Second Opinion: What are statins and who should be taking them?

Statins are medicines that limit cholesterol production by the liver, which is where about 75 percent of the body’s cholesterol comes from. Statins lower LDL cholesterol, the “bad” kind and can raise HDL, the “good” cholesterol. HDL is a cholesterol vacuum cleaner. Where LDL carries cholesterol to the body, HDL carries it away. Statins also decrease triglyceride fat in the body.

But the statin guidelines have changed. There is now more emphasis on a patient’s risk profile for heart disease and stroke than on the LDL level.

So who is at high risk? 

  • Those who have a known history of heart disease (not rocket science)
  • Those with an LDL greater than 190 (so LDL has not disappeared from the guidelines)
  • Those ages 40-75 years with Type 2 diabetes
  • Those ages 40-75 years with a 10-year risk of heart disease that is greater than 7.5 percent as calculated by a standardized cardiac risk calculator ( The calculator also considers age, gender, total and HDL cholesterol, smoking status and blood pressure.

The decision to start a statin should be made by you and your doctor and should be incorporated into a program that includes exercise and dietary discretion.

Ralph Robertson, M.D.

Medical Director of
Lackey Clinic