Q: I just had a phone appointment with my doctor to go over results from my blood test. I don’t remember the numbers, but my cholesterol levels are very close to needing to start medication. I’m going to make some changes to my diet and have my bloodwork repeated in the spring. My doctor said we would start a low dose of rosuvastatin if my numbers don’t improve. Can you tell me about this medication?
It can be hard to remember the results of a cholesterol test because so many different numbers are discussed. Your doctor was looking at your high-density HDL cholesterol, low-density LDL cholesterol, total cholesterol and triglycerides. If you are interested in knowing your exact numbers, you can create an account online through MyHealthNB which will then allow you access to your lab results.
Cholesterol is a fat-like substance found in our blood that is needed to keep our cells healthy and functioning properly. Cholesterol is naturally made in our liver, and levels are further increased by certain foods we eat such as fatty meats, processed meats, full-fat dairy products, fried foods and sugary drinks.
When there is too much cholesterol in your blood it starts to create fatty deposits on the inside of the walls of your blood vessels called plaques. As these plaques continue to develop our risk of heart attack and stroke increases because our blood flow becomes restricted as our blood vessels become narrow and potentially blocked.
There are no symptoms of having high cholesterol. The only way to monitor it is through a blood test. If you are healthy and without additional risk factors screening for high cholesterol should begin when males are over 40 and females are over 50. Screening may start earlier if you have risk factors for high cholesterol such as high blood pressure, diabetes, smoking, overweight, erectile dysfunction, or a family history of heart disease or stroke.
For anyone wanting to have their cholesterol levels checked and do not have a primary care provider to order bloodwork, check with your pharmacist as certain pharmacies offer cholesterol testing. We take a couple drops of blood from your fingertip and run it through a machine in the pharmacy which will provide you with results in about five minutes. There is no public coverage for getting this test done at the pharmacy, but some private insurance plans may cover the cost.
The most common class of medication used to treat high cholesterol is HMG CoA reductase inhibitors also known as statins. Rosuvastatin belongs to this group and is taken once daily as either a 5mg, 10mg, 20mg or 40mg tablet. It helps to lower blood cholesterol levels by decreasing the amount of cholesterol produced in our liver. It is important that you also decrease the amount of cholesterol in your diet and make changes to other risk factors you may have if possible.
The medication reduces our risk of heart attack and stroke by slowing the formation of new plaques and by stabilizing the old plaques, so they are less likely to break off and cause a blockage in a smaller blood vessel.
Rosuvastatin is generally quite well tolerated. Side effects that may present at the beginning of treatment include nausea or upset stomach, headache and constipation. Taking it with food can help to manage nausea and upset stomach, and increasing water and fibre intake can help to manage constipation. It’s important not to take antacids containing aluminum or magnesium two hours before or after taking rosuvastatin as they can decrease its absorption and therefore decrease its cholesterol-lowering effect.
There is a rare but serious condition that can occur when using statins called rhabdomyolysis which is associated with muscle damage. If you experience any unexplained muscle pain, weakness or stiffness that is not going away, or your urine is darkening to a brown colour, stop the medication and contact your prescriber immediately as emergency care may be required.
Treatment with a statin is typically lifelong. Your prescriber will continue to monitor your cholesterol levels through blood tests to assess your response to treatment and to determine if a dose change is required.
Erin Thompson (BSc, BScPharm) is a graduate of Dalhousie University and a community pharmacist practicing at Shoppers Drug Mart in Quispamsis N.B. Her opinions expressed in this column are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment.