Cholesterol is a fat (lipid) naturally produced in the body. We need it to produce cell membranes, hormones, and some vitamins. But we also get additional cholesterol from the foods we eat, and that combination can result in too high levels in our blood. When this happens, some of the fat can coat the heart’s coronary arteries, narrowing them. These deposits are called plaque. If that plaque forms a clot, it can block the blood flow, resulting in a heart attack.

Statins are cholesterol-lowering drugs that work in two ways: first, they block an enzyme in your body that regulates the production of cholesterol; second, because your body needs cholesterol, statins reabsorb excess that has built up, thus reducing plaque accumulation.

Statins are credited with helping reduce the rate of heart attacks and strokes, and they have been very beneficial to people who truly need them — people who have a genetic condition called familial hypercholesterolemia, and those who have recently suffered a heart attack or stroke.

Familial hypercholesterolemia is a genetic disorder that affects about 1 in 250 people, and significantly hikes the risk of dying at a premature age due to heart disease. People with familial hypercholesterolemia manufacture too much cholesterol, no matter how heart-healthy a lifestyle they live. As a result, people with hypercholesterolemia need to be on statins, often powerful ones, for the rest of their lives.

People who have recently suffered a heart attack or stroke are at high risk of suffering another one. To prevent this, their total cholesterol level needs to be 150 or lower, with a “bad” LDL cholesterol level of 50 to 70 or less, and a “good” HDL cholesterol level of 45 or more.