The incidence of cardiovascular disease in China has skyrocketed at an alarming rate. Coronary heart disease, the most influential of these diseases, is also receiving increasing attention. Many people have started taking antithrombotic drugs (e.g. aspirin) and seven or more proprietary Chinese medicines after the diagnosis of coronary heart disease. However, there is one drug use that is neglected by many people with coronary artery disease: statin lipid-lowering drugs. A large percentage of these people stop using statins because their blood lipids are already normal. In their eyes, statin is a lipid-lowering drug, so why can’t they stop it if their blood lipids are normal. In fact, coronary heart patients with normal blood lipids cannot stop using statins without permission. Coronary heart disease is generally referred to as coronary atherosclerotic heart disease, which is the growth of plaques on the inner wall of the coronary arteries that supply blood to the heart itself. The generation and growth of these plaques are closely related to cholesterol, and it can be said that cholesterol is the raw material for building atheromatous plaques, so lowering cholesterol in the blood can inhibit the growth of plaques. But it’s not quite that simple. The number one killer in the coronary heart disease family, myocardial infarction, is not new to everyone. But many people think that myocardial infarction is caused by atheromatous plaque slowly growing and then blocking blood vessels. In fact, the vast majority of myocardial infarctions occur not because the plaque is too large, but because it breaks, inducing an acute blood clot that blocks a coronary artery. So why do plaques rupture? There are various reasons for this, but two of them are important: 1. There is too much fat in the atheromatous plaque, and the part of the plaque becomes a dumpling with a large filling and thin skin; 2. The atheromatous plaque has an inflammatory response, and the inner layer of the blood vessel wrapping the plaque becomes unstable. Statin lipid-lowering drugs are not only as simple as lowering lipids, but also stabilize plaque and prevent rupture, making them a versatile player in the treatment of coronary heart disease. Therefore patients who clearly have coronary heart disease, especially those who have experienced unstable angina, myocardial infarction, or those with diabetes, should adhere to statins as prescribed by their doctors. Do lipid-lowering drugs hurt the liver? In addition to not realizing the importance, many patients are concerned about the side effects of statins, most notably liver problems. In my work, I often encounter patients who ask me “is this statin very toxic to the liver”, and some even refuse to take the drug because they are concerned about the liver safety of statins. A few years ago, I met a patient with coronary artery disease who stopped taking statin because the doctor at the health center told the patient that it was too hepatotoxic to take. But is this really the case? The truth is: 1. The incidence of statin-related liver injury is about 1.2/100,000, which is not even a “what-if” statement; 2. The incidence of liver failure because of statin use is only 1 in 5 million and is currently thought to be patient-specific; 3. Non-alcoholic fatty liver disease, chronic liver disease (such as chronic hepatitis B) and compensated cirrhosis are all allowed to use statins; 4, During the course of statin use, if liver enzymes are elevated within 3 times the upper limit, there is no need to discontinue the drug and the dosage can be reduced or continued to be monitored. Statins are not recommended for patients with: active liver disease, persistent elevated liver enzymes of unknown origin, elevated liver enzymes above 3 times the upper limit of normal for any reason, decompensated cirrhosis, acute liver failure. Finally, combining relevant guidelines and personal experience, I recommend that patients have their liver function checked before and one month after taking a statin, and then every 6 to 12 months to prevent serious side effects. For those who should take them, statins are definitely a drug with more pros than cons, and I hope this article will remove most people’s unnecessary concerns about statins and better regulate their use.