Statins: Should I Take Them?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Statins: Should I Take Them?

Get the facts

Your options

  • Start taking a medicine called a statin to lower your risk for heart attack and stroke.
  • Don't take a statin. Try lowering your risk with lifestyle changes.

Key points to remember

  • Medicines called statins can lower your risk of having a heart attack or stroke.
  • A heart-healthy lifestyle is important for lowering your risk whether you take statins or not. This includes eating healthy foods, being active, staying at a healthy weight, and not smoking.
  • Your doctor uses your cholesterol levels plus other things to find out your risk of heart attack and stroke. You and your doctor can decide whether you need to lower your risk and what treatment is best for you.
  • Some people may need to start taking a statin right away. That's because their chance of having a heart attack or stroke is high, and statins can reduce this risk.
  • For some people, it's not as clear if they need to take a statin. You and your doctor will need to look at your overall health and any other risks you have for heart attack and stroke.
  • Statins don't cause side effects in most people. Any side effects, such as muscle aches, feeling tired, or having an upset stomach, are most likely when higher doses are used.
FAQs

What increases your risk for heart attack and stroke?

Your overall health can help your doctor find out your risk for having a heart attack or stroke. Your doctor uses a few things to calculate your risk. These include:

  • Your cholesterol numbers.
  • Your blood pressure.
  • Whether or not you have diabetes.
  • Your age, sex, and race.
  • Whether or not you smoke.

You can help lower your risk with a heart-healthy lifestyle and medicines. The way you choose to lower your risk will depend on how high your risk for heart attack and stroke is. It will also depend on how you feel about taking medicines.

How can lifestyle changes lower your risk?

Everyone can help lower their risk with a heart-healthy lifestyle. This includes:

  • Eating a heart-healthy diet that is rich in fruits, vegetables, whole grains, fish, and low-fat or nonfat dairy foods.
  • Being active on most days of the week.
  • Losing weight if you need to, and staying at a healthy weight.
  • Not smoking.

Heart-healthy lifestyle changes are important whether you decide to take medicines or not. Medicines don't replace these healthy habits.

How do statins lower your risk?

Statins are a type of medicine used to lower the amount of cholesterol in your blood. Statins reduce the body's natural production of cholesterol.

Cholesterol is a type of fat in your blood. Your body needs it for many things, such as making new cells. But if you have too much, it starts to build up in blood vessels called arteries. This problem is called atherosclerosis. It is the starting point for most heart and blood flow problems, including heart attacks and strokes.

Along with lowering cholesterol levels in the blood, statins reduce inflammation around the cholesterol buildup (called a plaque). This may lower the risk that the plaque will break apart and cause a blood clot that can lead to a heart attack or stroke.

What are the risks and side effects of statins?

Statins don't cause side effects in most people.

When side effects happen, they tend to include minor problems such as:

  • Muscle aches.
  • Tiredness.
  • Upset stomach.

These may be bothersome but are not serious. Serious side effects are rare. They include liver and muscle problems, diabetes, and temporary memory problems.2

What do numbers tell us about benefits and risks of statins?

Benefits if you have heart disease
Effects of statins for people who have heart disease*
Risks within next 3 to 5 years With statins Without statins
Death from any cause 8 to 9 out of 100 11 to 12 out of 100
Death from heart or blood vessel problems 3 to 4 out of 100 8 to 9 out of 100
Nonfatal heart attack 5 to 6 out of 100 8 to 9 out of 100

*Based on the best available evidence (evidence quality: moderate)

Evidence shows that statins help people with heart disease by reducing the risk of death and heart attack. The quality of this evidence is moderate.

Take a group of 100 people who have heart disease. Here is their risk of death from any cause within the next 3 to 5 years:

  • Without statins, 11 to 12 out of 100 people with heart disease will die. This means that 88 to 89 out of 100 will not.
  • With statins, 8 to 9 out of 100 will die. This means that 91 to 92 will not.

Here is their risk of death from heart or blood vessel disease within the next 3 to 5 years:

  • Without statins, 8 to 9 out of 100 people with heart disease will die from a heart or blood vessel problem. This means that 91 to 92 out of 100 will not.
  • With statins, 3 to 4 out of 100 will die from a heart or blood vessel problem. This means that 96 to 97 out of 100 will not.

