Statin
A medicine that lowers cholesterol and reduces the risk of heart attack and stroke.
What it means
Statins reduce the liver's production of cholesterol by blocking an enzyme in its synthesis pathway. They also stabilise existing arterial plaques, which is part of why they work.
They are prescribed in two situations:
- Secondary prevention — after a heart attack, stroke or vascular diagnosis. Benefit is large and clear.
- Primary prevention — before any event, based on estimated 10-year risk. Benefit is real but smaller, and worth an honest conversation about absolute numbers.
In practice
Liver enzymes are checked before starting and at three months. Mild rises are common and rarely require stopping.
Muscle aches are the most reported side effect. Placebo-controlled trials find that the large majority of these symptoms occur equally on placebo — which does not make the pain imaginary, but does mean the statin is often not the cause, and a re-challenge frequently succeeds.
Why it matters
Anyone offered a statin for primary prevention is entitled to know their actual numbers — what their 10-year risk is, and what it becomes on treatment. We will always give the absolute figures rather than a relative risk reduction, because the two sound very different and only one is useful for deciding.
Severe, widespread muscle pain with dark urine is rare but requires stopping and same-day assessment.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026