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    Statins

    Also known as HMG-CoA reductase inhibitors, atorvastatin, rosuvastatin, simvastatin, pravastatin, fluvastatin

    Statins are tablets that lower LDL cholesterol by reducing the amount of cholesterol the body makes; they include atorvastatin, rosuvastatin and simvastatin.[1] Across 26 trials, each 1 mmol/L fall in LDL on statins cut major vascular events by just over a fifth, and the 2026 US guideline keeps them as the foundation of treatment.[2][3]

    Editor reviewedStrict sourcingUpdated WikiHealth and medicine, GLP-1 and metabolic medicine
    Key facts

    Statins are the first-line cholesterol-lowering drugs and the benchmark newer drugs are added to.[3] The NHS lists five main types: atorvastatin, fluvastatin, pravastatin, rosuvastatin and simvastatin. Each is a once-daily prescription tablet, usually taken long term.[1]

    This page is general information, not medical advice. Talk to a clinician before starting, stopping or changing a statin.

    How statins work

    Statins lower the amount of cholesterol the body makes. That reduces LDL cholesterol and helps prevent build-up in blood vessels.[1] The NHS says statins may be offered to people at higher risk of cardiovascular disease when lifestyle changes are not enough, and to people who already have cardiovascular disease.[4] In the US, the 2026 ACC/AHA guideline keeps statins as the first drug, adding other medicines only if LDL stays too high.[3]

    The evidence

    The Cholesterol Treatment Trialists’ Collaboration pooled individual data from 26 randomised trials with about 170,000 participants. Each 1.0 mmol/L (about 39 mg/dL) reduction in LDL cut major vascular events by just over a fifth (rate ratio 0.78) and all-cause mortality by 10%.[2] The analysis found no threshold within the range studied, and no effect on cancer incidence even at low LDL levels.[5] This “lower is better” finding underpins the LDL goals in the 2026 US guideline.[6]

    Side effects

    The NHS lists common side effects including headaches, dizziness, feeling sick, tiredness, digestive problems, muscle pain and sleep problems. It says people with severe liver disease, or who are pregnant or trying to conceive, should not take statins.[7]

    A 2022 analysis of 19 double-blind statin-versus-placebo trials found a small excess of mostly mild muscle pain, mainly in the first year. More than 90% of muscle-symptom reports among people taking statins were not caused by the statin.[8] People who cannot take statins have alternatives, including ezetimibe, bempedoic acid and PCSK9 drugs.[9] Bempedoic acid reduced cardiovascular events in statin-intolerant patients in CLEAR Outcomes.[10]

    Adding other drugs

    When statins alone are not enough, add-on drugs lower LDL further and have cut events in trials. Ezetimibe in IMPROVE-IT and the PCSK9 antibody evolocumab in FOURIER both reduced events on top of statins.[11][12] See pcsk9-inhibitors, obicetrapib and the cholesterol drugs guide.

    The CDC reports that only slightly more than half of US adults who could benefit from cholesterol medicine take it.[13]

    Next in the crash course

    Health & medicine

    PCSK9 inhibitors

    PCSK9 inhibitors lower LDL cholesterol: evolocumab and alirocumab injections, twice-yearly inclisiran and the 2026 oral pill enlicitide (Lipfendra).

    More in Health & medicine

    Developing in Health

    Questions readers ask

    How do statins work?

    They lower the amount of cholesterol the body makes, which helps stop cholesterol building up in blood vessels.[1]

    Do statins cause muscle pain?

    Sometimes, but less often than many people think. In a 2022 analysis of blinded trials, statins caused a small excess of mostly mild muscle pain, mainly in the first year, and over 90% of muscle complaints among people on statins were not due to the drug.[8]

    Who should not take statins?

    The NHS says people with severe liver disease, or who are pregnant or trying to get pregnant, should not take them.[7]

    Can I stop taking statins?

    The NHS advises talking to a doctor or pharmacist before stopping, because stopping can affect cholesterol levels.[15]

    Sources

    · 15 claims from 6 publishers

    Each numbered claim is a statement we checked against the sources listed with it. Tap a number in the text to see its sources in place.

    1. [1]

      The NHS describes statins as medicines that lower cholesterol by reducing the amount the body makes; the main types are atorvastatin, fluvastatin, pravastatin, rosuvastatin and simvastatin, taken as a once-daily tablet, usually long term. confirmedas of 2026-10-11

      • Statins · NHS (UK National Health Service) · How statins work (retrieved 2026-10-11)
      • Statins · NHS (UK National Health Service) · Types of statins (retrieved 2026-10-11)
      • Statins · NHS (UK National Health Service) · How statins work (retrieved 2026-10-11)
    2. [2]

      A Cholesterol Treatment Trialists' meta-analysis of 26 randomised statin trials (about 170,000 participants) found that each 1.0 mmol/L (about 39 mg/dL) reduction in LDL cholesterol cut the annual rate of major vascular events by just over a fifth (rate ratio 0.78) and all-cause mortality by 10%. confirmedas of 2026-10-11