And here is their risk of a nonfatal heart attack (a heart attack that doesn't cause death) within the next 3 to 5 years:

  • Without statins, about 8 to 9 out of 100 people will have a nonfatal heart attack. This means that about 91 to 92 out of 100 will not have one.
  • With statins, 5 to 6 out of 100 people will have a nonfatal heart attack. This means that 94 to 95 out of 100 will not.
Benefits if you don't have heart disease
Effects of statins for people who don't have heart disease*
Risks within next 3 to 5 years With statins Without statins
Death from any cause 3 to 4 out of 100 4 to 5 out of 100
Nonfatal heart attack 1 to 2 out of 100 2 to 3 out of 100

*Based on the best available evidence (evidence quality: borderline)

Evidence shows that statins may be helpful for some people who don't have heart disease. The quality of this evidence is borderline.

Take a group of 100 people who don't have heart disease. Here is their risk of death from any cause within the next 3 to 5 years:

  • Without statins, 4 to 5 out of 100 may die. This means that 95 to 96 out of 100 may not.
  • With statins, 3 to 4 out of 100 may die. This means that 96 to 97 out of 100 may not.

And here is their risk of a nonfatal heart attack within the next 3 to 5 years:

  • Without statins, about 2 to 3 out of 100 people may have a nonfatal heart attack. This means that about 97 to 98 out of 100 may not have one.
  • With statins, 1 to 2 out of 100 people may have a nonfatal heart attack. This means that about 98 to 99 out of 100 may not.
Risks

Most evidence shows that statins are safe.

Some studies suggest that statins may increase your risk of diabetes, liver problems, and a rare muscle problem called rhabdomyolysis. But this evidence is not clear. It is inconclusive.

Understanding the evidence

Some evidence is better than other evidence. Evidence comes from studies that look at how well treatments and tests work and how safe they are. For many reasons, some studies are more reliable than others. The better the evidence is—the higher its quality—the more we can trust it.

The information shown here is based on the best available evidence.3, 1, 4, 5, 6, 7, 8, 9The evidence is rated using four quality levels: high, moderate, borderline, and inconclusive.

Another thing to understand is that the evidence can't predict what's going to happen in your case. When evidence tells us that 2 out of 100 people who have a certain test or treatment may have a certain result and that 98 out of 100 may not, there's no way to know if you will be one of the 2 or one of the 98.

Why might your doctor recommend taking statins?

You and your doctor can work together to understand your risks and what treatment is best for you. Your doctor may recommend that you take statins if the benefits outweigh the risks.10, 11

Statins clearly recommended for these people

Some people may need to start taking medicine right away. That's because their chance of having heart attack and stroke is high, and statins can reduce this risk.

Your doctor is likely to recommend statins if you:

Statins recommended for these people

Some people may need to start taking medicine right away because their risk of having a heart attack and stroke is high enough that the benefits outweigh the risks.

Your doctor is likely to recommend statins if:

  • Your LDL cholesterol is 190 mg/dL or above.
  • You have diabetes and you are age 40 to 75.
  • Your 10-year risk of heart attack or stroke is 7.5% or above and you are age 40 to 75.
Statins not as clearly recommended for these people

In some people, it's not as clear if they need to take a statin. You and your doctor will need to look at your overall health and any other risks you have for heart attack and stroke.

You and your doctor may think about these things in deciding about medicine:

  • Your family history of early heart disease. Early heart disease means you have a male family member who was diagnosed before age 55 or a female family member who was diagnosed before age 65.
  • A high LDL cholesterol test result (160 mg/dL or higher)
  • Results of tests such as C-reactive protein, coronary calcium scan, or ankle-brachial index
  • Your lifetime risk of heart attack and stroke

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Take statins to lower your risk of heart attack or stroke Take statins to lower your risk of heart attack or stroke
  • You take a pill every day.
  • You make healthy lifestyle changes such as being active, eating healthy foods, losing weight, and quitting smoking.
  • Studies show that statins can:
    • Lower the risk of heart attack.
    • Lower the risk of stroke.
  • Statins don't cause side effects in most people.
  • Side effects are typically not serious. But they can be bothersome (muscle aches, tiredness, upset stomach).
Don't take statins Don't take statins
  • You make healthy lifestyle changes such as being active, eating healthy foods, losing weight, and quitting smoking.
  • You may be able to lower your risk of heart attack or stroke enough by making healthy changes.
  • You avoid taking pills every day.
  • Lifestyle changes may not be enough to lower your risk.
  • You may still be at risk for a heart attack or a stroke.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Stories about deciding whether to use medicine for high cholesterol

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

Heart disease runs in our family, so I know I need to be concerned about my health. I talked with my doctor about my family history and some other risk factors I have, including smoking. We decided that medicine would be a good idea for me, so I'm going to take it.

