Statins are drugs that help lower the level of cholesterol in the blood and are used for the treatment of hypercholesterolaemia which is one of the main risk factors for coronary artery disease. There are other lipid-lowering drugs, such as ezetimibe and fibrates, but they don't have the prognostic benefits of statins. Statins reduce overall cardiovascular risk independently of the baseline level of cholesterol and are therefore often prescribed, e.g. in patients with diabetes - which significantly increases the risk of developing cardiovascular disease - even if they have a normal level of cholesterol. Statins work by inhibiting an enzyme called HMG-CoA reductase, which reduces the level of total cholesterol and LDL (= ‘bad’) cholesterol. The most common statins are simvastatin, atorvastatin (Lipitor), rosuvastatin (Crestor), and pravastatin.
Most patients taking statins don’t experience any problems. Side effects of statins include muscle pain, upset stomach, headache, and sleeping problems. Side effects can also be generated by interactions between statins and other medications or food such as grapefruit juice. Despite the occasional negative publicity, the likelihood of a severe adverse effect related to statin is very low, about 1:10,000. This - very low - risk should be considered in the context of proven significant prognostic benefits of statins.