If you’ve got unhealthy cholesterol levels, then you’re at increased risk for heart disease and stroke. Making changes to your diet or exercise often is enough to move those levels into the healthy zone. But what should you do if diet or exercise isn’t enough?
That’s when it’s time to turn to prescription medications, and the gold standard is statins, which reduce how much cholesterol your body makes.
“Statins often get a bad reputation, but the evidence consistently shows they are highly effective and remain the cornerstone of cholesterol treatment and lowering heart disease risk,” says Laxmi Mehta, MD, director of Preventative Cardiology and Women’s Cardiovascular Health at The Ohio State University Wexner Medical Center.
Because not everyone can tolerate the side effects of statins, they sometimes get a bad reputation. The side effects that have been reported include muscle symptoms, diabetes, liver injury and some drug interactions. According to the American Heart Association’s review of available research, the risk of side effects remains quite low, and statins typically provide much more benefit than risk.
Non-statin cholesterol-lowering medications aren’t well-known
The good news is that there are non-statin medications. Unfortunately, many people aren’t aware of them. A new national survey commissioned by the Ohio State Wexner Medical Center shows 61% of Americans don’t know non-statin medicines exist.
“These newer non statin medication options can help lower LDL – the ‘bad’ cholesterol – for patients who need alternative therapies,” says Dr. Mehta, Sarah Ross Soter Endowed Chair for Women’s Cardiovascular Health Research.
Non-statin cholesterol medications are available in oral or injectable forms
Dr. Mehta recommends non-statin medication for patients who can’t tolerate the side effects of statins, need more LDL cholesterol-lowering than statins alone can provide, and have elevated atherosclerosis (buildup of fats and cholesterol in the arteries) or risk modifiers, such as elevated lipoprotein(a). Sometimes these medications are used in combination with statins for optimal cholesterol management, Dr. Mehta says.
Examples of non-statin medications that reduce cardiovascular events in high-risk patients:
- Ezetimibe: An oral medication that blocks cholesterol absorption at the intestinal level, reducing LDL cholesterol by 18–25%.
- PCSK9 inhibitors: A highly potent injectable medication administered every two to four weeks that can lower LDL cholesterol by 45–64%.
- Inclisiran: An injectable medication administered twice a year after the initial doses and can reduce LDL cholesterol by about 50%.
- Bempedoic acid: An oral medication, particularly for people who are intolerant to statins, used to help lower LDL cholesterol by 21-24%.
“Cardiovascular disease is the No. 1 killer of Americans. It’s also impacting people in their 20s and 30s much sooner than it has in the past for various reasons, including a surge in risk factors such as high blood pressure, diabetes and high cholesterol. Lifestyle contributors like poor diet, physical inactivity, substance use and vaping are also playing a significant role,” Dr. Mehta says. “Most people don’t know their cholesterol or other heart numbers unless they are checked. They may feel normal but be at risk, which is why routine testing is so important.”
How the survey was conducted
This study was conducted on behalf of The Ohio State University Wexner Medical Center by SSRS, a national, twice-per-month, probability-based survey. Data was collected Dec. 4-7, 2025, among a sample of 1,006 respondents via web or phone and administered in English.
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