Becky, age 56

I don't like taking pills all the time, and I would have to take statins for the rest of my life to keep getting any benefit from them. My only other risk factor is high blood pressure. I just want to try changing my habits. I will try eating healthy foods and getting enough exercise to help keep my weight under control.

Carole, age 58

My dad died of a heart attack when he was in his 50s. I must have inherited my high cholesterol from him. I don't want to die before my time, so I am going to take medicine.

Charles, age 48

I just had a cholesterol test and found out that my cholesterol is high. But my blood pressure and some other things are fine. I don't smoke. So my doctor and I talked about it. She gave me some ways I can eat better and get more exercise.

Diego, age 41

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take statins

Reasons not to take statins

I've tried eating better and being more active, but doing these things hasn't lowered my risk enough.

I want to try to make lifestyle changes to help lower my risk.

More important
Equally important
More important

I don't mind taking medicine for the rest of my life if it will reduce my risk of heart attack and stroke.

I hate the idea of taking pills for the rest of my life, even if they will reduce my risk of heart attack and stroke.

More important
Equally important
More important

I'm not worried about the side effects of these medicines.

I am worried about the side effects of these medicines.

More important
Equally important
More important

I worry about having a heart attack or a stroke, and I want to do everything I can to prevent it.

I'm not that worried about having a heart attack or a stroke.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking statins

NOT taking statins

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

Is taking medicine the only way to lower your risk of a heart attack or a stroke?

  • YesSorry, that's not right. You may be able to lower your risk with lifestyle changes, such as eating heart-healthy foods, losing weight if you need to, exercising, and quitting smoking.
  • NoYou're right. You may be able to lower your risk with lifestyle changes, such as eating heart-healthy foods, losing weight if you need to, exercising, and quitting smoking.
  • I'm not sureIt may help to go back and read "Get the Facts." You may be able to lower your risk with lifestyle changes, such as eating heart-healthy foods, losing weight, exercising, and quitting smoking.
2.

Do you still need healthy habits even when you're taking statin medicines?

  • YesYou're right. Even with statins, you will also need heart-healthy habits.
  • NoSorry, that's not right. Even with statins, you will also need heart-healthy habits.
  • I'm not sureIt may help to go back and read "Get the Facts." Even with statins, you will also need heart-healthy habits.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

Credits and References

Credits
Credits Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology
Specialist Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology

References
Citations
  1. Tonelli M, et al. (2011). Efficacy of statins for primary prevention in people at low cardiovascular risk: A meta-analysis. Canadian Medical Association Journal, 183(16): e1189–e1202.
  2. Statin label changes (2012). Medical Letter on Drugs and Therapeutics, 54(1386): 21.
  3. Taylor F, et al. (2011). Statins for the primary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews (8).
  4. Alberton M, et al. (2012). Adverse events associated with individual statin treatments for cardiovascular disease: An indirect comparison meta-analysis. QJM: An International Journal of Medicine, 105(2): 145–157.
  5. Bonovas S, et al. (2006). Statins and cancer risk: A literature-based meta-analysis and meta-regression analysis of 35 randomized controlled trials. Journal of Clinical Oncology, 24(30): 4808–4817.
  6. Hayward RA, et al. (2006). Narrative review: Lack of evidence for recommended low-density lipoprotein treatment targets: A solvable problem. Annals of Internal Medicine, 145(7): 520–530.
  7. Mills EJ, et al. (2011). Efficacy and safety of statin treatment for cardiovascular disease: A network meta-analysis of 170,255 patients from 76 randomized trials. QJM: An International Journal of Medicine, 104(2): 109–124.
  8. Shepherd J, et al. (2002). Pravastatin in elderly individuals at risk of vascular disease (PROSPER): A randomised controlled trial. Lancet, 360(9346): 1623–1630.
  9. Ward S, et al. (2007). A systematic review and economic evaluation of statins for the prevention of coronary events. Health Technology Assessment, 11(14): 1–160, iii–iv.
  10. Stone NJ, et al. (2013). 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online November 12, 2013. DOI: 10.1161/01.cir.0000437738.63853.7a. Accessed November 18, 2013.
  11. Smith SC, et al. (2011). AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation. Circulation, 124(22): 2458–2473. Also available online: http://circ.ahajournals.org/content/124/22/2458.full.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Statins: Should I Take Them?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Start taking a medicine called a statin to lower your risk for heart attack and stroke.
  • Don't take a statin. Try lowering your risk with lifestyle changes.

