How do statins work to lower cholesterol. What are the different types of statins available. Who should consider taking statins for heart health. What are the potential benefits and side effects of statin therapy.

Understanding Statins: The Primary Cholesterol-Lowering Medication

Statins are a class of medications widely prescribed to manage high cholesterol levels and reduce the risk of cardiovascular diseases. These drugs play a crucial role in modern preventive medicine, particularly for individuals who cannot sufficiently lower their cholesterol through lifestyle changes alone.

What are statins?

Statins are pharmaceutical agents designed to lower the levels of low-density lipoprotein (LDL) cholesterol, often referred to as “bad” cholesterol, in the bloodstream. They can effectively reduce LDL cholesterol by approximately 30%, with high doses potentially achieving reductions of up to 50%.

How do statins work?

The mechanism of action for statins involves inhibiting an enzyme called HMG-CoA Reductase, which is responsible for cholesterol production in the liver. By blocking this enzyme, statins:

• Slow down the production of LDL cholesterol in the liver
• Encourage the liver to remove existing cholesterol from the bloodstream
• Reduce overall blood cholesterol levels

The Multifaceted Benefits of Statin Therapy

While primarily known for their cholesterol-lowering effects, statins offer additional health benefits that contribute to their widespread use in cardiovascular disease prevention.

Can statins affect other lipid levels?

Yes, statins can influence other lipid parameters beyond LDL cholesterol:

• Triglycerides: Statins can help lower triglyceride levels, which are associated with liver disease, heart disease, and diabetes.
• HDL cholesterol: Some statins may modestly increase high-density lipoprotein (HDL) cholesterol, often called “good” cholesterol, which helps remove excess fats from the arteries.

Do statins have any effects beyond lipid management?

Indeed, statins offer benefits that extend beyond their primary role in lipid management:

1. Plaque stabilization: Statins can help stabilize atherosclerotic plaques in the arteries, reducing the risk of plaque rupture and subsequent blood clot formation.
2. Blood clot prevention: By stabilizing plaques and potentially through other mechanisms, statins may help prevent the formation of dangerous blood clots.
3. Anti-inflammatory effects: Some research suggests that statins may have anti-inflammatory properties, which could contribute to their cardiovascular benefits.

Who Should Consider Statin Therapy?

The decision to start statin therapy is based on various factors and should be made in consultation with a healthcare provider. Several groups of individuals may be candidates for statin treatment.

Are statins recommended for everyone with high cholesterol?

Not necessarily. While statins are often prescribed for high cholesterol, they are typically recommended in the following scenarios:

• When lifestyle changes alone have not sufficiently lowered cholesterol levels
• For individuals with very high LDL cholesterol levels
• In cases where there is a high risk of developing cardiovascular disease

Which medical conditions might warrant statin therapy?

Statins may be prescribed for individuals with:

1. Existing cardiovascular diseases, such as coronary artery disease or peripheral arterial disease
2. A history of heart attack or stroke
3. Diabetes
4. Chronic kidney disease
5. High blood pressure
6. Genetic conditions causing high cholesterol, like familial hypercholesterolemia (FH)

Types of Statins Available in the UK

In the United Kingdom, healthcare providers have access to five main types of statins, each with its own characteristics and potency.

What are the different statin medications available?

The five types of statins commonly prescribed in the UK are:

• Atorvastatin
• Rosuvastatin
• Pravastatin
• Simvastatin
• Fluvastatin

Each of these medications varies in its potency and specific properties, allowing healthcare providers to tailor treatment to individual patient needs.

Navigating Statin Therapy: What Patients Should Know

For individuals prescribed statins, understanding the nature of the treatment and potential considerations is crucial for optimal outcomes.

Is statin therapy a short-term or long-term treatment?

Statin therapy is typically a long-term commitment. Once initiated, patients are generally advised to continue taking statins to maintain the cholesterol-lowering effects and associated cardiovascular benefits. Discontinuing statin therapy without medical supervision can lead to a rebound in cholesterol levels and increased cardiovascular risk.

Can lifestyle changes complement statin therapy?

