Fact vs. Fiction: What You Really Need to Know About Statins

Statins are prescription medications that lower cholesterol and help prevent cardiovascular disease, the leading cause of death in the U.S. They are often the first treatment recommended, after lifestyle changes, and can reduce the risk of heart attack, stroke, and death by 25% or more. Despite a strong track record of safety and effectiveness, statins remain underutilized. Only about 60 percent of individuals with coronary artery disease or a history of stroke are receiving the recommended statin therapy, and just half of the 47 million U.S. adults who could benefit from statins are currently taking them.

Some of the hesitation comes from concerns about potential side effects, which many doctors say have been overblown. In recent years, social media has amplified misinformation, creating a negative stigma around statins by spreading claims that they are harmful or unnecessary. Our research scientists and clinicians at Private Health Management (PHM) provide a closer look at common worries associated with statins, and whether those concerns may or may not be justified.

How do statins work?
Statins, such as atorvastatin (Lipitor®), pravastatin (Pravachol®), rosuvastatin (Crestor®), and simvastatin (Zocor®), are used to lower blood cholesterol levels by targeting low-density lipoprotein (LDL), commonly known as “bad” cholesterol.

Statins work by blocking an enzyme in the liver that is responsible for making cholesterol, thus preventing the buildup of fatty deposits (plaques) in blood vessels, which can narrow or block arteries and lead to heart attacks or strokes. In addition to lowering cholesterol, statins may also have anti-inflammatory effects and help stabilize existing plaques, making them less likely to rupture and cause cardiovascular events, such as heart attack or stroke.¹

Common misconceptions about statins and what the science really says

Concern: Statins cause hardening of the arteries.

What science shows: No, statins do not cause hardening of the arteries. In fact, they help prevent the most dangerous consequences of arterial plaque buildup.

Misinterpretations of calcium scoring tests and how statins affect coronary artery calcification (CAC) have led to false claims that statins cause hardening of the arteries. There is some evidence these medications can increase calcium in plaques forming in the arteries, but this is not harmful. Rather, it usually means the plaques are becoming more stable and less likely to cause heart attacks.² Statins help reduce the soft, fatty parts of plaque that are more likely to rupture, replacing them with more stable, calcified tissue.³ This can slightly raise calcium scores on scans, even as overall heart risk goes down.

Concern: Statins cause dementia or Alzheimer’s.

What the science shows: No, there is no consistent evidence that statins cause dementia or Alzheimer’s disease.

The idea that statins harm memory has been circulating online, but this claim is not supported by scientific data. Concerns about statins and dementia began with a few early reports of short-term memory issues, which were rare and reversible, leading the FDA to add a precautionary note to statin labels in 2012.⁴ Since then, large and well-designed studies have not found a consistent link between statin use and cognitive decline. On the contrary, research suggests that statins may help lower the risk of dementia by improving blood flow to the brain and reducing inflammation.^5,6

Concern: Statins destroy muscles or cause permanent damage.

What the science shows: Statins do not “destroy” muscles or cause permanent damage in most people. While muscle aches are a well-known side effect, serious muscle injury is extremely rare and usually reversible.

While people report muscle aches while taking statins, research shows that many of these symptoms are not caused by the medication itself.⁷ The most serious muscle issue, rhabdomyolysis, is extremely rare and usually linked to high doses or other medications. Most people who experience muscle symptoms can manage them by adjusting the dose or switching to a different statin. A 2022 review of 19 clinical trials published in The Lancet found that, over an average follow-up of 4.3 years, only 3% more people taking statins reported muscle pain or weakness compared to those on a placebo.⁷

Concern: Cholesterol is actually good and statins are killing you.

What the science shows: While cholesterol is essential for your body, high levels of LDL cholesterol are a major cause of cardiovascular disease and lowering it with statins can save lives.

There have been claims that LDL cholesterol is unfairly labeled as harmful, arguing that it is essential for things like hormone production and brain health, and that lowering it with statins is unnatural or risky. However, there is strong scientific evidence that high LDL is a major contributor to plaque buildup in the arteries, which can lead to heart attacks and strokes.⁸ Large studies have shown that lowering LDL with statins significantly reduces these risks and even lowers the chance of death in high-risk individuals, such as having prior coronary disease, diabetes, or high cholesterol.^9,10 There is no evidence that reducing LDL to recommended levels is harmful and people with naturally low LDL tend to have healthier hearts and longer lives.¹¹

Concern: Natural remedies work better than statins.

