Appendix A: Grouping of statins

Appendix A: Grouping of statins

For the purpose of this guideline, statins are grouped into 3 different intensity categories according to the percentage reduction in low density lipoprotein cholesterol:

  • a 20% to 30% reduction is low intensity

  • a 31% to 40% reduction is medium intensity

  • a reduction of more than 40% is high intensity.

This grouping was agreed by GDG consensus, informed by analyses in the literature. See the full guideline for a discussion of this grouping.

Grouping of statins used in this guideline: reduction in LDL cholesterol by daily dose

Fluvastatin:

  • 20 mg/day, 21% reduction

  • 40 mg/day, 27% reduction

  • 80 mg/day, 33% reduction

Pravastatin:

  • 10 mg/day, 20% reduction

  • 20 mg/day, 24% reduction

  • 40 mg/day, 29% reduction

Simvastatin:

  • 10 mg/day, 27% reduction

  • 20 mg/day, 32% reduction

  • 40 mg/day, 37% reduction

  • 80 mg/day, 42% reduction

Atorvastatin:

  • 10 mg/day, 37% reduction

  • 20 mg/day, 43% reduction

  • 40 mg/day, 49% reduction

  • 80 mg/day, 55% reduction

Rosuvastatin:

  • 5 mg/day, 38% reduction

  • 10 mg/day, 43% reduction

  • 20 mg/day, 48% reduction

  • 40 mg/day, 53% reduction

MHRA advice: there is an increased risk of myopathy associated with high dose (80 mg) simvastatin. The 80 mg dose should be considered only in patients with severe hypercholesterolaemia and high risk of cardiovascular complications who have not achieved their treatment goals on lower doses, when the benefits are expected to outweigh the potential risks.

This information is from Law MR, Wald NJ, Rudnicka AR (2003) Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta‑analysis. BMJ 326: 1423.

  • National Institute for Health and Care Excellence (NICE)