Nearly 47 million people are prescribed statins, a class of drugs that help lower blood cholesterol, which can lessen the risk of heart attack and stroke.

But not all patients are taking their statins as prescribed. According to a study led by researchers at Beth Israel Deaconess Medical Center and the University of Pittsburgh, only 35% of people eligible for statins are taking them.

This doesn’t come as a surprise to Nancy Dagefoerde, APRN, a nurse practitioner at OSF HealthCare Cardiovascular Institute. She says people are hesitant because of misinformation about statins, particularly the side effects. This comes from the internet and/or family and friends and can feed already existing fears.

“People worry about muscle pain. That's a common side effect,” she says. “They think it's going to do something to their liver or their kidneys. It's going to cause diabetes; it's going to cause dementia. There's a lot of misconceptions out there and reading that (wrong) information scares people and then they choose not to take the medication and they don't look at the benefits.”

While the chance of developing serious side effects is low, Dagefoerde says there are other options for patients if they do develop muscle pain, including adjusting the dosage or trying another statin. The muscle pain, however, could be coming from another health issue, such as arthritis or a thyroid problem. That’s why it’s important to communicate with your care team.

Statins are typically recommended for people with elevated levels of LDL cholesterol; individuals with known cardiovascular disease, including heart attacks, strokes, or peripheral artery disease, and people with a high risk of cardiovascular diseases. Statins work by blocking the production of cholesterol as it is pulled from the bloodstream preventing damage to organs and blood vessels. Dagefoerde says that 80% of our cholesterol is manufactured in the liver and that is determined by our genetics.

But medication can have a dramatic, positive effect. “By lowering your cholesterol, the patient gets the benefit of reducing their heart attack and stroke risk or any blood vessel risk,” she says. “We could lower their heart attack and stroke risk in some cases up to 50%.”

Statins are important because in many cases dieting and exercise alone don’t lower our cholesterol numbers. “Oftentimes, it’s not going to budge with just diet and exercise so we have to figure out an adequate treatment plan for you,” says Dagefoerde. Still, most medical experts recommend 150 minutes of moderate exercise each week, the same amount of exercise for people who do not take statins.

In some cases, adults who are considered healthy can also benefit from taking statins as an added measure against future cardiovascular episodes. Some patients only take statins a few days a week to get protection for their blood vessels against heart attacks and strokes.

Dagefoerde says the bottom line when it comes to cholesterol issues is to have a frank discussion with your medical providers. Come to your appointment prepared with plenty of questions and ask about your potential risk – even if you haven’t had any heart issues. 

“If your risk is high, then we want to do more preventive cardiology,” she says.  “Let’s treat the cholesterol, the blood pressure, the sugar – and get active and eat healthy. These are all components for overall health and hopefully we can prevent problems down the line.”

Interview Clips 

B-Roll 

When Linda Norcross started experiencing back pain last August, she never imagined it could be a serious problem.

That is, until she paid a visit to an urgent care where she had an X-ray that revealed some startling news.

“I would say perhaps an hour later, I received a phone call, saying that I needed to go to the nearest emergency room because they detected or what they thought they saw was an aneurysm in my abdominal area," says Norcross, who lives in Loves Park, Illinois. "So I went to the emergency room and, yes, indeed I did.”

The 59-year-old Norcross was in shock.

An abdominal aortic aneurysm is a condition that happens when part of the aorta becomes enlarged. Typically, the abdominal aorta resembles a pipe, but when an aneurysm occurs it looks more like a balloon, and that’s when it can rupture, which can turn deadly if not treated immediately, according to Samantha Cox, DO, a vascular surgeon with OSF HealthCare. 

“When we see a patient that has what we call an abdominal aortic aneurysm, it would be an enlargement of that vessel to a certain size, where we would be concerned about the anatomy and how it may affect that person," says Dr. Cox. 

Common risk factors of an abdominal aortic aneurysm include being age 50 and older, being male and a family history of aneurysms. However, the greatest risk of all is smoking, which causes 75% of all cases.

While Norcross was experiencing back pain, that’s not always a telltale sign of a problem. But she had smoked for 47 years.

“Unfortunately, a lot of times there are no symptoms, which is one of the problems with abdominal aortic aneurysms," says Dr. Cox. "Most patients have no symptoms at all until they're in trouble. And when those patients get into trouble, it can be catastrophic. So, we really advocate for screening programs because there are truly no symptoms in large part.”

According to Dr. Cox, women haven't been historically screened or monitored as closely as men and that’s another problem. For example, the U.S. Preventive Services Task Force guidelines only recommend screening for men over 65 who have ever smoked. But women do get aneurysms, as well. The Society of Vascular Surgery guidelines include women in its screening programs, because women often have worse outcomes. They often rupture at a smaller size, and they often have a higher risk of dying associated with their aneurysm, adds Dr. Cox.

