The cholesterol-lowering medicines known as "statins" are highly effective and generally safe. In people at risk for heart disease or who have heart disease, statins substantially lower the chances of a heart attack and death.

There are six statins and they differ in their ability to reduce cholesterol. In addition, the evidence is stronger for some statins when it comes to reducing your risk of heart attack or death from heart disease or stroke. Thus, the choice of the best statin for you can be complex.

The statins vary widely in cost as well — from about $32 a month to more than $150 a month. Most people who take a statin must take the medicine for years, so the cost matters.   Taking the evidence for effectiveness, safety, and cost into account, we have chosen four statins as Consumer Reports Best Buy Drugs:

• Generic lovastatin and pravastatin — if you need to lower "bad" (LDL) cholesterol by less than 30%
• Generic simvastatin (20mg or 40 mg) — if you need 30% or greater LDL reduction and/or have heart disease or diabetes, or if you have had a heart attack or have acute coronary syndrome and your LDL level is not highly elevated.
• Atorvastatin (Lipitor) (40mg or 80mg) — if you have had a heart attack or have acute coronary syndrome and your LDL is highly elevated; use for two years and then reconfirm need or switch to generic simvastatin. Generic pravastatin and simvastatin became available in 2006. The price of these two medicines will decline in 2007, creating a significant savings opportunity compared to brand-name statins.

Most people who need a statin should take the lowest dose that reduces their "bad" LDL cholesterol to an acceptable "target" level. High doses of statins pose greater risk — of muscle and liver problems. But some people – such as those who have had heart attacks — may need higher doses.

No matter what dose you take, if you have muscle aches and pains when taking a statin, contact your doctor immediately. Also ask your doctor about splitting your statin pills. This can save you money and is a widely accepted practice.