Absolutely. While statins are powerful medications, they work best when combined with heart-healthy lifestyle choices. Patients on statin therapy are encouraged to:

• Maintain a balanced, nutrient-rich diet low in saturated and trans fats
• Engage in regular physical activity
• Manage stress effectively
• Avoid smoking and excessive alcohol consumption
• Control other risk factors such as high blood pressure and diabetes

Addressing Concerns: Side Effects and Alternatives

While statins are generally well-tolerated, some individuals may experience side effects or have concerns about long-term use.

What are common side effects of statins?

Most people tolerate statins well, but some may experience side effects. Common side effects can include:

• Muscle pain or weakness
• Digestive issues
• Headaches
• Sleep disturbances

It’s important to note that severe side effects are rare, and many side effects can be managed by adjusting the dosage or switching to a different statin.

Are there alternatives if someone can’t tolerate statins?

Yes, for individuals who cannot tolerate statins or achieve their cholesterol goals with statins alone, alternative or complementary treatments may be considered:

1. Ezetimibe: A medication that reduces cholesterol absorption in the intestines
2. PCSK9 inhibitors: Injectable medications that can dramatically lower LDL cholesterol
3. Bile acid sequestrants: Medications that bind to bile acids in the intestines, indirectly lowering cholesterol
4. Fibrates: Drugs primarily used to lower triglycerides but may also modestly affect cholesterol levels
5. Niacin: A B vitamin that can impact various lipid parameters

The choice of alternative treatments depends on individual patient factors and should be discussed with a healthcare provider.

The Future of Cholesterol Management: Emerging Therapies and Research

While statins remain the cornerstone of cholesterol management, ongoing research continues to explore new approaches to cardiovascular risk reduction.

What new cholesterol-lowering therapies are on the horizon?

Several innovative treatments are in various stages of development or early use:

• Inclisiran: A novel siRNA therapy that reduces PCSK9 production, administered only twice a year
• Bempedoic acid: An oral medication that works similarly to statins but with potentially fewer muscle-related side effects
• Gene therapies: Approaches targeting genes involved in cholesterol metabolism
• Antisense oligonucleotides: Therapies designed to interfere with the production of specific proteins involved in lipid metabolism

How might personalized medicine impact cholesterol management?

Advancements in genetic testing and biomarker analysis are paving the way for more personalized approaches to cholesterol management. Future treatments may be tailored based on an individual’s genetic profile, allowing for more precise and effective therapies with fewer side effects.

Empowering Patients: Making Informed Decisions About Statin Therapy

The decision to start statin therapy should be a collaborative process between patients and their healthcare providers, considering individual risk factors, preferences, and overall health goals.

What questions should patients ask their healthcare provider about statins?

To make an informed decision about statin therapy, consider asking:

1. What are my personal risk factors for cardiovascular disease?
2. How do the potential benefits of statins compare to the risks for my specific situation?
3. Are there lifestyle changes I can make alongside or instead of statin therapy?
4. How will we monitor the effectiveness and any potential side effects of the treatment?
5. What alternatives are available if I experience side effects or if statins are not effective for me?

By engaging in open dialogue with healthcare providers and staying informed about the latest developments in cholesterol management, patients can play an active role in their cardiovascular health. Statins, when used appropriately and in conjunction with healthy lifestyle choices, remain a powerful tool in the prevention and management of cardiovascular disease.

Statins and Cholesterol Medicine – HEART UK

For many people, lifestyle changes on their own are not enough to bring their high cholesterol down to a healthier level to lower the risk of heart disease.  Many people will need to take statins, the main type of cholesterol-lowering drug.

What are statins?

Statins are a type of medicine that are used to lower the cholesterol in your blood, helping to prevent heart disease and stroke.

Statins often work very well. They can reduce your LDL cholesterol by around 30%, sometimes even 50% with high doses.

You might be offered a statin if you have too much LDL-cholesterol (bad cholesterol) in your blood – whether it’s caused by your lifestyle or by genetic conditions which are passed down through families.

Like all medicines, statins can sometimes cause side effects. They usually don’t cause any, but if you do have side effects, it should be possible to switch to another statin or a lower dose, or try a different medicine.

Statins have been around for a long time and they have been changed and improved over the years.

Are you a healthcare professional? Visit our HCP section.

Find Out More

How do statins work?

Statins work by slowing down the production of LDL-cholesterol in the liver, where it’s made. Because the liver isn’t making so much cholesterol, it then takes cholesterol out of your blood to make bile with, so your blood cholesterol levels fall.

