I often have patients who stop taking their statins or refuse to take them because of “side effects”. This can range from muscle aches to memory loss (the latter side effect of which there is conflicting data for).

One option would be to switch to a more hydrophilic statin – like pravastatin (now generic) – which have been shown in studies to decrease the incidence of muscle aches and cognitive deficits.

There is a subset of patients who refuse any treatment, despite a markedly elevated LDL. To these patients who fear the side effects of statins I ask: “Are you aware of the side effects of an LDL above 200?”.

How about heart disease (about 30 percent risk reduction in the primary prevention of cardiovascular deaths with LDL lowering) and stroke (about a 21 to 29 percent risk reduction in the primary prevention of stroke with LDL lowering).

The “side effects” of markedly high cholesterol dwarf those of statin therapy. Once patients realize this, they often agree to treatment.