FACT SHEET FOR PATIENTS AND FAMILIES
Cholesterol: Statin Medication Decision Guide
Should you be taking statin medication to help manage your cholesterol? For some people doctors can make a clear
recommendation based on risk factors. For other people — like you — the answer is less clear. You and your doctor
together should consider your situation and decide what’s best for you. This decision guide can help.
What is cholesterol?
Cholesterol is a soft, waxy substance that carries digested
fat from your liver to parts of your body that need fat for
energy and healing. Your liver produces most of the
cholesterol in your body. Some also comes from eating
foods high in cholesterol and saturated fats. You have
different types of cholesterol:
•• LDL cholesterol is often called “bad” cholesterol. It
can build up in the walls of your blood vessels and
block the blood flow. This is called cardiovascular
disease, and it increases your risk for a heart attack,
a stroke, and other heart problems.
•• HDL cholesterol is often called “good” cholesterol.
It can remove some of the LDL cholesterol from your
artery walls and improve blood flow.
What are statins — and who should
take them?
Statins are the best type of medication for lowering your
risk of stroke and heart attack. They work by blocking an
enzyme that your body needs to make cholesterol. This
helps your body achieve a better balance between LDL
cholesterol and HDL cholesterol.
Experts at the American Heart Association recently
changed the recommendations for how we decide who
should takes statins:
•• In the past, statins were prescribed based on your
LDL (bad) cholesterol level. Statins were prescribed
if your LDL cholesterol was high. They were used to
help bring your LDL cholesterol down to a lower
target number based on your individual risk factors.
•• Current guidelines recommend prescribing based
on your risk factors for heart attack, stroke, and
other heart problems. We now understand that your
risk is based on a number of factors, including:
–– Whether you already have cardiovascular disease —
or a high calculated risk of getting it
–– Your HDL (good) cholesterol level and your total
cholesterol level (HDL and LDL combined)
–– Your age and sex
–– Whether you have diabetes or high blood pressure
–– Whether you smoke
Other factors might also be relevant. These could
include chronic health conditions or a family history
of cardiovascular disease.
You and your doctor must make a shared decision based
on your personal situation. Pages 2 and 3 of this handout
describe factors you should consider to help you decide.
The worksheet on page 4 can help you make your decision.
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Factors to consider when deciding whether to take a statin
Read about each of the factors below and discuss them with your doctor. On page 4 you can mark where
you are in relation to each factor. This can help you decide.
1. Your lifestyle habits
2. Benefits and risks of taking statins
Heart-healthy lifestyle habits are the most important way
to reduce your risk of heart attack, stroke, and other heart
problems — whether or not you take statins. Consider
your current lifestyle habits and how they affect your risk.
Then think about lifestyle habits you feel ready and able
to change.
All medications have both benefits and possible side
effects. Talk with your healthcare provider about what
you can expect.
Benefits of statins
Heart-healthy lifestyle habits include:
•• A low dose of a statin can lower cholesterol by
about one-third. Statins are considered to be the best
medications for lowering LDL cholesterol.
•• Staying active every day. Aim for at least 150 minutes
of physical activity per week, or about 30 minutes on
most days. Any activity is better than none.
•• Statins lower your risk of heart attack, stroke, and
other heart problems. This is true even for people
with normal cholesterol levels.
•• Eating a heart-healthy diet. This means eating:
•• A statin dose that’s tailored to your personal
health risks appears to be more important than
reaching a particular cholesterol level.
–– Lots of vegetables and fruits. Fill half your plate
with vegetables and add fresh fruit on the side.
–– More whole grains. Examples include whole-wheat
breads, pastas, and cereals, and whole-grain rice.
–– Heart-healthy proteins. Examples include extra-lean
meats, skinless white meat of chicken and turkey,
fish and shellfish, nuts, beans, and soy products.
–– Low-fat dairy products. Examples include skim or
1% milk, soymilk, and low- or nonfat yogurt, cheese,
and cottage cheese.
–– Unsaturated fats and oils. Examples include
vegetable oils such as olive and canola oil, peanuts,
avocados, seeds, raw nuts, and natural peanut butter.
–– Limited intake of added sugars, sweets, sweetened
drinks, and juices.
–– Less than 2400 mg of salt per day, if you also have
high blood pressure.
•• Reaching and maintaining a healthy body weight.
•• Quitting tobacco. If you use tobacco, quitting will
reduce your risk of cardiovascular disease.
Once you start taking a statin, you’ll need to keep taking
it to keep these benefits. Be sure to talk with your
healthcare provider if you want to stop taking it.
Possible side effects
Most people can take statins without any problems.
Very few people have serious side effects.
•• Statins can sometimes cause sore or aching muscles.
This is the most common side effect and it’s usually not
serious or very bothersome. In rare, severe cases, muscle
cells can break down and may damage your kidneys if
symptoms are ignored.
•• Statins can increase your blood glucose. Patients who
take statins and are prone to developing type 2 diabetes
may develop it earlier while taking a statin. Your
healthcare provider can monitor this and advise you on
how to prevent or delay the onset of type 2 diabetes.
•• In rare cases, statins may affect your liver function.
•• Statins may interact with other medications. Talk with
your doctor or pharmacist about all the medications
you’re taking, including vitamins and supplements.
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3. Your other health issues
5. Your risk of pregnancy
Other chronic conditions you have can increase your risk
of heart attack, stroke, and other heart problems. This is
especially true if you have not been able to manage these
conditions with treatment. These include:
You should not take statin medication when pregnant
or breastfeeding. If there’s a chance you may become
pregnant, do not take statins.
•• Diabetes or prediabetes
6. Your personal preferences
•• High blood pressure
Once you’ve considered your risk factors, consider your
preferences and values. How do you feel about taking a
medication every day? How do you feel about taking this
medication? Do you have a strong feeling about whether
or not you want to take it? If so, this should be part of
your discussion and decision.
•• Being overweight or obese, especially if you carry extra
weight around your waistline
•• Chronic kidney disease
•• Low HDL (good) cholesterol
•• Physical inactivity
4. Your family history
Risk of heart attack, stroke, and other heart problems is
higher in some families. If one of your parents or a brother
or sister has had a heart attack, stroke, or diagnosis of
cardiovascular disease before age 55 (for a man) or 65 (for
a woman), your risk may be higher.
If you have other questions about cardiovascular
disease, your personal risks, or this medication,
be sure to bring them up.
Support for lifestyle change
Changing your lifestyle is much easier if you have help.
Intermountain’s The Weigh to Health program teaches the
skills and habits needed to lose weight. These same skills
and habits will support your heart health.
Whether or not you need to lose weight, The Weigh
to Health program can help you make the lifestyle
changes that will reduce your risk of heart attack,
stroke, and other heart problems.
Some insurance providers cover the entire
cost of the program for participants who
complete it.
For more information, visit
intermountainhealthcare.org/nutrition
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How do I decide?
As you discuss your options with your
healthcare providers:
•• Remember that current medical research doesn’t
suggest a clear right or wrong answer for you.
•• Be honest about your lifestyle habits and what you
feel you are willing and able to change right now.
•• Talk with people who love and support you.
People who know you well can help you think
through your decision.
We both have cholesterol that’s in the same range — but my
other risk factors are really different than my wife’s. I decided to
take statins and she decided not to. We’re both happy.
Decision factors
Consider the factors you read about on pages 2 and 3 of this decision guide. Then mark the two lists below to record
how you feel about each one. Comparing the left and right sides may help you decide.
You may WANT to take a statin if:
You may NOT WANT to take a statin if:
1. Your lifestyle habits
‰‰ You have a heart-healthy lifestyle but your LDL cholesterol
is still high, so lifestyle change wouldn’t help much.
‰‰ You need to make lifestyle changes, but you don’t
feel ready or able to make them at this time.
‰‰ You have a heart-healthy lifestyle so your risk is lower.
‰‰ You have identified lifestyle changes that would help lower
your risk, and you feel ready and able to start making at
least one of these changes now.
2. Benefits and risks of taking statins
‰‰ You feel the potential benefits of taking statins are
greater than the potential risks.
‰‰ You feel the potential risks of taking statins are greater than
the potential benefits.
3. Your other health conditions
‰‰ You have another health condition that could
increase your risk, and it’s not in control at this time.
‰‰ You do not have another chronic health condition that could
increase your risk.
‰‰ You do have another health condition that could increase
your risk, but it’s in control.
4. Your family history
‰‰ One of your parents or siblings has had a heart attack,
stroke, or other signs of cardiovascular issues before age
55 (for a man) or 65 (for a woman).
5. Your risk of pregnancy
‰‰ There is no chance you will become pregnant.
‰‰ You are pregnant, may become pregnant, or are nursing.
6. Other reasons
© 2014 Intermountain Healthcare. All rights reserved. The content presented here is for your information only. It is not a substitute for professional medical advice, and it
should not be used to diagnose or treat a health problem or disease. Please consult your healthcare provider if you have any questions or concerns. More health information is
available at intermountainhealthcare.org. Patient and Provider Publications 801-442-2963 FS430 - 07/14 Also available in Spanish.
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