Doctors—and their patients—are losing faith in statins: 3 reasons they fall short
Key Takeaways
Industry Buzz
"One of the biggest reasons patients hesitate to take statins is fear of side effects. The most commonly reported issue is muscle pain or weakness, though studies suggest that only a tiny percentage of people experience statin-related muscle symptoms.” - Randall Turner, DO
“Patients do not feel an immediate benefit when taking them, which makes it harder to stay motivated." - Randall Turner, DO
Find more of your peers' perspectives and insights below.
Statins have been central to managing hypercholesterolemia since their introduction. However, despite their well-documented benefits in cardiovascular disease prevention, patient adherence has consistently remained low.
Related: New insights on statins: For some, they can reduce risk of dementia; for others, they can be replaced with better, cheaper drugsA study based on MarketScan and Medicare data found no significant improvement in statin adherence among patients without diabetes mellitus or coronary heart disease (CHD) between 2007 and 2014.
Efficacy
💉 Statins haven’t stopped heart disease. More meds or a new direction?
— Heart Surgeon Dr. Philip Ovadia (@ifixhearts) February 4, 2025
⁰#HeartHealth #Cholesterol #Wellness pic.twitter.com/AnfjKp4tfZ
While statins help lower cholesterol, they may also contribute to insulin resistance, increasing the risk of type 2 diabetes—a known risk factor for cardiovascular disease. Some researchers argue that the true benefit of statins may stem from their anti-inflammatory properties rather than their cholesterol-lowering ability, raising the question of whether other treatments targeting inflammation might be more effective.
Related: Managing statin-induced brain fog: New insights may mean new protocol for your clinicSide effects
Board-certified physician Randall Turner, DO, expresses his concerns: "One of the biggest reasons patients hesitate to take statins is fear of side effects. The most commonly reported issue is muscle pain or weakness, though studies suggest that only a tiny percentage of people experience statin-related muscle symptoms.”
Some of the most frequently reported SAS include:
Statin-associated muscle symptoms (SAMS) are reported by 5% to 20% of patients, though clinical trials and observational studies estimate an actual incidence of 1 per 1,000 or lower.
Rhabdomyolysis is reported in 2-3 cases per 100,000 people.
Diabetes risk slightly increases with preexisting risk factors.
Liver enzyme elevation is observed in nearly 2%, but severe liver injury is rare.
Neurological effects like memory loss, aggression, and hemorrhagic stroke remain controversial, with limited evidence.
The 2012 FDA label update for statin drugs added warnings about memory loss, confusion, and drug interactions that could increase muscle injury.[] While the FDA classified these effects as “non-serious and reversible,” public concerns have been escalating ever since. Many patients misinterpreted the warnings, leading to widespread hesitation and discontinuation.
Dr. Turner adds, “Some patients stop taking statins simply because they have heard negative stories online.”
Nevertheless, statins remain one of the most rigorously studied and widely prescribed medications. Dr. Turner reinforces this: “While newer cholesterol-lowering options exist, statins are still the go-to because they work well, are affordable, and have a well-documented safety record. For people with a history of heart disease, diabetes, or other risk factors, statins are a lifesaving medication rather than just a cholesterol-lowering drug.
Compliance
A 2025 systematic review identified concerns about side effects, especially muscle pain, fatigue, and cognitive impairment, among the most common reasons for poor adherence. However, the review also found an inconsistent association between reported side effects and actual adherence rates, suggesting that a nocebo effect may be at play.[]
Dr. Turner further explains, “Patients do not feel an immediate benefit when taking them, which makes it harder to stay motivated. Unlike medications that relieve symptoms, statins work in the background, lowering cholesterol and reducing heart disease risk over time. That means people may not recognize their importance until years down the road.”