Statins: Benefits, Side Effects and Myths

Statins are among the most widely studied medicines in the world. They lower LDL (“bad”) cholesterol and reduce the risk of heart attacks and strokes. Yet many people stop taking them because of worries about side effects.

Imagine being prescribed a statin after a mild heart attack, then reading online that they cause muscle damage. You stop them without telling anyone. At your follow-up, your doctor explains the actual risk and suggests a different dose. You restart, feel fine, and your cholesterol falls by half.

Who are statins for?

• People who’ve had a heart attack, stroke or other cardiovascular disease
• People at high risk based on age, blood pressure, cholesterol, diabetes, smoking and family history
• People with inherited very high cholesterol (familial hypercholesterolaemia)

How well do they work?

Large analyses show that lowering LDL cholesterol with statins reduces major heart attacks and strokes by roughly a fifth for each 1 mmol/L reduction. The benefit is greatest for people at highest risk.

But what about side effects?

• Muscle aches: commonly reported, but blinded trials show most aches happen just as often with a placebo. Serious muscle damage is rare.
• Diabetes: a small increased risk of developing type 2 diabetes, mainly in people already at risk; the heart benefits usually outweigh it.
• Liver: mild changes in liver tests occasionally; serious liver problems are very rare.
• Memory loss myth: good-quality studies haven’t shown statins cause dementia.

If you get side effects, don’t stop on your own. Your doctor can try a lower dose, a different statin or another cholesterol-lowering medicine. Seek medical advice promptly for unexplained severe muscle pain, weakness or very dark urine.

Statins work best alongside a healthy diet, activity, not smoking and blood pressure control.

Sources: Cholesterol Treatment Trialists’ Collaboration (The Lancet), American Heart Association, British Heart Foundation, NHS (Statins).