    3. [3]

      If lifestyle and statins do not lower LDL cholesterol enough, the 2026 guideline recommends adding nonstatin therapy such as ezetimibe, bempedoic acid or a PCSK9 monoclonal antibody, and notes that inclisiran is still being studied to show whether its LDL lowering reduces cardiac events. confirmedas of 2026-10-11

    4. [4]

      The NHS says statins may be offered to people at higher risk of cardiovascular disease when healthy lifestyle changes have not helped or are unlikely to help on their own, and to people who already have cardiovascular disease. confirmedas of 2026-10-11

      • Statins · NHS (UK National Health Service) · Who may be offered statins (retrieved 2026-10-11)
      • Statins · NHS (UK National Health Service) · Who may be offered statins (retrieved 2026-10-11)
    5. [5]

      The 2010 CTT meta-analysis found no evidence of a threshold within the cholesterol range studied and no significant effect on cancer incidence, even at low LDL levels. confirmedas of 2026-10-11

    6. [6]

      The 2026 ACC/AHA guideline brings back LDL cholesterol treatment goals of below 100 mg/dL for people at borderline or intermediate risk, below 70 mg/dL at high risk, and below 55 mg/dL for secondary prevention in people with ASCVD at very high risk. confirmedas of 2026-10-11

    7. [7]

      The NHS says statins should not be taken by people with severe liver disease or who are pregnant or trying to get pregnant, and lists common side effects including headaches, dizziness, nausea, tiredness, digestive problems, muscle pain and sleep problems. confirmedas of 2026-10-11

      • Statins · NHS (UK National Health Service) · Who may be offered statins (retrieved 2026-10-11)
      • Statins · NHS (UK National Health Service) · Side effects of statins (retrieved 2026-10-11)
    8. [8]

      A 2022 individual-participant meta-analysis of 19 double-blind statin-versus-placebo trials found statins caused a small excess of mostly mild muscle pain, mainly in the first year, and that more than 90% of muscle-symptom reports among people on statins were not due to the statin. confirmedas of 2026-10-11

    9. [9]

      The NHS lists alternatives for people who cannot take statins, including tablets such as ezetimibe, fibrates and bempedoic acid, and injections such as inclisiran, alirocumab and evolocumab. confirmedas of 2026-10-11

      • Statins · NHS (UK National Health Service) · Alternatives to statins (retrieved 2026-10-11)
      • Statins · NHS (UK National Health Service) · Alternatives to statins (retrieved 2026-10-11)
    10. [10]

      In CLEAR Outcomes (13,970 statin-intolerant patients, median follow-up 40.6 months), bempedoic acid, an ATP citrate lyase inhibitor, lowered LDL cholesterol by 21.1 percentage points more than placebo and reduced major cardiovascular events (11.7% vs 13.3%; hazard ratio 0.87), but gout and gallstones were more common. confirmedas of 2026-10-11

    11. [11]

      In IMPROVE-IT (18,144 patients after an acute coronary syndrome, median follow-up 6 years), adding ezetimibe, which reduces intestinal cholesterol absorption, to simvastatin lowered the 7-year rate of the primary cardiovascular endpoint to 32.7% from 34.7% (hazard ratio 0.936). confirmedas of 2026-10-11

    12. [12]

      In FOURIER (27,564 patients with atherosclerotic cardiovascular disease on statins, median follow-up 2.2 years), the PCSK9 antibody evolocumab cut LDL cholesterol by 59% versus placebo to a median of 30 mg/dL and reduced the primary cardiovascular endpoint (hazard ratio 0.85); injection-site reactions were more common (2.1% vs 1.6%). confirmedas of 2026-10-11

    13. [13]

      The CDC reports that slightly more than half of US adults (54.5%, or 47 million people) who could benefit from cholesterol medicine are taking it. confirmedas of 2026-10-11

      • High Cholesterol Facts · Centers for Disease Control and Prevention · 2024-10-24 · High total cholesterol in the United States (retrieved 2026-10-11)
    14. [14]

      In BROADWAY (2,530 patients with ASCVD or heterozygous familial hypercholesterolemia on maximum tolerated lipid-lowering therapy), obicetrapib 10 mg daily, a selective CETP inhibitor, lowered LDL cholesterol by 32.6 percentage points more than placebo at day 84, with similar adverse-event rates. confirmedas of 2026-10-11

    15. [15]

      The NHS says stopping statins may affect cholesterol levels and advises talking to a doctor or pharmacist before stopping. confirmedas of 2026-10-11

      • Statins · NHS (UK National Health Service) · How statins work (retrieved 2026-10-11)
    Revision history (1)
    1. Page created.

    Created Oct 11, 2026. Last reviewed by an editor on Oct 11, 2026. Next scheduled review: Jan 11, 2027.

    Cite this page

    "Statins." ContentLora, updated Oct 11, 2026. https://contentlora.com/wiki/statins

    Spotted an error? Suggest a correction or emailcorrections@contentlora.com.

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