As someone working closely with patients concerned about heart health, I’m often asked a straightforward but important question: what exactly are statins?
Put simply, statins are a group of medicines that lower cholesterol levels in the blood.
They work by blocking a substance your body needs to make cholesterol, particularly the “bad” type known as LDL (low-density lipoprotein) cholesterol. Reducing LDL helps prevent fatty deposits from building up in your arteries, lowering your risk of heart attack and stroke.
But if you're considering taking statins or you've just been prescribed them you’ll want to know more than just what they are. This blog covers everything I get asked about statins, from how they work and what they interact with, to side effects, alternatives, NHS availability and how to take them.
What Do Statins Actually Do?
Statins reduce the production of cholesterol in the liver. Less cholesterol in your blood means less chance of it sticking to your artery walls, which reduces the risk of atherosclerosis (hardening of the arteries).
They're usually prescribed for people who:
Have been diagnosed with cardiovascular disease
Have had a heart attack or stroke
Have high cholesterol levels and other risk factors (such as diabetes or high blood pressure)
Have a high QRisk score (indicating a high 10-year risk of heart disease)
In short, statins are preventative. They don’t cure existing heart disease, but they can help reduce the risk of future problems.
How Many Do I Take a Day?
Most statins are taken once a day. The exact dose depends on which statin you’re prescribed and your individual risk profile. Common options include:
It’s usually best to take your dose at the same time every day, and for some types (like simvastatin), it's recommended to take them in the evening as cholesterol production is higher at night. But this depends on the statin your doctor or pharmacist will give specific instructions.
Should I Take Statins With Food?
Statins can usually be taken with or without food. However, some people find they experience fewer side effects when taken with a meal.
You should always take your statin tablet with water, and avoid grapefruit juice, which can interfere with how some statins are broken down in the liver.
Are Statins Available on the NHS?
Yes, statins are available on the NHS. If you qualify based on your cholesterol levels or cardiovascular risk, your GP or cardiologist can prescribe them. The cost of a prescription in England is currently £9.90 (as of 2025), but they’re free in Scotland, Wales and Northern Ireland. If you're over 60 or have certain medical exemptions, you may not have to pay at all.
Do Statins Have Side Effects?
Like most medications, statins do carry some risk of side effects. Most people tolerate them well, but some experience issues such as:
Muscle aches or weakness
Headaches
Digestive problems (e.g., constipation, diarrhoea)
Sleep disturbances
More serious side effects, like liver damage or severe muscle breakdown (rhabdomyolysis), are very rare. In my experience, the vast majority of patients on statins either experience no side effects or very mild ones that resolve on their own.
Are There Long-Term Effects?
This is a fair concern, especially if you're expected to take statins for the rest of your life. Most long-term data has shown that statins are safe and effective when taken under supervision.
However, a few points are worth noting:
Muscle symptoms may become more common with age
Statins may slightly increase the risk of type 2 diabetes, particularly in people already at risk
Regular blood tests are usually recommended to monitor liver function and cholesterol levels
In general, the benefits outweigh the risks especially for those with a high chance of cardiovascular events. But it's important to review your medication annually with your doctor.
Do Statins Interact With Other Medicines?
Yes, some drug interactions are possible. It’s especially important to tell your doctor if you’re taking:
Antibiotics such as clarithromycin or erythromycin
Antifungal drugs
Warfarin or other blood thinners
Immunosuppressants
Some anti-HIV medications
Statins can also interact with over-the-counter supplements, including St John’s Wort and high-dose niacin. That’s why we always review the full medication list before prescribing them.
Why Would a Cardiologist Recommend Statins?
Statins aren’t prescribed just for high cholesterol. Cardiologists often recommend them when there’s a broader cardiovascular risk including age, blood pressure, family history, diabetes, and lifestyle factors.
They’re also part of secondary prevention, meaning if you’ve already had a heart attack or stroke, statins help prevent another one. The evidence behind this is strong, which is why they’re such a commonly used medication in cardiology.
Are There Natural Alternatives to Statins?
This is something I get asked regularly. There are lifestyle strategies that can lower cholesterol, such as:
Lifestyle Approach | Effectiveness on Cholesterol |
Reducing saturated fats | Moderate |
Increasing fibre intake | Moderate |
Plant sterols/stanols (in fortified spreads) | Mild |
Regular aerobic exercise | Moderate |
Strong if overweight | |
Strong for heart health |
Natural supplements like red yeast rice contain a statin-like compound (monacolin K), but the quality and safety are less reliable than prescription statins. Omega-3 supplements and dietary changes can help improve your heart health too, but they rarely reduce LDL cholesterol as much as statins.
For people at low to moderate risk, these changes might be enough on their own. But for higher-risk individuals, lifestyle alone is often not sufficient.
What Does the Research Say?
Numerous large-scale studies have supported the use of statins in reducing cardiovascular events:
The Heart Protection Study (20,000 participants) showed a significant reduction in heart attacks and strokes (Heart Protection Study Collaborative Group, 2002)
The JUPITER trial showed benefits even in people with normal LDL but high inflammation markers (Ridker et al., 2008)
Meta-analyses involving over 90,000 participants consistently show a reduction in heart-related deaths (Cholesterol Treatment Trialists' Collaborators, 2005)
Still, no treatment is perfect. Some critics argue that statins are overprescribed, especially in people with lower cardiovascular risk. That’s why using tools like QRisk is important to tailor treatment decisions.
Final Thoughts
Statins are one of the most widely prescribed medications for a reason: they help prevent heart attacks and strokes in people at risk. If you’ve been offered them, it means your doctor has identified a real benefit in managing your long-term cardiovascular health.
But like any medication, it’s not a one-size-fits-all solution. You should always weigh the benefits, side effects, and alternatives in discussion with your doctor or cardiologist. At Heartsure, we work closely with each patient to decide whether a statin fits into their overall plan for heart health.
If you’re unsure whether statins are right for you, or you’ve been prescribed one and want a second opinion, we’re happy to talk through your options. Get in touch with us here using our online portal or contact us page.
