Stopping Statins Safely: What You Need to Know Before Making the Switch

July 3, 2025/Andrew Le

Stopping statins, especially in older adults, can raise your chances of heart attacks, strokes, or even death. The risk grows fast. Within weeks, cholesterol levels spike. Heart protection drops. And for many, health problems come rushing back.

People who stop statins often feel more tired, more vulnerable. Some even face life-threatening events. 

So, what if you’re thinking of stopping? Or wondering if the side effects are worth it?

🔑 Key Takeaway

➤ Stopping statins can quickly raise your cholesterol and increase your risk of heart attacks, strokes, and even death, especially if you’re older.

➤ Within weeks or months, cholesterol levels often spike, and heart protection drops, even if you try to eat better or exercise more.

➤ Many people who stop statins feel worse, more tired or at risk, and some end up in the hospital with serious health problems.

➤ The chance of your cholesterol going back up is high; in one study, nearly 8 out of 10 people had unhealthy levels again within 10 weeks.

➤ Some older adults may be able to stop statins safely, but only if they have poor health or a short life expectancy, and always with a doctor’s help.

➤ If statins aren’t working for you or cause side effects, there are other medicines like ezetimibe, bempedoic acid, or PCSK9 inhibitors that can help manage cholesterol.

What Happens If You Stop Cholesterol Medication?

Discontinuing statin therapy, especially in older adults, has been linked to serious health consequences. Multiple studies have investigated this topic, each highlighting important outcomes related to cardiovascular risk and cholesterol levels.

Increased Risk of Cardiovascular Events

According to a large cohort study, stopping statins among people aged 75 and older was associated with a significantly higher risk of major adverse cardiovascular events (MACE). This study followed 67,418 long-term statin users in Denmark, split into two groups: those using statins for primary prevention (no history of cardiovascular disease) and those using them for secondary prevention (with a history of cardiovascular disease).

  1. In the primary prevention group, the adjusted hazard ratio for MACE was 1.32, which translates to 1 extra MACE per 112 people who stopped statins per year.
  1. In the secondary prevention group, the hazard ratio was 1.28, corresponding to 1 extra MACE per 77 people who stopped taking statins annually.

This means that people who stopped taking statins had significantly more heart attacks, strokes, and cardiovascular deaths than those who continued their medication. For example, among those without cardiovascular disease, the rate of myocardial infarction rose by 37%, and death from heart attack or stroke rose by 43%.

Sharp Rise in Cholesterol Levels

Another study examined what happened to cholesterol levels after stopping statins. They found that within 2 to 3 months, LDL cholesterol rose by 44.9%, and by 4 to 6 months, it increased by 54.6%. Total cholesterol also went up by over 30%, and triglycerides by 24%. These jumps were seen despite patients trying lifestyle modifications. Notably, people with diabetes and coronary artery disease were less likely to reach target cholesterol levels after stopping their statins.

High Relapse Rate of Dyslipidemia

One study looked at statin discontinuation in type 2 diabetic patients without heart disease. Their randomized controlled study found that 79% of patients who stopped statins had a relapse in dyslipidemia (defined as LDL-C >100 mg/dL) within just 10 weeks, compared to only 3% in the group that continued. This suggests that cholesterol levels rebound quickly once medication is stopped.

Health Decline and Frailty

The increased cardiovascular risk might not be the only issue. According to a study, statin discontinuation in older adults receiving multiple medications was linked to increased all-cause mortality and non-cardiovascular deaths, such as from infections or other chronic diseases. 

Their study found an adjusted hazard ratio of 1.14 for cardiovascular events, showing that stopping statins was also a sign of overall poorer health or frailty.

Statin discontinuation was associated not just with MACE but also with hip fractures and other negative health outcomes. This suggests stopping statins may reflect declining health rather than cause it directly, although the cardiovascular risks remain elevated either way.

