treatment,” says Dr. Sarraju.

If your LDL numbers aren’t decreasing after starting a statin, your doctor may raise your dosage amount.

Potential statin side effects

“In some circumstances, people may have side effects, which sometimes require your doctor to change the dose or change the medication,” shares Dr. Sarraju.

Common statin side effects include:

  • Headaches
  • Nausea
  • Dizziness
  • Constipation
  • Diarrhea

You may be tempted to stop taking statins completely if you’re having side effects — about 30% of people have a statin intolerance and may be unable to take the medication. But Dr. Sarraju says it’s important to have a conversation with your healthcare provider.

“Your doctor can figure out if your side effects are potentially related to your statin medication or what may be atypical or uncommon,” he explains.

Statins can be a long-term solution

Statins are a great option to help reduce your LDL cholesterol levels (and therefore, prevent plaque buildup in your arteries). Again, some may see improvements as early as four weeks.

But it’s not a quick, one-and-done fix. You’ll need to be on the medication long term. And you may also need to make certain lifestyle changes, like increasing your physical activity and eating a heart-healthy diet.

“Cholesterol doesn’t act in a day. Risk factors for heart disease don’t act in a day. They build up over time — be it cholesterol or high blood pressure,” points out Dr. Sarraju. “That’s why staying on a statin long term matters if you need one. The longer you control these risk factors, the more you lower your heart disease risk.”

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