1. What are the benefits of taking “statins”? The results of large clinical trials are well known: statins are the safest and most effective drugs prescribed for clinical use. Therefore, statins are safe and well-tolerated for most people. In adults, regardless of age, sex, history of heart disease, and in patients with diabetes and hypertension, statins have been shown to prevent myocardial infarction, prevent most strokes, and reduce death from most causes of heart disease. In most patients, the benefits of statins far outweighed their side effects. 2. What should I tell my doctor before starting lipid-regulating drug therapy? Before starting any new treatment, patients should be sure to tell their doctor about all medications and dietary supplement treatments they are taking. Be sure to let your doctor know if you have severe liver disease, peptic ulcers, or active bleeding. If there is diabetes, be sure to tell your doctor about any changes in blood sugar levels. If there may be an allergy to any medication to lower cholesterol, medication should not be started to lower cholesterol. During treatment, women should tell their doctor if they are pregnant or planning to become pregnant, as some medications may be harmful to the fetus. Similarly, if breastfeeding, it should be noted that some medications may be present in the milk and may be harmful to the breastfed baby. 3. What are “statin” drugs? By what mechanism do “statins” lower blood lipids? Statins are a class of drugs used to lower LDL cholesterol (bad). They work by inhibiting hydroxymethylglutaryl coenzyme A reductase (HMG-CoA reductase), a key enzyme for cholesterol synthesis in the liver. Blocking this enzyme causes the liver to synthesize less cholesterol and remove more cholesterol from the blood. Currently, there are seven different prescription HMG-CoA reductase inhibitors (statins). 4. Are all “statin” drugs the same? The first statins on the market (such as lovastatin) were not as powerful in lowering LDL cholesterol as the later statins. For this reason, lower doses of newer statins are as effective in lowering LDL cholesterol as higher doses of the earlier statins on the market. However, some of the earlier statins are still in use, which means that different manufacturers other than the original manufacturer are making and selling (under different trademarks and names) these earlier statins. After the doctor tests the patient’s LDL cholesterol level, the doctor discusses with the patient the target cholesterol reduction needed and determines which is better, the older statin at a higher dose or the newer statin at a lower dose, based on this target value. The cost-benefit ratio, insurance coverage, etc. are also considered.