What is statins?

Statins are medicines that lower your cholesterol and your risk for a heart attack and stroke.

Cholesterol is a type of fat in your blood. If you have too much cholesterol, it can build up in blood vessels. This raises your risk of coronary artery disease, heart attack, and stroke.

Statins lower cholesterol by blocking how much your body makes. This prevents cholesterol from building up in your blood vessels. This is called hardening of the arteries. It is the starting point for some heart and blood flow problems, such as coronary artery disease. Statins may also reduce inflammation around the buildup (called plaque). This can lower the risk that the plaque will break apart and lead to a heart attack or stroke.

A heart-healthy lifestyle is important for lowering your risk whether you take statins or not. This includes eating healthy foods, being active, staying at a healthy weight, and not smoking.

Examples of statins include:

• Atorvastatin (Lipitor).
• Pravastatin (Pravachol).
• Simvastatin (Zocor).

Statins interact with many medicines. So tell your doctor all of the other medicines that you take. These include prescription medicines, over-the-counter medicines, dietary supplements, and herbal products.

Take a statin regularly so that it can work well. High cholesterol doesn't make you feel sick. That's why some people may not feel that they need to take their medicine. But it's important to take your statin because it can lower your risk of heart attack and stroke. Talk with your doctor if you have side effects that bother you.

Here are some examples of statins. For each item in the list, the generic name is first, followed by any brand names.

• Atorvastatin (Lipitor)
• Pravastatin (Pravachol)
• Simvastatin (Zocor)

This is not a complete list of statins.

• You must take statins on a regular basis for them to work well. If you stop, your risk for heart attack and stroke may go back up.
• Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• If you have side effects that bother you, talk to your doctor. You may be able to take a different statin.
• Check with your doctor or pharmacist before you use any other medicines. This includes over-the-counter medicines. Make sure your doctor knows all of the medicines, vitamins, herbal products, and supplements you take. Taking some medicines together can cause problems.

Statins lower the amount of cholesterol in your blood by reducing how much cholesterol your body makes.

Along with lowering cholesterol levels in the blood, statins reduce inflammation around the cholesterol buildup (called a plaque). This may lower the risk that the plaque will break apart and cause a blood clot that can lead to a heart attack or stroke.

The goal in treating cholesterol is to lower your chance of having a heart attack or a stroke. The goal is not to lower your cholesterol numbers alone.

The following guidelines are from the American College of Cardiology and the American Heart Association.

The two main types of treatment are:

• Heart-healthy lifestyle.
• Medicines called statins.

The way you choose to lower your risk will depend on how high your risk for heart attack and stroke is. It will also depend on how you feel about taking medicines. Your doctor can help you know your risk. Your doctor can help you balance the benefits and risks of your treatment options.

Heart-healthy lifestyle

A heart-healthy lifestyle is always important, even if you take medicines to lower your risk.

To be heart-healthy:

• Eat heart-healthy foods.
• Lose weight if you need to, and stay at a healthy weight.
• Be active on most, if not all days of the week.
• Don't smoke.
• Manage other health problems.

Statins

You and your doctor can work together to understand your risks and what treatment is best for you. Your doctor may recommend that you take statins if the benefits outweigh the risks.

Statins strongly recommended for these people

Your doctor is likely to strongly recommend statins if you:

• Have coronary artery disease.
• Have peripheral arterial disease.
• Had a heart attack.
• Had a stroke.

Statins recommended for these people

Your doctor is likely to recommend statins if:

• Your LDL cholesterol is 190 mg/dL or above.
• You have diabetes and you are age 40 to 75.
• Your 10-year risk of heart attack or stroke is 7.5% or above and you are age 40 to 75.

Statins not as clearly recommended for these people

For some people, it's not as clear if they would benefit from a statin. To help you decide, you and your doctor can look at your overall health and any other risks you have for heart attack and stroke.

When deciding about medicines, you and your doctor may think about:

• Your family history of early coronary artery disease. Early coronary artery disease means you have a male family member who was diagnosed before age 55 or a female family member who was diagnosed before age 65.
• A high LDL cholesterol test result (160 mg/dL or higher).
• Results of tests such as C-reactive protein, coronary calcium scan, or ankle-brachial index.
• Your lifetime risk of heart attack and stroke.

Other medicines

Your doctor may talk with you about also taking a cholesterol absorption inhibitor or a PCSK9-inhibitor. These medicines can also reduce the risk of heart attack and stroke for some people. These medicines may be taken along with a statin.

Other medicines can improve cholesterol and triglyceride levels, but they have not been proven to lower the risk of a heart attack or a stroke. These medicines include bempedoic acid, bile acid sequestrants, fibric acid derivatives, and nicotinic acid (niacin).

Statins are used to lower cholesterol and the risk for a heart attack and stroke.

Some people who take statins report that they have more muscle aches. But it's not clear whether these are actually a side effect of statins. Most side effects will go away if you stop taking the medicine. You may have other side effects not described here. Check the information that comes with your medicine.