Lipoprotein Changes and Inflammation

Several studies have shown that stopping statins also reverses their anti-inflammatory and vascular protective effects. Studies reported that statin withdrawal can increase inflammation and impair blood vessel function. This might explain why events like heart attacks can increase shortly after discontinuation.

When Might It Be Safe to Stop Statins?

When might it be safe to stop statins in older adults? 

That question is complex, and recent research gives important insights based on both clinical guidelines and patient perspectives.

According to a study that reviewed 18 international cardiovascular prevention guidelines, most guidelines have little concrete advice on when to discontinue statins in older adults. Although 16 of these guidelines addressed statin use in this age group, only three suggested considering discontinuation in people with poor health or limited life expectancy. Still, they offered no practical steps on how to do it. The authors also noted that while statin intolerance was addressed, none of the guidance was specifically tailored to older adults.

On the other hand, patient-centered research adds depth to this issue. According to a mixed-methods study involving 47 patients aged 65 and older, only 22% were willing to try discontinuing statins, while 41% were reluctant. One reason patients gave for continuing was their belief in the statin’s protective effect. However, those who saw themselves at low cardiovascular risk or felt burdened by multiple medications were more open to stopping. Interestingly, although 94% of participants said they would continue taking statins if their doctor advised it, 96% said they would not feel abandoned if the physician recommended stopping it. This shows how important physician input is in such decisions.

The researchers also found that fear played a big role. Nearly half of the patients feared having a cardiovascular event after stopping statins, and those with that fear were more likely to want to continue. Yet, many didn’t feel confident enough to make the decision on their own, 70% preferred their doctor to decide. Even among those open to stopping, a safe discontinuation plan, including monitoring, was important.

So, when is it safe? 

According to both studies, stopping statins might be considered when an older patient has poor health, a limited life expectancy, or when the burden of the medication outweighs its benefits. But the decision should be individualized. Many older adults rely heavily on their primary care physicians for guidance and are more comfortable with deprescribing if they trust their doctor’s recommendation.

Alternative to Statins

If you’re wondering about alternatives to statins for lowering cholesterol, there are several options available, especially if you’ve experienced side effects or your cholesterol levels remain high despite using statins. These alternatives target cholesterol in different ways, and many are backed by data from clinical studies.

  1. One major alternative is ezetimibe, a daily tablet that stops your small intestine from absorbing cholesterol from food. According to the British Heart Foundation, ezetimibe lowers LDL or “bad” cholesterol by 15% to 22% when taken on its own. When combined with a statin, it improves outcomes even more, bringing LDL levels down by 21% to 27%. NICE guidelines support its use either alone when statins are not tolerated or in combination when statins aren’t enough.
  1. Another alternative is bempedoic acid, which works similarly to statins but only inside the liver. This lowers the risk of side effects like muscle pain. According to a study, bempedoic acid alone can reduce LDL cholesterol by 17% to 28%. When used together with ezetimibe, the reduction can reach about 28%. The combination pill, sold as Nexlizet, is approved by the FDA for use regardless of statin tolerance.
  1. PCSK9 inhibitors like alirocumab (Praluent) and evolocumab (Repatha) offer another strong option. These are injectable medicines given every 2 to 4 weeks. They block a liver protein that limits how much cholesterol your body can remove. These drugs can lower LDL cholesterol by up to 60% and cut the risk of heart attacks, strokes, or death by about 20% in patients with heart disease. They’re usually recommended when statins and ezetimibe haven’t done enough or aren’t tolerated.
  1. Inclisiran (Leqvio) works similarly to PCSK9 inhibitors but with a twist. Instead of blocking the protein, it stops your body from making it in the first place by silencing the gene using RNA. Inclisiran can lower LDL cholesterol by 52%. It requires fewer injections, only twice a year after the initial doses, which can be more convenient for some people. NICE allows its use only in people who have already had a heart attack or stroke and need more cholesterol control beyond statins.
  1. Fibrates like gemfibrozil (Lopid) and fenofibrate (Tricor) focus more on lowering triglycerides than LDL cholesterol, though they can offer a mild LDL reduction. Fibrates are sometimes used with statins or ezetimibe, but combining gemfibrozil with a statin can raise the risk of side effects and is usually avoided.
  1. Bile acid sequestrants like cholestyramine (Prevalite), colestipol, and colesevelam also help. They bind to bile acids in your gut, forcing the liver to use more cholesterol to make new bile, which lowers cholesterol levels. They are effective but less convenient because they require taking many pills multiple times a day and can interfere with other medications and nutrients.
  1. There are also natural or over-the-counter (OTC) alternatives, though they usually work best alongside lifestyle changes. Some common ones include red yeast rice, omega-3 fatty acids, psyllium, berberine, and vitamins like niacin, C, and D. These options can help but should always be discussed with a healthcare provider because they still carry risks and interactions.

