When is it worth taking statins to lower high cholesterol?

The health impact of lowering cholesterol levels with statins will very much depend on your individual risk of cardiovascular disease. A doctor can help you determine your own risk.

The following table might make it clearer why other risk factors have to be considered too. It describes two men and two women who are at “low” or “high” risk of cardiovascular disease. “Low risk” means they have high cholesterol levels only. "High risk" means that, in addition to having high cholesterol levels, they have other risk factors such as smoking, high blood pressure or diabetes.

The number in the first column indicates how many out of 100 people will have a heart attack or stroke within the next ten years if they don't take statins. The number in the second column indicates how many people will have one of these cardiovascular events within the next ten years if they take statins during that time. The third column shows the difference between the two groups – in other words, the number of people that statins will prevent heart attacks or strokes in.

The table makes it clearer that women and men who have a higher risk of cardiovascular disease benefit more from statins than those who have a low risk. In other words, the higher your risk of cardiovascular disease, the more likely you are to benefit from taking statins. But it isn't possible to predict who will benefit from the treatment and who will not.

Statins are usually well tolerated. But a few studies suggest that there is a small group of people who react more sensitively to these drugs, and who may get muscle pain when they use them.

Statins can also lead to an increase in blood sugar levels. In studies, statins were found to lead to high blood sugar levels in 1 out of 1,000 people per year. But it's not clear whether this affects their health.

Rhabdomyolysis is an extremely rare but serious side effect where the muscle tissue in certain muscles gradually breaks down. This can lead to permanent paralysis, and the breakdown products can cause serious kidney damage. In studies, rhabdomyolysis was found to occur in 1 out of 10,000 people who took statins for longer periods of time. Signs of rhabdomyolysis include muscle pain and dark-colored urine. So it's important to seek medical advice if you have these symptoms.

Many people would rather not have to take medication regularly over longer periods of time. They might worry that leftover medication will build up in their body. But fears like this are unfounded: Our bodies continuously break down medications and get rid of them with the help of various mechanisms.