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Q&A With Heart Experts: How Do I Know If a Statin is Right For Me?

CardioSmart Contributor

In this series, heart specialists answer common questions about statins and heart health.

Question: How do I know if a statin is right for me?

Answer: Doctors use tools to figure out who should take statins to prevent heart disease. These tools estimate your risk for having a cardiovascular event in the next 10 years. The PREVENT tool is a new evidence-based cardiovascular prediction tool developed using data from 6.5 million U.S. adults to estimate cardiovascular risk. Depending on your estimated risk of developing atherosclerotic cardiovascular disease (ASCVD) based on the PREVENT calculator, you might benefit from statin therapy. Other tools that your doctor may use include Pooled Cohort Equation (PCE), ASCVD Risk Estimator Plus, and SCORE2.  

Question: Are statins overprescribed?

Answer: Unfortunately, studies show that up to 44% of patients who could benefit from statins are not taking them—often due to fear of side effects(Masson et al 2021). But skipping statins in certain patients can leave them at a higher risk for heart attacks and strokes.

Key Points

  • High cholesterol does not necessarily mean you need a statin medication. All people  benefit from lifestyle optimization with diet and exercise, but some people who are higher risk are more likely to benefit from the addition of a medication.
  • More accurate assessment tools, like the PREVENT calculator, are less likely to overestimate risk and therefore, less likely to cause an “overprescribing” of statin medications.
  • If you have high cholesterol, discuss your personal risk of having a cardiovascular event with your clinician. 

Read More: Q&A With Heart Experts: Statins

Zhou H, Zhang Y, Zhou MM, et al. Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10-Year Atherosclerotic Cardiovascular Risk Prediction. J Am Heart Assoc. Feb 18 2025;14(4):e039454. doi:10.1161/jaha.124.039454

Khan SS, Matsushita K, Sang Y, et al. Development and Validation of the American Heart Association’s PREVENT Equations. Article. Circulation. 2024;149(6):430-449. doi:10.1161/CIRCULATIONAHA.123.067626

Shetty NS, Gaonkar M, Patel N, et al. PREVENT and Pooled Cohort Equations in Atherosclerotic Cardiovascular Disease Risk Prediction: A Post Hoc Analysis of SPRINT. Mayo Clin Proc. Jan 4 2025;doi:10.1016/j.mayocp.2024.08.024

Anderson TS, Wilson LM, Sussman JB. Atherosclerotic Cardiovascular Disease Risk Estimates Using the Predicting Risk of Cardiovascular Disease Events Equations. Article. JAMA Internal Medicine. 2024;184(8):963-970. doi:10.1001/jamainternmed.2024.1302

Heaton J, Alshami A, Imburgio S, et al. Comparison of pooled cohort equation and PREVENT™ risk calculator for statin treatment allocation. Article. Atherosclerosis. 2024;399doi:10.1016/j.atherosclerosis.2024.118626
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