Statins slow down LDL-cholesterol production by blocking an enzyme called HMG-CoA-Reductase – the medical name for statins is HMG-CoA Reductase inhibitors. Enzymes are proteins in the body which speed up normal processes. In this case, LDL production.

Statins can lower your triglycerides

As well as lowering your LDL-cholesterol, statins can lower your triglycerides too, and high triglycerides are linked to liver disease, heart disease and diabetes.

Statins can raise HDL cholesterol

Statins can sometimes raise your HDL-cholesterol – the type of cholesterol which helps to clear the fat from of your arteries, but their main effect is lowering LDL cholesterol.

Who can take statins?

You might be prescribed a statin if you have heart disease or another disease of the heart and blood vessels, or if you are at risk of developing them in the next 10 years.

If you have high cholesterol

You should be offered a statin if you have high cholesterol and lifestyle changes haven’t been enough to bring it under control.

Depending on your cholesterol levels and how healthy you are otherwise, you and your doctor or nurse might want you to try to bring your cholesterol levels down with a healthy diet and lifestyle first, before starting statins.

If you are at risk of developing heart disease

You will probably be prescribed a statin if you are at high risk of developing heart disease or a disease of the blood vessels. For example, if you have:

• diabetes
• kidney disease
• high blood pressure
• people in your family have died from heart disease.

You doctor will take lots of things into account to get an idea of your risk of developing diseases.

If you have been diagnosed with heart disease

You will probably be offered a statin if you already have a disease of the blood vessels, for example:

• peripheral arterial disease (PAD) or poor blood circulation
• coronary artery disease, where the blood vessels leading to the heart have become narrowed
• heart attack, where the blood supply to the heart is cut off
• stroke, where the blood supply to the brain is cut off.

Statins can stop your illness from getting worse. And if you have already had a heart attack or stroke, they can help prevent another one.

If you have a genetic condition

You might be offered a statin if you have high cholesterol caused by a genetic problem such as familial hypercholesterolaemia (FH).

Statins can help to prevent blood clots

Statins help to stabilize the fatty, hardened parts of the arteries, known as plaques. Plaques can form when you have high cholesterol or other problems such as high blood pressure or diabetes.

These hardened areas are usually unstable, meaning that they can burst. When they do, they release chemicals that cause blood clots to form. The blood clots can block the artery or bits can break off and block a blood vessel in another part of the body, cutting off the blood supply.

This is why you might be prescribed a statin if you have health problems that mean you’re at risk of a heart attack or stroke, even if you don’t have high cholesterol.

There are five types of statins in the UK. 

• atorvastatin
• rosuvastatin 
• pravastatin
• simvastatin
• fluvastatin 

Taking statins

If you start taking statins, you’ll need to keep taking them in the long term – as your cholesterol levels will rise again if you stop taking them.

They come as a tablet which you will need to take once a day. They should start to work within two to three months.

You should have check-ups with your doctor or nurse and have blood tests to see how well your statins are working. This is usually after three months. You will have a cholesterol check to see if your cholesterol level has changed, and a liver function test to see if your liver is healthy. 

It is recommended that you have these tests again a year later to keep any eye on your cholesterol and liver.

Statins can sometimes interact with other medicines and cause side effects. Talk to your doctor about any other medicines you’re taking before you start taking statins to make sure they’re suitable for you.

Getting the most from your statins

• Take your statins every day to keep your cholesterol levels down.
• Take them at the same time every day.
• Your doctor or nurse might suggest you take your statins at night, before you go to bed. That’s because the liver is more active in making cholesterol at night. This is except for atorvastatin and rosuvastatin which you can take at any time.
• If you forget to take your tablet, carry on as normal the next day. Don’t take an extra one to make up for it.
• Avoid grapefruit juice if you are taking simvastatin, and no more than one or two small glasses of grapefruit juice if you are taking atorvastatin. 
• Speak to your doctor if you are struggling with your statins, for example, if you’re having side effects. Don’t simply stop taking them because your cholesterol will go back up again. There’s usually a very simple solution, such as trying a different statin or a lower dose.
• Keep looking after your health by eating healthily, being active, watching what you drink and stopping smoking if you smoke. Statins can lower your cholesterol but they will work better if your lifestyle is healthy too. Plus, you’ll be looking after your body as a whole, lowering your blood pressure, your weight and your risk of health problems.

