21.5 Million More Americans Now Qualify for Statins, and Many Don’t Know It—Are You One of Them?
Learn who might now be eligible for the life-saving cholesterol-lowering drugs
Key Takeaways
- 21.5 million more U.S. adults now qualify for statins under new 2026 guidelines.
- Updated cholesterol guidelines put greater emphasis on long-term cardiovascular risk.
- Qualifying for a statin doesn’t automatically mean you need to take one; talk to your doctor.
You’ve likely heard all the buzz about cholesterol-lowering statins but perhaps haven’t taken the plunge and talked to your doctor yet. Maybe fears of statin side effects are holding you back (spoiler alert: Most are minor and resolve in time) or you simply don’t know if you qualify. If the reason you haven’t started taking one of these lifesaving drugs is the latter, a new JAMA analysis says more than 21 million more Americans now qualify for statins under the new 2026 cholesterol guidelines released earlier this year—and many may not even realize it. We spoke to top cardiologists about who these newly eligible Americans are and what you should know about whether statins are a good fit for you.
What are statins?
Before we dive into the new JAMA research and why millions more now qualify for statins, let’s get a refresher on what the drugs are. “A statin is a type of medication used to lower ‘bad’ LDL cholesterol in the blood,” explains Kardie Tobb, DO, MS, FASPC, FACC, a board-certified preventive cardiologist and the medical director for the Cone Health HeartCare Women’s Heart Health and Cardio-Obstetrics Clinic. “It works mainly by reducing the amount of cholesterol made by the liver. Statins can help prevent cholesterol buildup in the arteries and lower the risk of heart attack and stroke, especially in people at higher risk of cardiovascular disease.”
Do you now qualify for statins?
A new JAMA analysis examined what the updated 2026 cholesterol guidelines from the American College of Cardiology and American Heart Association mean for Americans. The analysis found that under the new guidelines, 21.5 million more U.S. adults now qualify for the medication, bringing the total number of adults who qualify to 87.5 million.
What updates sparked this change? “One of the biggest changes is how we assess cardiovascular risk,” explains Sirisha Vadali, MD, a board-certified noninvasive cardiologist and advanced lipidologist. “Instead of relying primarily on a cholesterol number or focusing solely on a person’s risk of experiencing a cardiovascular event over the next 10 years, the updated guidelines now allow us to look at a person’s overall and long-term cardiovascular risk.”
Renato A. Apolito, MD, a cardiologist and medical director of the cardiac catheterization laboratory at Jersey Shore University Medical Center, agrees that looking at a person’s long-term cardiovascular risk is beneficial. “Because you can’t make up for lost time, we should think about risk reduction and cholesterol reduction as if we’re investing for retirement,” says Dr. Apolito. “The longer you do this, the higher the dividends are down the road.”
Who qualifies for statins under the 2026 cholesterol guidelines?
“Many of these 21.5 million people are people we historically would have said, ’Your 10-year risk isn’t high enough to worry about medication yet,’” says Dr. Tobb. “The new guidelines essentially say: ‘Let’s not ignore what happens after those 10 years.’”
Dr. Tobb says the newly eligible group includes people with risk factors such as:
- High blood pressure
- Younger adults with a higher lifetime/30-year cardiovascular risk
- Moderately elevated LDL cholesterol, especially when it’s persistent
- Overweight or obesity and other cardiometabolic risk
- Chronic kidney disease
- Diabetes
- A significant premature heart disease family history
- Elevated Lipoprotein(a) or Lp(a)
- Certain inflammatory conditions
- Elevated triglycerides or apoB
- Certain reproductive risk factors, like gestational diabetes, preeclampsia or early menopause
“The guideline also specifically recommends lipid-lowering therapy for adults 40 and older with diabetes, stage 3 or 4 chronic kidney disease or HIV, regardless of LDL level,” adds Dr. Tobb. “But there’s another striking finding: Age drives a very large portion of the expansion. The JAMA analysis estimates that more than 93 percent of adults ages 70 to 79 and 85 percent of those ages 60 to 69 meet criteria for primary-prevention statin therapy under the new guideline, compared with only about 11 percent of adults ages 30 to 39.”
How to tell if statins may be right for you
If you fall into the categories above and qualify for statins “on paper,” you may be wondering if that means you should take statins in practice.
“Qualifying for a statin doesn’t necessarily mean that every patient needs to start one,” says Dr. Vadali. “Guidelines help us identify people who may benefit from treatment, but the final decision should still be individualized. For a person whose risk falls into more of a gray area, we may look at additional information before making that decision. For example, a coronary artery calcium scan can show whether calcified plaque has already developed in the heart’s arteries and can sometimes help determine how aggressive we need to be with prevention. The goal is not to put everyone on medication, but to identify cardiovascular risk early and choose the prevention strategy that makes the most sense for that individual patient.”
What to ask your doctor before taking statins
When having a conversation with your doctor about whether or not statins may be right for you based on the new cholesterol guidelines, Dr. Vadali recommends asking a few basic questions, including:
- What specifically about my health makes you recommend a statin?
- What is my overall cardiovascular risk?
- What benefit could I expect from taking statins?
- Are there any side effects or medication interactions I should know about?
- How will we monitor whether the medication is working for me?
“I also think it’s important to ask what else you can do in addition to taking medication,” adds Dr. Vadali. “A statin should never replace the foundation of prevention, which includes regular physical activity, a heart-healthy diet, maintaining a healthy weight, not smoking and keeping blood pressure and blood sugar under control.”
The bottom line on statin eligibility
Millions of Americans find statins to be an extremely helpful part of supporting their cholesterol and overall heart health, and these new guidelines mean more Americans could have access to them. A quick conversation with your doctor can help you make the best decision for you. The best way to lower your cardiovascular risk or high cholesterol is to use all of the options available to support your health, whether that includes a statin, exercise, lifestyle changes or a combination of all of the above.
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