What the science shows: No, natural remedies like garlic, turmeric, red yeast rice, or detox “cleanses” have not been shown to work better than statins in reducing the risk of heart attacks, strokes, or death.

Some social media influencers and alternative health advocates promote natural remedies like garlic, turmeric, apple cider vinegar, red yeast rice, and detoxes as safer, more “natural” alternatives to statins. While some of these substances may offer mild cholesterol-lowering or anti-inflammatory effects, the results are generally small and inconsistent.¹² For example, red yeast rice contains a statin-like compound, but its potency and safety vary between products, and it lacks the regulation and oversight of prescription medications.¹³ Most importantly, no natural remedy has been proven in large clinical trials to reduce the risk of heart attacks or strokes as effectively as statins.

Key takeaways
Decades of high-quality research and clinical guidelines support the use of statins as a key tool for lowering the risk of cardiovascular disease. These medications have been shown to reduce major cardiovascular events and mortality across diverse populations, especially in high-risk individuals. Leading medical organizations, including the U.S. Preventive Services Task Force, the American College of Cardiology, and the American Heart Association, endorse statin therapy based on this robust evidence.¹⁴ While healthy lifestyle choices remain essential, statins provide an additional layer of proven protection, with a well-established safety profile when appropriately monitored.

References

1. CDC. Million Hearts® The Scoop on Statins. Centers for Disease Control and Prevention https://millionhearts.hhs.gov/learn-prevent/scoop-on-statins.html (2021).
2. van Rosendael, A. R. et al. Association of Statin Treatment With Progression of Coronary Atherosclerotic Plaque Composition. JAMA Cardiology 6, 1257–1266 (2021).
3. Lee, S.-E. et al. Effects of Statins on Coronary Atherosclerotic Plaques: The PARADIGM Study. JACC: Cardiovascular Imaging 11, 1475–1484 (2018).
4. Schultz, B. G., Patten, D. K. & Berlau, D. J. The role of statins in both cognitive impairment and protection against dementia: a tale of two mechanisms. Translational Neurodegeneration 7, 5 (2018).
5. Lee, M. et al. Low-density lipoprotein cholesterol levels and risk of incident dementia: a distributed network analysis using common data models. J Neurol Neurosurg Psychiatry (2025) doi:10.1136/jnnp-2024-334708.
6. Olmastroni, E. et al. Statin use and risk of dementia or Alzheimer’s disease: a systematic review and meta-analysis of observational studies. European journal of preventive cardiology (2021) doi:10.1093/eurjpc/zwab208.
7. Reith, C. et al. Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials. The Lancet 400, 832–845 (2022).
8. Silverman, M. G. et al. Association Between Lowering LDL-C and Cardiovascular Risk Reduction Among Different Therapeutic Interventions: A Systematic Review and Meta-analysis. JAMA 316, 1289–1297 (2016).
9. Mhaimeed, O. et al. The importance of LDL-C lowering in atherosclerotic cardiovascular disease prevention: Lower for longer is better. American Journal of Preventive Cardiology 18, 100649 (2024).
10. Zhang, Y. et al. Association Between Cumulative Low-Density Lipoprotein Cholesterol Exposure During Young Adulthood and Middle Age and Risk of Cardiovascular Events. JAMA Cardiology 6, 1406–1413 (2021).
11. O’Keefe, J. H., Cordain, L., Harris, W. H., Moe, R. M. & Vogel, R. Optimal low-density lipoprotein is 50 to 70 mg/dl: Lower is better and physiologically normal. Journal of the American College of Cardiology 43, 2142–2146 (2004).
12. Laffin, L. J. et al. Comparative Effects of Low-Dose Rosuvastatin, Placebo, and Dietary Supplements on Lipids and Inflammatory Biomarkers. Journal of the American College of Cardiology 81, 1–12 (2023).
13. Banach, M. et al. Red yeast rice for dyslipidaemias and cardiovascular risk reduction: A position paper of the International Lipid Expert Panel. Pharmacological Research 183, 106370 (2022).
14. US Preventive Services Task Force. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement. JAMA 328, 746–753 (2022).