Key points to remember

  • Medicines called statins can lower your risk of having a heart attack or stroke.
  • A heart-healthy lifestyle is important for lowering your risk whether you take statins or not. This includes eating healthy foods, being active, staying at a healthy weight, and not smoking.
  • Your doctor uses your cholesterol levels plus other things to find out your risk of heart attack and stroke. You and your doctor can decide whether you need to lower your risk and what treatment is best for you.
  • Some people may need to start taking a statin right away. That's because their chance of having a heart attack or stroke is high, and statins can reduce this risk.
  • For some people, it's not as clear if they need to take a statin. You and your doctor will need to look at your overall health and any other risks you have for heart attack and stroke.
  • Statins don't cause side effects in most people. Any side effects, such as muscle aches, feeling tired, or having an upset stomach, are most likely when higher doses are used.
FAQs

What increases your risk for heart attack and stroke?

Your overall health can help your doctor find out your risk for having a heart attack or stroke. Your doctor uses a few things to calculate your risk. These include:

  • Your cholesterol numbers.
  • Your blood pressure.
  • Whether or not you have diabetes.
  • Your age, sex, and race.
  • Whether or not you smoke.

You can help lower your risk with a heart-healthy lifestyle and medicines. The way you choose to lower your risk will depend on how high your risk for heart attack and stroke is. It will also depend on how you feel about taking medicines.

How can lifestyle changes lower your risk?

Everyone can help lower their risk with a heart-healthy lifestyle. This includes:

  • Eating a heart-healthy diet that is rich in fruits, vegetables, whole grains, fish, and low-fat or nonfat dairy foods.
  • Being active on most days of the week.
  • Losing weight if you need to, and staying at a healthy weight.
  • Not smoking.

Heart-healthy lifestyle changes are important whether you decide to take medicines or not. Medicines don't replace these healthy habits.

How do statins lower your risk?

Statins are a type of medicine used to lower the amount of cholesterol in your blood. Statins reduce the body's natural production of cholesterol.

Cholesterol is a type of fat in your blood. Your body needs it for many things, such as making new cells. But if you have too much, it starts to build up in blood vessels called arteries. This problem is called atherosclerosis. It is the starting point for most heart and blood flow problems, including heart attacks and strokes.

Along with lowering cholesterol levels in the blood, statins reduce inflammation around the cholesterol buildup (called a plaque). This may lower the risk that the plaque will break apart and cause a blood clot that can lead to a heart attack or stroke.

What are the risks and side effects of statins?

Statins don't cause side effects in most people.

When side effects happen, they tend to include minor problems such as:

  • Muscle aches.
  • Tiredness.
  • Upset stomach.

These may be bothersome but are not serious. Serious side effects are rare. They include liver and muscle problems, diabetes, and temporary memory problems.2

What do numbers tell us about benefits and risks of statins?

Benefits if you have heart disease
Effects of statins for people who have heart disease*
Risks within next 3 to 5 years With statins Without statins
Death from any cause 8 to 9 out of 100 11 to 12 out of 100
Death from heart or blood vessel problems 3 to 4 out of 100 8 to 9 out of 100
Nonfatal heart attack 5 to 6 out of 100 8 to 9 out of 100

*Based on the best available evidence (evidence quality: moderate)

Evidence shows that statins help people with heart disease by reducing the risk of death and heart attack. The quality of this evidence is moderate.

Take a group of 100 people who have heart disease . Here is their risk of death from any cause within the next 3 to 5 years:

  • Without statins, 11 to 12 out of 100 people with heart disease will die. This means that 88 to 89 out of 100 will not.
  • With statins, 8 to 9 out of 100 will die. This means that 91 to 92 will not.

Here is their risk of death from heart or blood vessel disease within the next 3 to 5 years:

  • Without statins, 8 to 9 out of 100 people with heart disease will die from a heart or blood vessel problem. This means that 91 to 92 out of 100 will not.
  • With statins, 3 to 4 out of 100 will die from a heart or blood vessel problem. This means that 96 to 97 out of 100 will not.

