The ‘optimal’ time of day to take statins for cholesterol – when they are most ‘superior’

Statins: How the drug prevents heart attacks and strokes

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Statins are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is commonly branded the “bad” cholesterol because it can gum up the inside of your arteries, thereby hiking your risk of heart disease. Statins help to reverse this harmful mechanism by reducing the production of it inside the liver.

The benefits of taking statins is well documented, what is less clear is the best time of day to take them.

That’s because “evidence about the optimal time of day at which to administer statins is lacking”, researchers wrote in the Journal of Clinical Lipidoloy.

They set out to remedy this by objective by “synthesising” evidence about effects of morning versus evening statin administration on lipid profile.

A lipid profile is a blood test that can measure the amount of cholesterol in your blood.

To determine the “optimal” time of day to take statins, researchers searched PubMed, SCOPUS, Web of Science, and Embase databases to identify the relevant studies.

Eleven articles with 1034 participants were eligible for the analysis.

According to the researchers, “low-density lipoprotein cholesterol (LDL-C) lowering was statistically greater in the evening-dose group”.

After delving further into their analysis, they “showed that evening dose of statins was significantly superior to morning dose for lowering LDL-C in case of both short and long half-life statins”.

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LDL cholesterol lowering was “significantly greater” in the evening dose than in the morning dose in case of short-acting statins, the researchers concluded.

Short-acting and long-acting statins – the key difference

Statins can be split into two groups – low-intensity short-acting statins (for example, pravastatin and simvastatin) and high-intensity long-acting statins (such as atorvastatin and rosuvastatin).

According to the British Heart Foundation (BHF), for most people, a lower-intensity statin will be enough to reduce their cholesterol sufficiently, but if it’s not, your doctor may want to increase the dose or switch to a higher-intensity one.

Statins side effects

Side effects can vary between different statins, but common side effects include:

• Headache
• Dizziness
• Feeling sick
• Feeling unusually tired or physically weak
• Digestive system problems, such as constipation, diarrhoea, indigestion or farting
• Muscle pain
• Sleep problems
• Low blood platelet count.

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine you’re taking.

It’s run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA).

“Your doctor should discuss the risks and benefits of taking statins if they’re offered to you,” advises the NHS.

The risks of any side effects also have to be balanced against the benefits of preventing serious problems.

A review of scientific studies into the effectiveness of statins found around one in every 50 people who take the medicine for five years will avoid a serious event, such as a heart attack or stroke, as a result.

Natural ways to lower high cholesterol

You can lower high cholesterol levels by tweaking your diet.

“To reduce your cholesterol, try to cut down on fatty food, especially food that contains a type of fat called saturated fat,” advises the NHS.

Examples of saturated fat include fatty meat, butter and cakes and biscuits.

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