An inexpensive, long-established medication that dependably lowers LDL ("bad") cholesterol by slowing its production in the liver. In people at high risk it means fewer heart attacks and strokes and, in the highest-risk groups, longer life; the benefit is smaller at lower risk. Main trade-offs are muscle aches, a modest rise in diabetes risk, and mild liver changes. (Full Review)
| Marker | Target | Why |
|---|---|---|
| LDL cholesterol | < 70–100 mg/dL | Primary treatment target |
| Apolipoprotein B (apoB) | < 80 mg/dL (< 60 high risk) | Direct count of artery-clogging particles; better predictor than LDL alone |
| Non-HDL cholesterol | < 100–130 mg/dL | Captures all atherogenic cholesterol; useful when triglycerides are high |
| ALT / AST (liver enzymes) | < ~30 U/L | Detects liver stress or injury |
| Creatine kinase (CK) | Within normal; recheck if muscle symptoms | Flags muscle injury / rhabdomyolysis |
| Fasting glucose / HbA1c | HbA1c < 5.4–5.6% | Screens for statin-associated diabetes |
| Creatinine / eGFR | eGFR > 60 mL/min/1.73m² | Guides dosing and interaction risk |
| TSH | ~0.5–2.5 mIU/L | Rules out hypothyroidism, which raises cholesterol and muscle risk |
| Lipoprotein(a) [Lp(a)] | < 75 nmol/L (~< 30 mg/dL) | Inherited residual risk marker; statins may raise it slightly |
Cadence: Recheck lipids ~6–12 weeks after starting or changing the dose; then review lipids, glucose, and symptoms every 6–12 months; liver or muscle enzymes as prompted by symptoms.