Which statin is best at lowering cholesterol?
Every statin is a little different, but they all have one thing in common—helping to lower cholesterol levels in people who haven't been able to control their numbers through diet and exercise. These medications are designed to improve heart health.
What do statins do?
Statins are a class of medications that help to lower LDL-cholesterol (bad cholesterol), triglycerides, Apolipoprotein B (Apo B), as well as raise HDL-cholesterol (good cholesterol).
They work by inhibiting an enzyme called HMG-CoA reductase, which is involved in the production of cholesterol in the liver. By blocking this enzyme, statins reduce the liver's ability to produce cholesterol, leading to a decrease in overall cholesterol levels in the bloodstream.
How to determine the right statin dose for you?
This depends on a number of factors.
- How much do you need to lower your cholesterol by?
It’s well known how much of a reduction in cholesterol you will get with a particular statin dose (see below). Your healthcare provider can help you to pick a statin that will get you back into a normal range and they will verify this with a blood test after you start taking it.
- Do you have a history of cardiovascular disease?
If yes, it’s recommend to start on a high-intensity statin, or the highest dose statin you can tolerate, to help reduce your risk of another event. The two high-intensity statins are atorvastatin and rosuvastatin.
- Are you taking other medications?
Certain statins interact with other medications. It’s important to tell your healthcare provider what medications you are taking. Statins like Zypitamag and pravastatin have a reduce potential to interact with other medications.
- Do you eat foods that contain Grapefruit Juice?
If yes, you should avoid statins like atorvastatin and simvastatin as they can interact with Grapefruit juice. If that is the case, your healthcare provider will likely have you take a statin like rosuvastatin or Zypitamag.
- Are you diabetic?
If you are diabetic, the more recent blood cholesterol guidelines recommend that anyone aged 40 to 75 should be taking a moderate-intensity statin, regardless of your cholesterol levels.
- Do you have risk factors for heart disease?
Healthcare providers will often determine your 10-year ASCVD risk score. ASCVD stands for atherosclerotic cardiovascular disease. You can learn about various risk factors your healthcare provider looks for as well as calculate your risk on our ASCVD Risk Calculator blog.
- Have you taken a statin previously and experienced side effects?
If this is the case your healthcare provider will likely lower your statin dose or switch you to another statin. Certain people are at a higher risk of experiencing statin side effects than others. Most people are able to start taking another statin to get their cholesterol numbers under control.
Learn more about factors to consider when choosing the right statin for you
What is a normal LDL-cholesterol range?
Most adults should keep their LDL (bad cholesterol) levels below 100 milligrams per deciliter (mg/dL).
If you have a history of cardiovascular disease (ie: heart attack or stroke), this number should be even lower, preferably less than 70 mg/dL.
Here is how most healthcare providers categorize LDL-cholesterol:
| Normal | Below 100 mg/dL |
| Near optimal | 100 – 129 mg/dL |
| Borderline high | 130 – 159 mg/dL |
| High | 160 – 189 mg/dL |
| Very high | 190 mg/dL or higher |
How much do statins lower cholesterol?
This depends on the statin you are taking. Statins are classified as low-intensity, moderate intensity, and high intensity.
- Low intensity statins: Decrease LDL-cholesterol by 30% or less
- Moderate intensity statins: Decrease LDL-cholesterol by 30% to 49%
- High intensity statins: Decrease LDL-cholesterol by 50% or more
Please see the chart below to see where each statin falls in the chart.
| Statin Dose & Intensity | |||
| Low Intensity | Medium Intensity | High Intensity | |
| Mevacor® (Lovastatin) |
10, 20 mg | 40, 80 mg | |
| Pravachol® (Pravastatin) |
10, 20 mg | 40, 80 mg | |
| Zorcor® (Simvastatin) |
5, 10 mg | 20, 40 mg | |
| Lescol® (Fluvastatin) |
20, 40 mg | 80 mg | |
| Lipitor® (Atorvastatin) |
10, 20 mg | 40, 80 mg | |
| Crestor® (Rosuvastatin) |
5, 10 mg | 20, 40 mg | |
| Zypitamag® (Pitavastatin) |
2, 4 mg | ||
Comparing Statins
We have a lot of content on statin medications on our website. Read one of the reviews below from one of our pharmacists comparing the different statins