Are statins safe?

It is quite understandable to have questions if you need to take a new medicine. Statins are the most widely used medicine to lower cholesterol and they have been around for a long time. There have been a lot of news stories about them which sometimes puts people off taking them.

We are often asked if statins are safe and if there are any side effects. It’s up to you whether you start taking them or not, so we’ve put together some answers to common questions to help you decide.

Questions and answers about statins

Side effects, uses, function, and risks

Statins are a group of medications that can help lower blood cholesterol levels. Side effects include headache, nausea, and rash.

Cholesterol plays a role in normal cell and body function. However, very high levels can lead to atherosclerosis. This causes cholesterol-containing plaques to build up in the arteries and block blood flow.

By reducing blood cholesterol levels, statins also lower the risk of heart attacks, strokes, and chest pain, also called angina.

Researchers estimate that nearly 30% of people aged 40 and over in the United States take some form of statin. Below, we describe the uses, risks, and possible benefits of these drugs.

Doctors typically prescribe statins to lower blood cholesterol levels. These drugs block the action of a liver enzyme that helps produce cholesterol. They are also known as HMG-CoA reductase inhibitors.

Statins can reduce the amount of low-density lipoprotein (LDL) cholesterol in the body. People sometimes refer to this type as “bad” cholesterol. Statins can also raise levels of high-density lipoprotein (HDL), or “good,” cholesterol.

In addition, statins can lower the amount of fats, called triglycerides, in the blood.

Types of statins include:

• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• lovastatin (Mevacor)
• pitavastatin (Livalo, Livazo)
• pravastatin (Pravachol)
• rosuvastatin (Crestor)
• simvastatin (Zocor)

Atorvastatin and rosuvastatin are the most potent, while fluvastatin is the least.

Combination drugs are also available. For instance, Vytorin is a combination of simvastatin, which is a statin, and ezetimibe, a drug that reduces the absorption of dietary cholesterol.

People who are taking simvastatin, atorvastatin, or lovastatin should avoid grapefruit and grapefruit juice to reduce the risk of an interaction.

Most people who take statins have minor side effects, if any. Minor side effects can include:

• pins-and-needles sensations
• bloating
• a rash
• a headache
• nausea
• abdominal pain
• diarrhea

The two most serious side effects are liver failure and skeletal muscle damage. These are rare.

Specifically, statins may lead to muscle damage in 1 in 10,000 people who take this type of drug each year. The damage is typically reversible once the person stops taking the statin.

More rarely still, a severe type of muscle damage called rhabdomyolysis may occur, in an estimated 2–3 in 100,000 people taking this type of drug per year.

Also, some research has linked statin use with cataracts. However, a 2017 review found no clear evidence of this.

In addition, statins may slightly increase a person’s risk of type 2 diabetes.

Finally, statins may be linked with memory problems, though the evidence has been mixed. According to a 2018 review, statins may cause temporary memory impairment, but they may also have a protective effect against age-related cognitive decline. Research into this is ongoing.

What is rhabdomyolysis?

Rhabdomyolysis initially causes muscle pain and can worsen to cause significant muscle breakdown or kidney failure. In rare cases, it can be fatal.

The condition is more common in people who take a statin in combination with another drug that carries rhabdomyolysis risk or raises the level of statin in the blood.

Before prescribing a statin to anyone with liver disease, a doctor should thoroughly discuss the risks and possible benefits.

If the liver disease is stable and chronic, taking a low-dose statin may carry greater benefits than risks. If the liver disease is progressive, however, guidelines warn against using statins.

If liver disease develops while taking a statin, the person’s doctor may recommend reducing the dosage of the statin, switching statins, or stopping their use.

People who are pregnant, breastfeeding, or intending to become pregnant should not take statins.

It is typically not safe to combine statins with:

• erythromycin, an antibiotic
• clarithromycin (Biaxin), another antibiotic
• itraconazole, an antifungal medication
• diltiazem (Cardizem), a drug often used to treat high blood pressure, angina, or arrhythmias
• verapamil, a drug often used for similar purposes
• fibrate drugs, which also lower LDL cholesterol levels
• protease inhibitors, a treatment for AIDS

Statins inhibit an enzyme called HMG-CoA reductase, which controls cholesterol production in the liver. The medicine blocks the enzyme, thereby slowing down the cholesterol production process.

