So are statins a savior or a scam? Life does not always provide nice clean answers to such simple dichotomies - Steven Novella


image by: Dr. Nishit Choksi, MD

HWN Suggests

Why Do Statins Remain Controversial?

When the first statin drug was approved, we were cautiously optimistic. Lovastatin (Mevacor) was introduced in 1987. Four years later, we published a book titled Graedons’ Best Medicine (Bantam © 1991). We wrote that Mevacor was highly effective at lowering LDL cholesterol. But we did note that “Mevacor may actually increase one important risk factor for atherosclerosis called Lp(a).” Fast forward 30 years. Why in the world would lovastatin, atorvastatin, simvastatin and other statins remain controversial more than three decades later?

read full article


 Why Do Statins Remain Controversial?

The statin wars have been raging for decades. How can statins remain controversial after so many years? Statins remain controversial because of questions about side effects and the balance of benefit to risk. Many people assume that statins represent a magic bullet against heart disease, heart attacks and premature death. They may conclude that if their LDL cholesterol levels remain low, even if they eat burgers, fries and milkshakes, they have nothing to worry about. And many physicians assume that side effects are minor or nonexistent for most people.

4 myths about statins

More than one in four adults ages 45 and older in the United States take a cholesterol-lowering statin. But these popular medications are often misunderstood. Here's what you need to know to take them safely.

5 Reasons to Stop or Switch Statins

Statins—a class of drug that includes atorvastatin (Lipitor), simvastatin (Zocor), and others—are among the most effective drugs for lowering cholesterol. They are also among the most widely prescribed drugs of all time. Like other drugs, however, statins have potentially serious side effects, and there are instances in which they should not be taken. Here is a rundown of things you should look out for if you are taking a statin, and times when you should steer clear of the drugs altogether.


NEXLETOL and NEXLIZET are indicated as adjuncts to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease who require additional lowering of LDL-C.


CRESTOR (rosuvastatin calcium) is a prescription drug belonging to a group of medicines called statins that are used to treat high cholesterol. Along with diet, CRESTOR lowers LDL (bad) cholesterol and raises HDL (good) cholesterol. It's also been proven to slow the progression of atherosclerosis, the buildup of plaque in your arteries over time, as part of a treatment plan to lower cholesterol to goal.


LIPITOR (atorvastatin calcium) tablets are a prescription medicine that is used along with a low-fat diet. It lowers the LDL ("bad") cholesterol and triglycerides in your blood. It can raise your HDL ("good") cholesterol as well.


ZETIA, along with a healthy diet, can help lower LDL (bad) cholesterol when diet and exercise alone are not enough. Unlike some statins, ZETIA has not been shown to prevent heart disease or heart attacks.


Zocor (simvastatin) belongs to a group of drugs called HMG CoA reductase inhibitors, or "statins." Simvastatin reduces levels of "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while increasing levels of "good" cholesterol (high-density lipoprotein, or HDL).

Statins, also known as HMG-CoA reductase inhibitors, inhibit HMG-CoA reductase (3-hydroxy-3-methylglutaryl coenzyme A reductase) an enzyme involved in the synthesis of cholesterol especially in the liver. Decreased cholesterol production leads to an increase in the number of LDL (low density lipoprotein) membrane receptors, which increases clearance of LDL cholesterol from circulation.


By reducing the production of cholesterol, statins are able to slow the formation of new plaques and occasionally can reduce the size of plaques that already exist. In addition, through mechanisms that are not well understood, statins may also stabilize plaques and make them less prone to rupturing and develop clots.

Apolipoprotein B (apoB)

Several studies have shown that apoB may be a better predictor of cardiovascular disease risk than LDL-C.

Introducing Stitches!

Your Path to Meaningful Connections in the World of Health and Medicine
Connect, Collaborate, and Engage!

Coming Soon - Stitches, the innovative chat app from the creators of HWN. Join meaningful conversations on health and medical topics. Share text, images, and videos seamlessly. Connect directly within HWN's topic pages and articles.

Be the first to know when Stitches starts accepting users

Stay Connected