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Controlling Cholesterol with Statins

by Michael Johnson

| Updated April 3, 2024 |
Cholesterol has become a household name, but do you really know why understanding this topic really matters? This waxy substance called cholesterol is actually important when carrying out body functions, like producing hormones and vitamins for the body. It becomes a bad thing when the level of cholesterol is really high. However, when cholesterol levels get too high, that's when problems can arise.

Now, the sad reality is that close to a third of adults living in the United States are battling unhealthy levels of cholesterol. “Bad” Cholesterol has a negative reputation; however, thanks to Statins, the effects that come with high LDL can be controlled, thereby keeping you healthier for a long time.

I've heard about "good" and "bad" cholesterol. What's the difference?

When you hear "cholesterol," think of two types; Good cholesterol, HDL, and the “Bad” cholesterol, LDL. The Good cholesterol keeps your blood vessels clear by taking unwanted cholesterol back to the liver where it's broken down. Bad cholesterol, LDL, on the other hand, does the opposite; too much can clog arteries and raise heart attack or stroke risks.

If tests show high total cholesterol in your bloodstream, it means more bad than good. To control this balance between good (HDL) and bad (non-HDL), statins are key players often reserved for those at significant risk of heart issues. What you should know is, they don't all work alike. Your doctor will guide you through choosing one that fits just right—a bit like finding a comfortable pair of shoes.

Statins tackle an enzyme in your liver, slashing its ability to make artery-clogging fats. Remembering these points helps guard against future cardiovascular troubles by using wise treatment options, including statin therapy, when necessary.
statins image
Photo by Seth Shay Martin from Johns Hopkins medicine

What are statins? How do they work?

Statins do more than just lower your "bad" cholesterol. They're the most used pills, with 40 million people in the U.S. taking them for heart help. These drugs came from mold and work on a liver enzyme that manages fat-making.

They also shield us from heart disease beyond cutting fats. Doctors have seen individuals with weak hearts dodge another attack thanks to statins; these meds keep arteries clear and dial down swelling, too. Even some cancers might not stand a chance against them because of how they calm inflammation across our bodies.

Beyond this, scientists at Stanford found out why statins are so powerful. It's all about what goes on deep inside our cells' control centers where DNA lives wrapped tight around proteins forming spools called chromatin. When researchers treated blood vessel liner cells with simvastatin (that’s one type of statin), these little guys got better at making new vessels like capillary tubes. They thought looking into gene activity would show something grand but turned up almost empty-handed until ATAC-seq showed changes didn't happen within genes themselves but were due to repackaging DNA in cell nuclei instead.

I've heard that there are some risks to taking statins. Should I be worried?

Statins can drop your cholesterol, sure. But they come with risks. Your muscles might ache or get weak; it's common but usually mild.

Liver problems are rare, yet doctors will check your liver enzymes to be on a safer side. Feeling fuzzy in the head? Some individuals report this too. Memory slips or confusion are sometimes reported, but this isn't so clear-cut as a side effect.

Some people face digestion troubles like gas, diarrhea, and nausea—the stomach just doesn't sit right sometimes. On top of that, serious issues like higher blood sugar levels and type 2 diabetes have shown up in studies. Remembering these risks helps keep you informed and safe while using statins under medical advice.

Alternatives to Statins Explored

You have options if statins don't work for you. Plant sterols can block cholesterol from food. They're in some oils, seeds, and made into spreads or supplements too.

Drugs like ezetimibe reduce the amount your body takes in from meals; it may be paired with a statin but works alone as well. Another choice is bile acid sequestrants that bind to bile, so your liver uses excess cholesterol to make more bile instead of letting it roam free in your bloodstream. These alternatives aren’t always enough on their own though you should talk things over with a doctor who knows what’s up.
Alternatives to Statins Explored image
Image credit; Towfiqu barbhuiya on Unsplash

Statins Dosage Guidelines

If you're 40 or older with no heart disease yet, you would need to hear this. You might need statins if your risk of a heart attack or stroke in the next decade is high because of factors like diabetes, high blood pressure, or smoking—basically things that mess with your arteries. The United States Preventive Services Task Force says people fitting this bill should use these drugs to cut their risk.

Doctors often plug numbers into a formula called ACC/AHA Pooled Cohort Equations; it takes into account stuff like age and whether you smoke to estimate how likely you're to get hit by serious heart problems soon. This calculator gives a score. If it's over ten percent for ten-year troubles and cholesterol isn't high, statins may be recommended for safety.


1.Why is it important to keep cholesterol levels in the blood low?

High levels of "bad" LDL cholesterol can lead to the accumulation of plaque, in our arteries hindering the flow of blood, which is harmful.

2.I thought a healthy diet and regular exercise would keep my cholesterol in check. Not so?

While they may benefit your health in general, simply relying on them might not be enough to manage cholesterol levels particularly if other risk factors are at play.

3.I've heard you shouldn't drink grapefruit juice if you're taking a statin. Is that true?

Yes it is true,Grapefruit juice can indeed have an impact on how the body processes statins altering the effectiveness of the medication.


1.British Heart Foundation. “Cholesterol and Statins.”, British Heart Foundation, 29 Nov. 2019, 

2.Fulghum, Debra. “Side Effects of Cholesterol-Lowering Statin Drugs.” WebMD, WebMD, 9 Sept. 2008, 

3.Corliss, Julie. “Statin Alternative Lowers Heart-Related Deaths.” Harvard Health, 1 Oct. 2023, Accessed 28 Mar. 2024.

4.“Healthy People with High Cholesterol Don’t Stand to Benefit from Statins, Research Says.” News-Medical, 20 Sept. 2022,  Accessed 28 Mar. 2024.

5.“Should You Take a Statin for Your High Cholesterol?” Yale Medicine, 

Article by
Michael Johnson
I am Dr. Michael Johnson. I am dedicated to providing the best medical care to my patients. In my spare time, I enjoy sharing medical knowledge with a broader audience. Writing has become a major hobby of mine, allowing me to express my passion for medicine. I particularly enjoy writing health-related articles, aiming to provide readers with practical medical advice and information. Through my writing, I hope to help more people understand how to stay healthy, prevent diseases, and better understand medical knowledge.

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