And here is their risk of a nonfatal heart attack (a heart attack that doesn't cause death) within the next 3 to 5 years:

  • Without statins, about 8 to 9 out of 100 people will have a nonfatal heart attack. This means that about 91 to 92 out of 100 will not have one.
  • With statins, 5 to 6 out of 100 people will have a nonfatal heart attack. This means that 94 to 95 out of 100 will not.
Benefits if you don't have heart disease
Effects of statins for people who don't have heart disease*
Risks within next 3 to 5 years With statins Without statins
Death from any cause 3 to 4 out of 100 4 to 5 out of 100
Nonfatal heart attack 1 to 2 out of 100 2 to 3 out of 100

*Based on the best available evidence (evidence quality: borderline)

Evidence shows that statins may be helpful for some people who don't have heart disease. The quality of this evidence is borderline.

Take a group of 100 people who don't have heart disease . Here is their risk of death from any cause within the next 3 to 5 years:

  • Without statins, 4 to 5 out of 100 may die. This means that 95 to 96 out of 100 may not.
  • With statins, 3 to 4 out of 100 may die. This means that 96 to 97 out of 100 may not.

And here is their risk of a nonfatal heart attack within the next 3 to 5 years:

  • Without statins, about 2 to 3 out of 100 people may have a nonfatal heart attack. This means that about 97 to 98 out of 100 may not have one.
  • With statins, 1 to 2 out of 100 people may have a nonfatal heart attack. This means that about 98 to 99 out of 100 may not.
Risks

Most evidence shows that statins are safe.

Some studies suggest that statins may increase your risk of diabetes, liver problems, and a rare muscle problem called rhabdomyolysis. But this evidence is not clear. It is inconclusive.

Understanding the evidence

Some evidence is better than other evidence. Evidence comes from studies that look at how well treatments and tests work and how safe they are. For many reasons, some studies are more reliable than others. The better the evidence is—the higher its quality—the more we can trust it.

The information shown here is based on the best available evidence.3, 1, 4, 5, 6, 7, 8, 9The evidence is rated using four quality levels: high, moderate, borderline, and inconclusive.

Another thing to understand is that the evidence can't predict what's going to happen in your case. When evidence tells us that 2 out of 100 people who have a certain test or treatment may have a certain result and that 98 out of 100 may not, there's no way to know if you will be one of the 2 or one of the 98.

Why might your doctor recommend taking statins?

You and your doctor can work together to understand your risks and what treatment is best for you. Your doctor may recommend that you take statins if the benefits outweigh the risks.10, 11

Statins clearly recommended for these people

Some people may need to start taking medicine right away. That's because their chance of having heart attack and stroke is high, and statins can reduce this risk.

Your doctor is likely to recommend statins if you:

Statins recommended for these people

Some people may need to start taking medicine right away because their risk of having a heart attack and stroke is high enough that the benefits outweigh the risks.

Your doctor is likely to recommend statins if:

  • Your LDL cholesterol is 190 mg/dL or above.
  • You have diabetes and you are age 40 to 75.
  • Your 10-year risk of heart attack or stroke is 7.5% or above and you are age 40 to 75.
Statins not as clearly recommended for these people

In some people, it's not as clear if they need to take a statin. You and your doctor will need to look at your overall health and any other risks you have for heart attack and stroke.

You and your doctor may think about these things in deciding about medicine:

  • Your family history of early heart disease. Early heart disease means you have a male family member who was diagnosed before age 55 or a female family member who was diagnosed before age 65.
  • A high LDL cholesterol test result (160 mg/dL or higher)
  • Results of tests such as C-reactive protein, coronary calcium scan, or ankle-brachial index
  • Your lifetime risk of heart attack and stroke

2. Compare your options

  Take statins to lower your risk of heart attack or stroke Don't take statins
What is usually involved?
  • You take a pill every day.
  • You make healthy lifestyle changes such as being active, eating healthy foods, losing weight, and quitting smoking.
  • You make healthy lifestyle changes such as being active, eating healthy foods, losing weight, and quitting smoking.
What are the benefits?
  • Studies show that statins can:
    • Lower the risk of heart attack.
    • Lower the risk of stroke.
  • You may be able to lower your risk of heart attack or stroke enough by making healthy changes.
  • You avoid taking pills every day.
What are the risks and side effects?
  • Statins don't cause side effects in most people.
  • Side effects are typically not serious. But they can be bothersome (muscle aches, tiredness, upset stomach).
  • Lifestyle changes may not be enough to lower your risk.
  • You may still be at risk for a heart attack or a stroke.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Stories about deciding whether to use medicine for high cholesterol

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"Heart disease runs in our family, so I know I need to be concerned about my health. I talked with my doctor about my family history and some other risk factors I have, including smoking. We decided that medicine would be a good idea for me, so I'm going to take it."