Final Words

You might wonder if you can stop taking cholesterol medication once your levels look good. The answer is not so simple. For most people, especially older adults, stopping statins can be risky. Cholesterol can rise quickly, and the protection they offer fades fast. That can lead to heart attacks, strokes, or even death.

Even if you feel fine or improve your diet, the numbers often go back up. Many who stop feel worse, more tired, and some face serious health problems. Unless you’re in poor health or have a short life expectancy, stopping statins should only happen with a doctor’s close guidance.

FAQs on Stopping Statins Safely

Do I have to take statins forever?

Usually, yes. Statins work only while you take them. If you stop, your cholesterol can go back up, raising your risk of heart problems.

Why do some people want to stop statins?

Some people worry about side effects like muscle pain or high blood sugar. Others think they don’t need the medicine anymore.

Can lifestyle changes replace statins?

Healthy habits help, but they might not be enough by themselves. Diet and exercise can lower cholesterol, but you’ll still need a doctor to check your levels.

Sources

  • Kim, M.-K., Kim, H.-L., Min, H.-S., Kim, M.-S., Yoon, Y. E., & Park, K.-W. (2008). Changes of the lipoprotein profiles with time after discontinuation of statin therapy. Korean Circulation Journal, 38(1), 36–42. https://doi.org/10.4070/kcj.2008.38.1.36.
  • Lee, S.-H., Kwon, H.-S., Park, Y.-M., Ko, S.-H., Choi, Y.-H., Yoon, K.-H., & Ahn, Y.-B. (2014). Statin discontinuation after achieving a target low density lipoprotein cholesterol level in type 2 diabetic patients without cardiovascular disease: A randomized controlled study. Diabetes & Metabolism Journal, 38(1), 64–73. https://doi.org/10.4093/dmj.2014.38.1.64
  • Rea, F., Biffi, A., Ronco, R., Franchi, M., Cammarota, S., Citarella, A., Conti, V., Filippelli, A., Sellitto, C., & Corrao, G. (2021). Cardiovascular outcomes and mortality associated with discontinuing statins in older patients receiving polypharmacy. JAMA Network Open, 4(6), e2113186. https://doi.org/10.1001/jamanetworkopen.2021.13186.
  • van der Ploeg, M., Floriani, C., Achterberg, W. P., Bogaerts, J., et al. (2019). Recommendations for (discontinuation of) statin treatment in older adults: Review of guidelines. Journal of the American Geriatrics Society, 68(3). https://doi.org/10.1111/jgs.16219.
  • Brunner, L., Mooser, B., Spinewine, A., Rodondi, N., & Aubert, C. E. (2024). Older adult perspectives on statin continuation and discontinuation in primary cardiovascular disease prevention: A mixed-methods study. Patient Preference and Adherence, 18, 15–27. https://doi.org/10.2147/PPA.S432448.
  • Bardolia, C., Amin, N. S., & Turgeon, J. (2021). Emerging non-statin treatment options for lowering low-density lipoprotein cholesterol. Frontiers in Cardiovascular Medicine, 8, 789931. https://doi.org/10.3389/fcvm.2021.789931.
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