What Is a Statin and How Does It Lower Cholesterol?

“If you have high cholesterol, it is important to take steps to lower it,” said Evan Choi, MD, Catholic Health Cardiologist. “High cholesterol can cause serious health problems like heart disease and stroke.”

Too much cholesterol can lead to excess plaque in arteries. Plaque is a buildup of cholesterol and fat that can block blood flow to your heart and other parts of your body.

Your primary care physician (PCP) may recommend taking a statin to bring your cholesterol into the normal range and reduce your risk of developing further health problems. Statins block an enzyme the liver uses to make cholesterol, and they help your liver remove cholesterol already in the blood.

What is a normal total cholesterol level?

There are two types of cholesterol: low-density lipoprotein (LDL, or “bad” cholesterol) and high-density lipoprotein (HDL, or “good” cholesterol). Statins can decrease your LDL by 50% or more. They also increase your HDL, which helps bring cholesterol to the liver for removal from the body.

A normal total cholesterol level is below 200 mg/dL. In the normal range:

HDL is 60 mg/dL or higher
LDL is below 100 mg/dL

Your cholesterol is considered high if your total cholesterol level is 240 mg/dL or higher. In this range:

HDL is under 40 mg/dL (men) or under 50 mg/dL (women)
LDL is 160 mg/dL or higher

Who needs a statin?

If you are between 40 and 75 years old, you can benefit from a statin if you:

Have diabetes and an LDL of at least 70 mg/dL
Have an LDL of at least 70 mg/dL and a high risk of getting heart disease
Have an LDL above 160 mg/dL, a family history of early coronary artery disease

Dr. Choi explained that the medicine can also benefit people whose cholesterol cannot be brought into a normal range with diet changes and physical activity.

What statins do physicians usually prescribe?

There are several FDA-approved statins your physician may prescribe, such as Lipitor^®.

Your prescription depends on several factors, including:

Age
Family history
Other medicines you are taking
Risk factors for heart disease and blood vessel disease
Sex
Your target cholesterol level

How long do I need to take a statin?

“You typically have to take them for the rest of your life,” said Dr. Choi. “Your body will always produce cholesterol, which will build up if you stop taking your medication.”

Physicians recommend taking it at the same time every day so you remember to take it. Most people take them before bed.

Your medication may not work as well if you skip or stop taking doses. Your body needs a certain amount of the medication at all times to be effective. If you miss a dose, do not take an extra one to make up for it. Take your next dose as usual.

What are the side effects of statins?

They are generally safe and effective for most people. However, they can cause side effects.

Common side effects include:

Confusion
Diarrhea
Dizziness
Headache
Interactions with other medicines
Joint or muscle aches
Nausea

Most people do not have side effects. If you have side effects with one statin, your physician can prescribe another.

Can I manage cholesterol without statins?

Physicians do not recommend statins for everyone. Your physician may avoid prescribing them if you:

Are at risk for cardiovascular disease
Are pregnant or nursing
Have an increased risk for myopathy, a condition that attacks the skeletal muscles
Have an underactive thyroid
Have had a previous allergic reaction to statins
Have liver problems

“You may be able to manage your cholesterol without medicine if you make significant lifestyle changes,” said Dr. Choi. “Your physician will monitor if these changes lower your cholesterol enough."

Lifestyle changes include: