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Statins: what the evidence says
The most-studied preventive drugs in medicine, and the muscle-ache question.
The Cochrane evidence: statins reduce LDL, and each 1 mmol/L of LDL lowering cuts major vascular events by about a fifth. They are prescribed by risk — a healthy thirty-year-old with mildly high cholesterol usually gets diet and time; the person who has had a heart attack gets a statin almost by default, because the benefit is largest where the risk is largest.
The famous side effect is muscle aches, and the honest number is that in trials the excess was small — roughly one person in fifty reports it — while in the real world it is reported more often, partly because the drugs are taken by the people most likely to ache anyway. The clinical answer is practical: if aches appear, the dose, the drug or the timing changes, and most people find a version that works.
The numbers
- Roughly 20% fewer major vascular events per 1 mmol/L LDL lowered (Cochrane).
- Excess muscle symptoms in trials: on the order of 1 in 50.
Source: Cochrane — statins for the primary prevention of cardiovascular disease · checked 2026-09-07
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