What statins do
Your liver makes most of the cholesterol in your blood. Statins slow that down, lowering “bad” LDL cholesterol, which is the kind that builds up in the walls of your arteries. They also make existing fatty patches more stable and less likely to crack open and trigger the clot that causes a heart attack.
Large studies involving hundreds of thousands of people show that, for every 1 mmol/L drop in LDL cholesterol, the risk of heart attacks and strokes falls by about a fifth.
Who is offered a statin?
- Everyone who has had a heart attack, angina, a stroke or a stent, usually at a high dose. This is where the benefit is biggest.
- People with a 10% or higher chance of a heart attack or stroke in the next 10 years, worked out with the QRISK3 calculator. NICE guidance says people below 10% can also consider one if they want to.
- People with inherited high cholesterol (familial hypercholesterolaemia).
- Many people with type 1 or type 2 diabetes, or chronic kidney disease.
The common ones
| Statin | Notes |
|---|---|
| Atorvastatin | The most prescribed. Can be taken at any time of day. |
| Rosuvastatin | Strong. Can be taken at any time of day. |
| Simvastatin | Usually taken in the evening. More interactions with other medicines. |
| Pravastatin | Milder. Sometimes used if others cause side effects. |
You’ll usually have a blood test about 3 months after starting, to check it’s working.
Side effects: the evidence
Muscle aches are the side effect people worry about most. In careful trials where people took a statin some months and a dummy tablet other months without knowing which, most of the aches happened just as often on the dummy tablet. That doesn’t mean aches are imaginary, but it does mean a statin is often wrongly blamed. If you get aches, don’t just stop: talk to your GP or pharmacist, because a lower dose or a different statin often solves it.
Rare but serious: severe muscle pain or weakness all over, especially with dark brown urine, can be a sign of muscle damage. Stop the statin and get urgent medical advice the same day.
Statins can slightly raise blood sugar and the chance of developing type 2 diabetes in people already close to it. For almost everyone offered one, the heart benefit is much bigger.
Things that interact
- Grapefruit: large amounts of grapefruit or grapefruit juice raise levels of simvastatin and atorvastatin. Check your leaflet.
- Some antibiotics, such as clarithromycin and erythromycin, and some antifungal medicines. Always tell a prescriber or pharmacist you take a statin.
- Alcohol: heavy drinking with statins increases the risk of liver problems.
If statins really don’t suit you
There are other ways to lower cholesterol: ezetimibe tablets, bempedoic acid tablets, and injected medicines such as inclisiran, which is given twice a year once it’s established. Your GP or a lipid clinic can advise.
Myths
“My cholesterol is natural, so lowering it is harmful.”
Your body needs some cholesterol, but it makes plenty. There’s no evidence that lowering LDL cholesterol to the levels statins reach is harmful, and strong evidence it prevents heart attacks.
“I can just eat healthily instead.”
A healthy diet helps and is worth doing, but it usually lowers cholesterol by less than 10%. After a heart attack, or with inherited high cholesterol, diet alone is rarely enough.
“Statins cause memory loss.”
Large trials haven’t found that statins cause memory problems or dementia.
“Once I start, I can never stop.”
Most people take them long term because the benefit continues, but it’s always your choice. Talk it through rather than stopping suddenly.
Sources
This page is based on the published guidance below. It was last updated on 30 September 2026. Read how we write our content, or email hello@chestpain.org.uk to report a mistake.