Statin intolerance is real, researchers find. Another (more costly) drug may get around the problem.

Statins such as Lipitor and its generics have revolutionized cardiovascular care for nearly two decades as an effective, inexpensive way to reduce LDL cholesterol, the so-called bad cholesterol in the bloodstream.

Not everyone can take them, though; a significant number of people complain of muscle pain, weakness and cramping so severe that they discontinue the therapy even at the risk of a heart attack or stroke. Their resistance to the medication has been controversial, because in most cases there are no biomarkers for the muscle problems individuals describe. Some researchers have speculated that the problem is psychological, the “nocebo” effect of blaming the medication for the pain.