Norcross went to OSF HealthCare Saint Anthony Medical Center in Rockford, Illinois. She was referred to Dr. Cox, who, as a vascular surgeon, is well versed in treating abdominal aortic aneurysms. Norcross’s aneurysm measured six centimeters in size, or about two inches in diameter, which surpassed the threshold of five centimeters – the size when it is recommend to be repaired in women.

Dr. Cox performed a minimally invasive procedure using an endograft through Norcross’s groin without making an abdominal incision. The endovascular stent graft is placed inside of the abdominal aorta to help protect the aneurysm from rupturing. 

The surgery was a success and Norcross was able to leave the hospital the next day.

These days, Norcross is feeling good and grateful for the care she received. She’s feeling less fatigued, is treating her high blood pressure, and made some lifestyle changes including walking more and drinking less caffeine. The biggest change: she finally gave up smoking. She still has follow-up appointments with Dr. Cox.

Norcross says she’s feeling especially grateful this Christmas season that her aneurysm was caught in time.

“It can be fixed when you know about it, but once it gets past that point, which mine was well on its way," says Norcross. "So, if I had not hurt my back. Most times it's found accidentally, by looking for something else or at something else. So that's how mine was discovered, accidentally.”

Dr. Cox says the bottom line when it comes to treating abdominal aortic aneurysms is making a diagnosis before it’s too late. And that’s where screening comes in. She encourages men and women, 65 and older with a smoking history, to get screened. It can be done in an office setting and takes less than one hour to complete.

“We see here a great outcome that maybe if years had passed and the aneurysm had progressed, our outcome would have been a different story," she says. "I'm glad we're here to tell this one today. It was a very good story. And a patient who's become a champion for recognizing aneurysms, and I'm very proud of her for that.”

For more information, visit OSF HealthCare.

Linda Norcross Interview Clips

Dr. Samantha Cox Interview Clips 

B-Roll 

The Great American Smokeout rolls around every year during the third week of November and it has helped millions of people quit since it started in the early 1970s. The idea is not necessarily to make people stop cold turkey on that day, but rather to have tobacco users begin to think about quitting or to start the process if they plan to make it their quit date.

The campaign is important because according to the American Cancer Society, smoking causes more than 480,000 deaths every year, or about one in five deaths. More than 16 million Americans live with a smoking-related disease.

Dr. Jesse VanLe, a cardiothoracic surgeon for OSF Cardiovascular Institute in Bloomington, Illinois, is a strong supporter of the Great American Smokeout, which will be Thursday, November 18.

Smoking harms almost every tissue and organ in the body, including your heart and blood vessels. Nicotine, one of the main chemicals in cigarettes, causes your heart to beat faster and your blood pressure to rise. Carbon monoxide from smoking also gets into the blood and robs your body of oxygen.

According to Dr. VanLe, those who smoke have good reason to worry about its effect on their health.

“The World Health Organization has estimated that the number of cardiovascular associated events is approximately 17 to 18 million per year attributed to smoking,” he says. “A person who is 40 years old who smokes, they'll have approximately nine years taken off their life by the time they reach 60 to 70. Nine years, which is a lot.”

Despite the data, quitting isn’t easy for most smokers. According to research offered by the Illinois Quitline, it can take the average person five to seven times before they quit for good. Dr. VanLe says it is important not to get discouraged, and suggests surrounding yourself with supportive family and friends and changing habits that can trigger the urge to smoke.

“The population that has the most success would be the one not exposing themselves to the advertisements: other people who smoke for example, not visiting the bar anymore, or they have a very strong family system that helps them out and encourages them to quit. At first it is very difficult, but if you can do it after six months, with strong family support, and change the environment, then you'll be more successful,” says Dr. VanLe.

Over time people who quit smoking see many benefits to their health. According to the Centers for Disease Control and Prevention (CDC), some benefits of quitting even start immediately after that last cigarette. Within minutes a person’s heart rate will drop, in 24 hours the nicotine level in the blood drops to zero, and in a matter of days the carbon monoxide level in the blood drops to a level of someone who does not smoke.

“Some process takes longer than others but we know the chemicals and everything can be reversed within five years. And that's a tremendous amount of reversal in terms of coronary occlusive disease that you can do. So let's start from day one. You can measure the difference,” encourages Dr. VanLe.

Here are some good guidelines for what kind of nicotine replacement therapy you might want to try to address the physical addiction. Along with counseling, the Illinois Tobacco Quitline offers up to six weeks of free nicotine replacement therapy (NRT) to enrolled clients who qualify.

As for using e-cigarettes to quit smoking, Dr. VanLe says there isn’t enough research to know the long-term, potential harmful impact. He also points out the Federal Food and Drug Administration hasn’t approved the devices as a smoking cessation tool because of the lack of research connected with their use.

The Illinois Tobacco Quitline is 1-866-QUIT-YES. It can offer a variety of support and helpful tools. You can also find an OSF HealthCare behavioral therapist or doctor who can help you quit smoking or end smokeless tobacco use.

Interview Clips - Dr. Jesse VanLe

B-Roll - Smoking