Statins are medicines that lower the levels of harmful (LDL) cholesterol in the blood. This can help to shrink the plaques that block arteries and help improve the blood supply to important organs in the blood.

Statins act on the liver to reduce the amount of cholesterol it makes and helps it take LDL cholesterol out of the blood.

Why should I take a statin?

There are many conditions that are linked to having arteries narrowed or blocked by fatty deposits. Examples of this are angina, heart attacks, strokes or poor circulation to the legs (claudication or peripheral vascular disease). Anyone living with diabetes will have a higher risk of developing cardiovascular problems, and statins help to reduce this risk.

Statins can also be used to prevent circulation problems in people who don’t have other medical conditions. People with high blood pressure, a family history of heart problems and high cholesterol levels may be prescribed statins to prevent heart attacks and strokes in the future. There is also evidence that statins can help reduce the risk of stroke in people aged over 65.  

Why is having a high cholesterol harmful?

Cholesterol is used by the body to make important substances like hormones, bile and cell membranes. High levels of LDL cholesterol is a risk because it causes hardening and narrowing of the arteries (atherosclerosis) and cardiovascular disease (CVD). Statins lower the levels of LDL cholesterol in your blood.

How long do I need to take a statin?

Cholesterol is needed by the body so your liver will always try to make more cholesterol. If you stop taking a statin, your cholesterol levels will go up again so it is important to keep taking your statin every day. You will get the most benefit from taking it regularly on a long-term basis.

When should I take my statin?

Please make sure you take your medication regularly as advised. Statins are usually taken at night, as this is when your liver makes the most cholesterol. However some statins can be taken in the mornings as they have a longer-lasting effect. Check with your doctor or pharmacist when you should be taking your statin.

Are there any foods, drinks or other medications I should avoid?

Your doctor or pharmacist should let you know about any interactions with other medication you are taking - for example the antibiotic clarithromycin should not be used at the same time as a statin.

For people taking statins, grapefruit and grapefruit juice are potentially harmful as they can increase the risk of side effects.

What are the side effects of statins?

Most people taking statins don’t have any significant problems. But, like any medication, statins have the potential to cause side effects. The most common side effect that people notice are muscular aches and pains. However a recent study of atorvastatin 20mg found no difference in the aches and pains that people felt with or without the medicine. Your doctor can do a blood test to see if there is any serious impact of the statin on your muscles.

If you do notice any side effects, or if they change or get worse, let your pharmacist or GP know.

As statins act on the liver, your doctor will ask you to get a blood test done a few months after starting on a statin to check that there is no significant adverse effect on your liver. If there are any problems, you may be advised to reduce your dose or switch to a different type of medication to lower your cholesterol.

What are the differences between statins?

There are a number of different statins that can be prescribed - and different ones may suit different people. Some statins are more powerful than others, but higher doses can cause more side effects.

For people who have angina or cardiovascular disease - you may be advised to have high intensity statin treatment to try and get your LDL cholesterol down by more than 40%. This could be 80 mg of Simvastatin, 80 mg of Atorvastatin or 40 mg of Rosuvastatin. These doses can be lowered or you can try a different statin if they are causing side effects.

Can I take a statin if I'm pregnant?

If you are pregnant or breastfeeding you should stop taking any statins. If you are already taking statins and are planning to become pregnant, speak to your GP first.

How else can I lower my cholesterol?

You can also improve your cholesterol by:

  • Eating a low fat diet or mediterranean style diet
  • Increasing your physical activity
  • Maintaining a healthy weight, BMI and waist circumference

Food products containing plant sterols can reduce blood cholesterol levels - but these have not been proven to improve health outcomes so they will probably not be recommended by your health professionals.

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Reviewed by Dr. Kingshuk Pal