Statins typically work well and can reduce LDL cholesterol by around 30% — or even 50%, with a high dosage.

People usually continue taking statins even after reaching their target cholesterol level to maintain the protection against atherosclerosis.

People usually take statins to reduce high cholesterol and prevent atherosclerosis, lowering the risk of heart disease in the process.

A doctor may recommend statins:

• a person has peripheral arterial disease
• after a heart attack or stroke
• if a blood test gives an LDL cholesterol reading of 190 milligrams per deciliter (mg/dl) or higher
• if the reading is 70 mg/dl or higher in people aged 40–75 with diabetes
• if the reading is 70 mg/dl or higher in people aged 40–75 with a high risk of developing heart disease or a stroke

Atherosclerosis can develop and form plaques even when blood cholesterol levels are low. Statins may benefit people who already have atherosclerosis or have a high risk of developing it, even if they do not have high cholesterol levels.

Statins are a group of drugs that can reduce high cholesterol, lowering the risk of atherosclerosis and heart problems.

Statins typically cause mild side effects, if any, but these drugs can, rarely, cause significant, and even life threatening, adverse effects.

Discuss the risks and possible benefits of taking a statin thoroughly with the doctor.

What are statins and natural statins? After all, they are most often prescribed in the prevention and treatment of diseases accompanied by high cholesterol levels. Let’s look at what statins are, how they affect cholesterol, and whether natural statins exist.

What are statins?

Statins are a group of drugs that inhibit the liver enzyme that produces cholesterol and also speed up the metabolism of “bad” cholesterol. To date, they are considered the most effective means for correcting cholesterol levels, used in primary and secondary prevention of complications of atherosclerosis. When taken correctly, they reduce the risk of heart attack, stroke and heart failure.

Who should take statins?

• people at risk of cardiovascular pathologies, especially hypertensive patients with regular pressure surges;
• patients suffering from diabetes of any form;
• people with a history of hypercholesterolemia – elevated blood cholesterol levels;
• persons recovering from a heart attack, including those with coronary syndrome or angina pectoris;
• patients with cardiac ischemia, even with normal levels of cholesterol in the blood;
• patients diagnosed with atherosclerotic capillary changes.

How do statins work in the body?

Statins can significantly lower blood levels of low-density lipoprotein cholesterol. This is the same “bad” cholesterol that forms cholesterol plaques, thereby disrupting the patency of blood vessels and contributing to the development of atherosclerosis. The bulk of “bad” cholesterol, up to 60-70% is produced by the body itself. The action of statins is primarily aimed at suppressing the production of cholesterol in the liver.

The effectiveness of statins can reduce the level of cholesterol in the blood by almost 55%, which reduces the risk of developing cardiovascular diseases caused by atherosclerotic changes by almost 25% ¹ .

But! Statins also have a downside – they negatively affect liver function, and over time can provoke liver disease.

Natural statins

Synthetic statins can be replaced with more gentle natural or natural statins. By adhering to the rules of a healthy diet and the general recommendations of a doctor, you can regulate the level of cholesterol and keep it within the normal range.

One such natural complex is Lactoflorene® CHOLESTEROL . This Italian Probiotic Complex helps support healthy cholesterol levels with Fermented Red Rice. Fermented red rice – is considered a natural analogue of synthetic statins and one of the most powerful products that normalize cholesterol. It has been used by traditional healers of China for many centuries to normalize digestion and “activate” the blood. Today it is a real superfood, like no other cholesterol-lowering one.

The action of the fermented red rice extract in Lactoflorene® CHOLESTEROL is additionally enhanced with vitamin B3, a powerful antioxidant – coenzyme Q10, as well as bifidobacteria, limiting the absorption of cholesterol. The complex formula Lactoflorene® CHOLESTERO L helps maintain normal cholesterol levels and helps reduce the risk of developing cardiovascular diseases.

Where are natural statins found?

