The targets for what's considered a "healthy" cholesterol level are getting lower and lower, and ads touting the benefits of cholesterol-lowering statin drugs are commonplace. So it's no surprise that many women who don’t have heart disease wonder if they should start taking a statin for prevention. On the other hand, those who have watched the ups and downs of hormone therapy may feel a sense of déjà vu about the enthusiasm for these relatively new drugs. The June issue of the Harvard Women’s Health Watch says that whether you should take a statin to prevent heart disease depends upon one thing—your risk of heart attack.

If your risk is low, taking a statin or any cholesterol-lowering drug could do more harm than good. Statins can cause liver and muscle damage, and they require close monitoring. If you’re trying to avoid a first heart attack, chances are good that some lifestyle choices—not smoking, controlling your weight, eating a heart-healthy diet, and getting regular exercise—may do the trick.

But for women who already have heart disease or are at very high risk for it, taking a statin, which helps lower LDL (“bad”) cholesterol, is probably a good idea—in addition to lifestyle measures. “Everyone agrees that women with heart disease or a heart disease equivalent such as diabetes benefit—possibly even more than men—from LDL lowering,” says Dr. Paula Johnson, a member of the Harvard Women’s Health Watch advisory board.

The article also tells you how to determine your heart attack risk and when to consider taking a statin.