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Cholesterol in seniors: what alternatives to statins?

3 min read Published on 09/16/2026 Cholesterol

Statins are commonly prescribed to manage cholesterol, particularly in seniors, because of their effectiveness in lowering LDL cholesterol ("bad" cholesterol). While usually well tolerated, they can have side effects, especially in seniors, due to comorbidities and polymedication, which become more frequent with age. Gentler alternatives, sometimes better suited to an individual's state of health, may be considered, under a doctor's advice.

How do statins work?

Statins are drugs that act by inhibiting a specific enzyme in the liver, HMG-CoA reductase, responsible for cholesterol production. By reducing this production, statins lower the LDL cholesterol level in the blood, which decreases the risk of atherosclerotic plaque formation in the arteries. Statins are recognised for their effectiveness in the primary and secondary prevention of cardiovascular events, especially in people with high risk factors. However, their prolonged use, especially in seniors, can cause unwanted side effects.

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What are the side effects of statins?

Although statins are effective, they are not without drawbacks. The most common side effects of statins include muscle pain, digestive disorders and an increase in liver enzymes. In some patients, these effects can be severe enough to warrant stopping treatment. For seniors, the situation is even more complex. Studies, such as those carried out by INSERM, suggest that the benefit-risk balance of statins may change after the age of 75. At that age, the risks associated with side effects can sometimes outweigh the benefits.

What are the natural alternatives to statins?

Alternatives to statins, whether natural or medicinal, are possible in cases of statin intolerance, specific contraindications (such as certain liver disorders), or simply when patients prefer to avoid medication for personal reasons. With the agreement of a health professional, and in cases of moderately elevated cholesterol, taking food supplements may be considered.

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Phytosterols

Phytosterols are plant compounds that chemically resemble cholesterol. When consumed in sufficient amounts, they can help reduce LDL cholesterol by competing with it for absorption in the intestine. They occur naturally in certain foods, but are also available as food supplements.

Are there other non-statin medicinal solutions?

It is important to note that other non-statin medicinal solutions exist and may be prescribed by your doctor if suited to your profile. Among the non-statin drugs used against cholesterol, the main ones are ezetimibe and PCSK9 inhibitors.

Ezetimibe

Ezetimibe is a drug that reduces cholesterol by preventing its absorption in the intestine. It is often used alongside statins, but can also be an alternative for those who do not tolerate them well. Ezetimibe is generally well tolerated.

PCSK9 inhibitors

PCSK9 inhibitors act by increasing the number of LDL receptors on liver cells, which removes more LDL from the blood. These drugs are often used in high-risk patients who cannot reach their cholesterol goals with statins or ezetimibe alone. Although effective, they are generally reserved for more complex cases because of their cost and mode of administration (injections). For seniors, managing cholesterol is a major health challenge. Although statins are often the first medicinal option offered, alternatives exist for those seeking gentler, less aggressive solutions. It is essential to discuss with a doctor to determine the best strategy to adopt.

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