Statins are a class of prescription medications designed to lower levels of low-density lipoprotein (LDL), often referred to as “bad” cholesterol. By targeting the liver’s cholesterol production, statins help slow arterial plaque formation, lower inflammation in artery walls, and reduce the risk of heart attacks and strokes. They also help stabilize existing plaque to prevent rupture. Typically, once you begin taking statins, doctors recommend long-term use for continued protection.
Statins may be prescribed if you:
Have elevated LDL cholesterol levels
Have experienced a heart attack or stroke—or are at high risk
Have diabetes and are over 40 years old
These medications rank among the most frequently prescribed in the U.S., with over 40 million users.
The U.S. FDA has approved eight statins, including:
Atorvastatin (Lipitor)
Fluvastatin (Lescol)
Lovastatin (Mevacor and Altoprev)
Pitavastatin (Livalo)
Pravastatin (Pravachol)
Rosuvastatin (Crestor)
Simvastatin (Zocor)
Your healthcare provider selects the appropriate statin based on your LDL reduction needs and any other medications you may be taking. Individual responses and tolerability can vary.
Many users report muscle aches or fatigue. However, a large trial found that over 90 percent of these symptoms occurred even when patients were taking placebos—not statins—suggesting genuine statin-related muscle issues are uncommon. Adjusting the statin type or dosage often resolves them.
Some individuals report mild confusion or memory lapses on statins. These symptoms are usually temporary and improve upon discontinuation. Large clinical trials have found no increased risk of dementia or lasting cognitive decline.
Statins may slightly raise blood sugar levels, potentially increasing type 2 diabetes risk—especially at higher doses or among individuals already at risk. Yet, organizations such as the FDA continue to stress that the cardiovascular benefits generally outweigh this small risk. Monitoring blood sugar and reinforcing healthy habits can help manage this concern.
For patients who cannot tolerate statins or who continue to have high cholesterol, several non-statin therapies are available:
Ezetimibe (Zetia): Reduces cholesterol absorption from food and bile with minimal side effects.
Bempedoic acid (Nexletol): Lowers liver cholesterol production and avoids muscle tissue; side effects may include gout, mild kidney impact, and gallbladder inflammation.
Bile acid sequestrants: Prevent bile acids from being reabsorbed, causing the liver to use blood cholesterol to produce more; side effects may include gastrointestinal discomfort and muscle pain.
PCSK9 inhibitors: Newer injectable options for individuals with inherited high LDL or those unresponsive to maximal statin therapy; side effects may include flu-like symptoms and injection site discomfort.
For some individuals, diet and exercise alone may successfully lower cholesterol. Effective strategies include:
Following diets such as the DASH plan, rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy, while limiting sugar and saturated fats.
Engaging in at least 30 minutes of daily moderate physical activity.
Managing stress, achieving a healthy weight, and quitting smoking.
Statins remain a cornerstone in preventing cardiovascular events by managing high cholesterol. Though side effects like muscle aches, memory issues, or modest blood sugar increases can occur, most patients experience clear benefits. Alternatives and lifestyle changes ensure there are options for those who cannot take statins. Always consult your healthcare provider to determine the most appropriate treatment for your individual health needs.
(Rh/Eth/TLMSM)
