If you have high cholesterol, your HCP may talk to you about prescribing a statin to lower it and protect your heart health.
What Are Statins?
Statins work by reducing the amount of cholesterol made by the liver and help the liver remove cholesterol that is already in the blood. Statins can also reduce the inflammation in the artery walls. This inflammation can lead to blockages that can damage organs such as the heart and brain.
Statins come as tablets or capsules that you swallow once a day. Statins that stay in your system for a short amount of time will work best if you take them in the evening. This is because your liver makes most of its cholesterol while you sleep, and taking the medication at night helps it work when it is needed most. Other forms of statins can be taken at other times of the day. The key is to be consistent in taking them the same way, every day, as prescribed.
Some types of statins include:
- Atorvastatin (Caduet® or Lipitor®).
- Lovastatin (Mevacor® or Altoprev™).
- Pitavastatin (Livalo® or Zypitamag®).
- Rosuvastatin (Crestor® or Ezallor Sprinkle®).
- Simvastatin (FloLipid®, Vytorin® or Zocor®).
Statins do not work instantly, but their effectiveness comes from steady and long‑term use.
What Is Cholesterol?
Cholesterol is a waxy, fat‑like substance your body needs to make hormones, vitamin D, and the acid you use to digest foods. If you have too much cholesterol in your blood, it can collect inside your arteries. This creates barriers that make it harder for your blood to get through your blood vessels.
It comes from two places:
- Your liver, which makes most of the cholesterol in your body
- Your diet, especially foods like meat, eggs, butter, cheese, and full‑fat dairy
Cholesterol travels through the bloodstream on particles called lipoproteins:
- LDL (“bad”) cholesterol can stick to artery walls and form plaque
- HDL (“good”) cholesterol helps carry cholesterol back to the liver so it can be removed
When your LDL levels stay high, plaque builds up, your arteries begin to narrow, and your blood flow becomes restricted. This raises the risk of heart attacks and strokes.
How Statins Help Prevent Heart Disease
Heart disease develops slowly, often without symptoms. Plaque builds up over years, narrowing arteries and making them more fragile. Statins interrupt this process.
They help:
- Lower LDL (“bad”) cholesterol
- Reduce plaque growth
- Stabilize existing plaque
- Improve blood flow
- Lower the risk of heart attack and stroke
- Reduce inflammation inside artery walls
- Reduce the amount of fatty deposits in your arteries and stop any more from building up
For people at higher risk, statins can cut the chance of a heart attack or stroke by about 50%.
Who May Need a Statin
Doctors use a variety of ways to identify high-risk patients. These include examining all of your heart health measures, like blood pressure, blood glucose and body mass index (BMI). They may also examine the results of tests that assess plaque build-up, such as a coronary calcium scan. You will also have a blood test before starting your statin medication and afterwards to determine if it is lowering your cholesterol levels.
A clinician may recommend a statin if you:
- Have very high LDL cholesterol
- Have diabetes
- Have already had a heart attack, stroke, or peripheral artery disease
- Have multiple risk factors like high blood pressure or smoking
- Have a high calculated risk of heart disease based on age, sex, family history, and lab results
Some people inherit genes that make their bodies produce too much cholesterol, even if they eat well and stay active. In those cases, lifestyle changes alone may not be enough.
Benefits and Risks
Benefits include:
- Lower LDL and triglycerides
- Higher HDL in some people
- Lower risk of heart attack and stroke
- Lower risk of needing stents or bypass surgery
- Lower risk of dying from heart disease
Despite these benefits, just over one in four people (29%) taking a statin describes some type of symptom.
Risks include:
- Headache
- Nausea
- Dizziness
- Gas
- Diarrhea
- Constipation
- Achy muscles or joints
- Confusion
- Memory loss
- Damage to your kidneys
- Damage to your liver
- Muscles breaking down (rhabdomyolysis)
- Type 2 diabetes or high blood sugar
Most side effects can be managed by adjusting the dose or switching to a different statin. Statins should not be taken during pregnancy, breastfeeding, or by people who are planning to become pregnant.
Why Statins Matter for Everyone’s Heart Health
There are clear distinctions regarding heart health and statin use among different Asian ethnicities. South Asians who are living in the United States generally have lower levels of HDL (“good”) cholesterol compared to their white counterparts. People of South Asian descent (Bangladesh, India, Nepal, Pakistan and Sri Lanka) have a higher risk of developing heart disease than the general American population. Meanwhile people with Japanese backgrounds are more likely to be sensitive to statin drugs and may require lower doses.
It is also important to note that Black and Hispanic adults face higher rates of high blood pressure, diabetes, stroke, and early heart disease. Yet, Black and Hispanic people are less likely to receive statins even when medically eligible.
A 2023 JAMA Cardiology study found:
- 37.6% of white adults at risk were taking statins
- Only 23.9% of Hispanic adults were taking them
- Only 23.8% of Black adults were taking them
These differences remained even after adjusting for cholesterol levels, blood pressure, diabetes, smoking, age, and sex. Lack of insurance, limited access to routine care, and missed prescribing opportunities all contribute to this gap.
This is a major disparity because statins are affordable, effective, and are proven to save lives. When underserved communities do not receive them or stop taking them early due to fear or misinformation, preventable heart disease continues to hit them harder.
Taking Control
Understanding statins is not about rushing into medication, it is about having the information you need to make a confident and informed decision. Asking your clinician about your cholesterol numbers, your personal risk, and whether a statin could help you is a powerful step toward protecting your heart and your future.
Sources
Ethnicity a ‘risk-enhancing’ factor under new cholesterol guidelines | American Heart Association
Genetic High Cholesterol: Why Your “Perfect” Diet Isn’t Lowering Your Levels | Ubie Doctor’s Note
How do statins prevent heart attacks and strokes? | CDC
How Statin Drugs Protect the Heart | Johns Hopkins Medicine
Racial disparities exist in use of statins to reduce heart disease risk | UT Southwestern
Statins: How They Work | Cleveland Clinic
The Scoop on Statins | Million Hearts
The Scoop on Statins: What Do You Need to Know? | Million Hearts
Why Certain Statins Should Be Taken At Night | Marley Drug