Should you be on a statin?

Whether you need to be on a statin depends on your cholesterol levels and other risk factors for heart and blood vessel (cardiovascular) disease. Your doctor will consider all of your risk factors for heart attacks and strokes before prescribing a statin.

Knowing your cholesterol numbers is a good place to start.

• Total cholesterol. Most people should try to keep their total cholesterol below 200 milligrams per deciliter (mg/dL), or 5.2 millimoles per liter (mmol/L).
• Low-density lipoprotein (LDL) cholesterol. Aim to keep this "bad" cholesterol under 100 mg/dL, or 2.6 mmol/L. If you have a history of heart attacks or you're at a very high risk of a heart attack or stroke, you may need to aim even lower (below 70 mg/dL, or 1.8 mmol/L).

The most important thing your doctor will keep in mind when thinking about statin treatment is your long-term risk of a heart attack or stroke. If your risk is very low, you probably won't need a statin, unless your LDL is above 190 mg/dL (4.92 mmol/L).

If your risk is very high — for example, you've had a heart attack in the past — a statin may be helpful even if you don't have high cholesterol.

Besides cholesterol, other risk factors for heart disease and stroke are:

• Tobacco use
• Lack of exercise
• High blood pressure
• Diabetes
• Overweight or obesity
• Narrowed arteries in your neck, arms or legs (peripheral artery disease)
• Family history of heart disease, especially if it was before the age of 55 in male relatives or before 65 in female relatives
• Older age