Statin medications lower cholesterol levels in your blood. This can reduce the chance of a
, stroke, and premature death in people who have an elevated risk of developing heart disease or who already have it.
Statins work by blocking a liver enzyme needed to make cholesterol. The body needs some cholesterol to maintain good health. High blood levels of LDL cholesterol and low levels of HDL cholesterol are associated with an increased risk of arterial blockage throughout the body, which could eventually lead to heart attack, stroke, and peripheral artery disease in the legs. Statins may also moderately reduce triglyceride levels, decrease inflammation in arteries, and help raise HDL levels.
There are seven statin drugs, but they’re not all the same. Some statins are backed by stronger evidence than others that they lower cholesterol or reduce the risk of a heart attack or premature death from heart disease or a stroke.
Our recommendations about who should consider a statin drug to lower their cardiovascular risks are based in part on new guidelines from the American College of Cardiology and the American Heart Association. Previous strategies focused mainly on reducing elevated LDL or “bad” cholesterol to very low levels. But the new guidelines consider your overall risk of a heart attack or stroke in the next 10 years more important than LDL cholesterol levels alone. The guidelines determine your risk based on additional factors, including your age, blood pressure level, whether you smoke, are overweight, or have diabetes or other medical problems.
Diet and lifestyle changes , such as quitting smoking, losing weight if you need to, and exercise, can help lower your risk of heart attack and stroke. And in some cases, doing these can reduce your risk enough so that you don’t need a statin. Regardless of whether you take a statin or not, you should still follow them.
Statins can vary widely in cost—from as little as $53 per month to more than $600. Most people who take a statin must continue to do so for years—perhaps for the rest of their life—so the cost can be an important factor to consider.
Certain generic statins can cost as little as $4 for a month’s supply through discount generic programs run by major chain stores, such as Kroger, Sam’s Club, Target, and Walmart. For an even better bargain, you can buy a three-month supply for $10 through these programs. See the price chart below for the generic statins that are likely to be available through these programs.
Note: Our medical advisers say that if you fall into this category, you should consider a statin, but for some people, especially those with a 10-year risk less than 10 percent, diet and lifestyle changes could be the first step—those changes could lower your risk enough that you are no longer considered a candidate for a statin.
1. People older than 75, those with multiple and/or serious medical conditions, such as impaired kidney or liver function, those with a history of stroke or muscle disorders
2. People who currently use medications that could interact with statins
3. People of Asian heritage
Taking the evidence for effectiveness, safety, and cost into account, we have chosen the following statins as Consumer Reports Best Buy Drugs.
All of our Best Buys—atorvastatin, lovastatin, pravastatin, and simvastatin—have been shown to reduce the risk of heart attack and deaths from heart attacks, and are available as inexpensive generics. You could save more than $100 per month if you pay out-of-pocket, and you select a generic instead of a brand name statin.
Higher doses and high-intensity statins pose a greater risk of rare, but serious side effects, such as muscle breakdown that can lead to permanent kidney damage, coma, and possibly death. But some people—such as those who have very high LDL, have suffered a heart attack, or have diabetes—may require a high-intensity statin.
No matter which statin or dose you take, if you experience muscle aches and pains when taking a statin, contact your doctor immediately.
To save money, ask your doctor about splitting your statin pills. This can cut your costs substantially and is a widely accepted practice.