• Fruit. The richest in natural statins: citrus fruits, apples, red grapes, avocados and pomegranates. All of them contain various kinds of natural statins: vitamin C, pectins or resveratrol, which effectively fight “bad” cholesterol.
• Berries. Of all foods, berries contain the highest number of statins, however, to get enough of them to lower cholesterol, you need to consume at least one glass of berry juice or fresh berries daily. Preference should be given to blackberries, currants, strawberries, viburnum, strawberries or blueberries.
• Vegetables. The champion in the content of natural statins among vegetables is white cabbage. It retains a large amount of nutrients in any type of heat treatment: stewing, boiling, steaming. You can put garlic in second place, followed by other vegetables: carrots (preferably raw), eggplant, sweet peppers, tomatoes, beets and onions.
• Mushrooms. Especially oyster mushrooms. The statins they contain are closest to synthetic drugs. To get enough statins, you need to eat at least 9 a dayg oyster mushroom.
• Herbs and fresh herbs. Another great alternative to artificial statins. Greens can be eaten as an independent dish or added to food in abundance. But herbs are good because they keep statins both fresh and dried.

CHOLESTEROL UNDER CONTROL WITH

CHOLESTEROL

gluten free

lactose free

HELP TO MAINTAIN
NORMAL CHOLESTEROL LEVEL

• prevention and maintenance of normal blood cholesterol levels
• control of cholesterol levels in people with moderate hypercholesterolemia
• reduced risk of cardiovascular disease
• prevention and maintenance of the normal functioning of the cardiovascular system

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Statins – drugs used to treat and prevent atherosclerosis – increase the risk of developing diabetes mellitus

Diabetes instead of atherosclerosis – Gazeta.Ru

November 26, 2012, 03:42 pm
Science

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The use of statins, drugs used to treat and prevent atherosclerosis, increases the risk of developing diabetes. However, this risk is small compared to the reduction in cardiovascular disease as a result of taking statins.

An article proving this assertion was published in The Lancet .

New drug for heart attack prevention proven effective and safe in clinical trials

The new drug AMG 145, which lowers “bad” cholesterol (LDL) in the blood, has proven its effectiveness, safety and tolerability in the second phase of clinical trials. ..

Statins are a group of lipid-lowering drugs used to treat and prevent atherosclerosis. Atherosclerosis – the formation of “plaques” of cholesterol on the walls of blood vessels – leads to the development of heart attacks and strokes.

Statins are the most popular drugs used to treat and prevent vascular disease.

alone (the most popular) drug from this group in 2010 had 94 million prescriptions in the United States.

After the discovery of the enzyme mevastatin in 1976 by Japanese scientists, which prevents the formation of cholesterol and “bad” low-density lipoproteins (LDL), cardiology made a huge breakthrough, having learned not only to successfully treat atherosclerosis, but also to prevent its development. But, like any other drug, statins have a number of side effects: statin myopathy (rhabdomyolysis – muscle symptoms manifested as weakness of the proximal muscles), a negative effect on the liver – an increase in the number of “liver” transaminases.

The latest clinical observations of doctors come down to the fact that in addition to the already known side effects of statins, there is also a threat of developing diabetes.

A systematic review of studies conducted in Medline, Embase and the Cochrane Central Register since 1994 to 2009. The scientists selected the trials according to certain criteria: they had to describe data from at least a thousand patients, and the duration of the studies had to be at least one year. The review did not take into account the results obtained in patients who are on hemodialysis (a method of extrarenal blood purification for acute and chronic renal failure), and in patients with transplanted organs.

A total of thirteen statin trials were reviewed, involving 91,140 patients.

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90,002 The researchers found that out of this number, 4,278 patients developed diabetes mellitus within (on average) four years.

Researchers concluded that statin therapy was associated with a 9 percent increased risk of incident diabetes compared with placebo.

Despite this, they noted that statin therapy is associated with a slightly increased risk of developing diabetes, which is small compared to the reduction in cardiovascular disease associated with their use.

The results of this study were discussed at the American Heart Association Congress, which was recently held in Los Angeles. Dr. Barton Duell of the Oregon Health and Sciences University, who took part in the discussion, pointed out that although there are suggestions that statins may increase the possibility of developing diabetes in high-risk patients, this should not stop doctors from using these drugs. The small risk does not outweigh the significant reduction in the progression of cardiovascular diseases, the outcome of which can be sudden death of the patient, the doctor said.

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