Statins, cholesterol-lowering medicines
Statins are drugs that help to lower the level of cholesterol in blood and also reduce overall cardiovascular risk independently of the baseline level of choleserol. They work by inhibiting an enzyme called HMG-CoA reductase which reduces the level of total and LDL ‘bad’ LDL cholesterol. The most common statins are simvastatin, atorvastatin (Lipitor), rosuvastatin and pravastatin.
- Cerebrovascular disease (manifesting as ministroke – TIA, stroke and dementia)
- Coronary artery disease (angina and acute coronary syndrome)
- Peripheral vascular disease (claudications – pain in legs in walking)
Statin can be prescribed for people:
- In primary prevention (healthy but at risk of developing heart disease)
- In secondary prevention (pre-existing heart disease)
- With high cholesterol due to a genetic defect (familial hypercholesterolaemia, FH)
Most patients taking statins don’t experience any problem. Side effects of statins include muscle pain, upset stomach, headache and sleeping problems. Side effects can be also generated by interactions between statins and other medications or food such as grapefruit juice. The likelihood of a serious adverse effect related to statin is very rare, about one person out of ten thousand. This small risk should be considered in context of proven significant prognostic benefits of statins.