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JAMA Patient Page
April 3, 2013


JAMA. 2013;309(13):1419. doi:10.1001/jama.2013.3041

Statins (also called HMG-CoA reductase inhibitors) are medications used to lower bad cholesterol, which is a waxy material that the body produces and that is also found in saturated fats and animal products. Your body needs cholesterol for your cells to work properly. There are 2 kinds of cholesterol. “Bad” cholesterol (low-density lipoprotein cholesterol or LDL-C) builds up in the arteries to form plaque, which can block arteries and cause high blood pressure, heart disease, a stroke, or a heart attack. Conversely, “good” cholesterol (high-density lipoprotein cholesterol or HDL-C) helps the body get rid of bad cholesterol. Cholesterol is measured by a simple blood test and reported as a number. It is optimal for bad cholesterol to be as low as possible and for good cholesterol to be as high as possible. The best way to lower your cholesterol is through diet and exercise, but because genetics can play a role, diet and exercise are not always enough.

Statin use: benefits and risks

If you have had a heart attack or if you have other types of blockages in your arteries, your doctor will recommend that you lower your bad cholesterol. He or she may also prescribe a statin to help you do so, depending on your LDL-C level and other factors, including age, family history, and presence of smoking, high blood pressure, overweight, or diabetes.

Like most medications, statins can have side effects. These include muscle pain or muscle weakness; nausea, constipation, or diarrhea; liver damage; and kidney damage. Recently, researchers have found that for a small number of people, statins are associated with an increased risk of type 2 diabetes. Researchers continue to evaluate these and other side effects.

Research has demonstrated that statins are effective for lowering bad cholesterol, and most physicians prescribe them for patients who have had a heart attack. However, there is some question as to whether taking statins is a good idea for people who have not had a heart attack but are at risk of one because of their high bad cholesterol level.

One question involves disagreement about whether the statin side effects are merely uncomfortable or actually pose significant heath risks. The other question is whether reducing bad cholesterol will actually help you live longer than you otherwise would. Some of this disagreement involves how physicians interpret the results of studies. However, a 2010 analysis combined the results of 11 studies and found that taking statins did not lower the death rate for people who did not have heart disease.

If your physician recommends taking a statin, talk to him or her about the risks and benefits for your individual situation.

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Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.