Am I Taking Cholesterol Medication For My Arteries or My Veins?

The driving force for recommending use of anti-cholesterol medications (“statins”) is that if a certain group of patients take these drugs over several years, statins can reduce the risk of heart attack, stroke and death.  These particular patients have already had at least one cardiovascular diagnosis or event after which the medication is prescribed.  The medicine works on the diseased arteries by preventing them from becoming worse.  There are also patients who have diabetes, or high blood cholesterol or multiple other risks for stroke or heart attack who benefit from statins even though they have not had one of these severe events.  The benefit of statins here is that if taken over at least 5 years, the risks of a first heart attack or stroke and death are diminished.

Interestingly, even though statins work on arteries throughout the body, researchers have failed to show that these drugs benefit arteries of the legs which can become diseased and limit blood flow to the feet and toes.  While patients with leg artery disease usually are also started on statins, the benefit they get is mostly in the reduction of future stroke and heart attack and not better blood flow to their feet.

Statin medications do not work directly on veins.  The same disease process of blood vessel narrowing in arteries does not occur in veins.  However, blood clots still develop in veins for a variety of other reasons.  Statins may assist the work of the blood thinner medications that are usually prescribed when a clot is detected in the vein.  They also can help reduce the chance of a recurrent blood clot from forming after blood thinners are stopped.  However, it seems statins are no better than taking a daily baby aspirin (81mg) in preventing a second blood clot from forming in a vein and therefore, daily aspirin is prescribed for at least a year after the patient completes the initial blood thinner therapy.

In summary, anti-cholesterol medications primarily work on arteries and their benefit is to prevent stroke and heart attack.  They do not appear to have much effect on improving circulation to the legs, either in the arteries or the veins.  Still, statins are quite beneficial and will be prescribed for years to come.