— Becky, age 56

"I don't like taking pills all the time, and I would have to take statins for the rest of my life to keep getting any benefit from them. My only other risk factor is high blood pressure. I just want to try changing my habits. I will try eating healthy foods and getting enough exercise to help keep my weight under control."

— Carole, age 58

"My dad died of a heart attack when he was in his 50s. I must have inherited my high cholesterol from him. I don't want to die before my time, so I am going to take medicine."

— Charles, age 48

"I just had a cholesterol test and found out that my cholesterol is high. But my blood pressure and some other things are fine. I don't smoke. So my doctor and I talked about it. She gave me some ways I can eat better and get more exercise."

— Diego, age 41

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take statins

Reasons not to take statins

I've tried eating better and being more active, but doing these things hasn't lowered my risk enough.

I want to try to make lifestyle changes to help lower my risk.

             
More important
Equally important
More important

I don't mind taking medicine for the rest of my life if it will reduce my risk of heart attack and stroke.

I hate the idea of taking pills for the rest of my life, even if they will reduce my risk of heart attack and stroke.

             
More important
Equally important
More important

I'm not worried about the side effects of these medicines.

I am worried about the side effects of these medicines.

             
More important
Equally important
More important

I worry about having a heart attack or a stroke, and I want to do everything I can to prevent it.

I'm not that worried about having a heart attack or a stroke.

             
More important
Equally important
More important

My other important reasons:

My other important reasons:

   
             
More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking statins

NOT taking statins

             
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Is taking medicine the only way to lower your risk of a heart attack or a stroke?

  • Yes
  • No
  • I'm not sure
You're right. You may be able to lower your risk with lifestyle changes, such as eating heart-healthy foods, losing weight if you need to, exercising, and quitting smoking.

2. Do you still need healthy habits even when you're taking statin medicines?

  • Yes
  • No
  • I'm not sure
You're right. Even with statins, you will also need heart-healthy habits.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

         
Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

 
Credits
By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology
Specialist Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology

References
Citations
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  2. Statin label changes (2012). Medical Letter on Drugs and Therapeutics, 54(1386): 21.
  3. Taylor F, et al. (2011). Statins for the primary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews (8).
  4. Alberton M, et al. (2012). Adverse events associated with individual statin treatments for cardiovascular disease: An indirect comparison meta-analysis. QJM: An International Journal of Medicine, 105(2): 145–157.
  5. Bonovas S, et al. (2006). Statins and cancer risk: A literature-based meta-analysis and meta-regression analysis of 35 randomized controlled trials. Journal of Clinical Oncology, 24(30): 4808–4817.
  6. Hayward RA, et al. (2006). Narrative review: Lack of evidence for recommended low-density lipoprotein treatment targets: A solvable problem. Annals of Internal Medicine, 145(7): 520–530.
  7. Mills EJ, et al. (2011). Efficacy and safety of statin treatment for cardiovascular disease: A network meta-analysis of 170,255 patients from 76 randomized trials. QJM: An International Journal of Medicine, 104(2): 109–124.
  8. Shepherd J, et al. (2002). Pravastatin in elderly individuals at risk of vascular disease (PROSPER): A randomised controlled trial. Lancet, 360(9346): 1623–1630.
  9. Ward S, et al. (2007). A systematic review and economic evaluation of statins for the prevention of coronary events. Health Technology Assessment, 11(14): 1–160, iii–iv.
  10. Stone NJ, et al. (2013). 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online November 12, 2013. DOI: 10.1161/01.cir.0000437738.63853.7a. Accessed November 18, 2013.
  11. Smith SC, et al. (2011). AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation. Circulation, 124(22): 2458–2473. Also available online: http://circ.ahajournals.org/content/124/22/2458.full.

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