Statins: What Are They?

What Are Statins?

Statins are drugs that help in lowering cholesterol by interfering with its production in the liver. Statins are relatively safe but are not recommended for pregnant patients and patients with liver disease. As with all other medicines, there are some side effects from taking statins, too, but their benefits outweigh the risks for most patients with high cholesterol levels, heart problems, and stroke.

How Do Statins Lower Cholesterol?

• Statins slow down the liver’s ability to make cholesterol.

• They act by blocking an enzyme (HMG CoA reductase) that is needed to produce cholesterol in the body.

• When the liver makes less cholesterol, it tries to remove more cholesterol from the blood.

• The liver does this by increasing the number of LDL (bad cholesterol) receptors.

• These receptors remove bad cholesterol from the bloodstream.

• Statins also reduce the production of fats that carry cholesterol and triglycerides.

• As a result, bad cholesterol and triglyceride levels go down, helping protect the heart.

What Are the Different Types of Statins Available?

The commercially available statins are

• Atorvastatin.

• Fluvastatin.

• Lovastatin.

• Pitavastatin.

• Pravastatin.

• Rosuvastatin.

• Simvastatin.

Who Should Consider Using Statins?

Statins help lower bad cholesterol and reduce the risk of heart attacks and strokes. They should always be taken only on a doctor’s advice.

The guidelines for the use of statins are

• People with high LDL (bad) cholesterol that does not improve with diet and exercise.

• Those who have had a heart attack, stroke, or heart disease.

• Individuals with a high risk of heart disease due to smoking, high blood pressure, or family history.

• Patients with familial hypercholesterolemia have a genetic condition causing very high cholesterol.

• Some older adults, after discussion with a doctor about the benefits and risks.

What Do Statins Do to Your Body?

• Statins help lower your blood cholesterol. They do this by decreasing the amount of cholesterol produced in your liver.

• Less cholesterol production prevents fatty deposits from forming in your blood vessels. As a result, your blood will be able to flow more easily, which will lower the risk of heart attack and stroke.

• Statins can also help reduce the inflammation that occurs within your blood vessels. This will give your heart an extra layer of protection and prevent blockage.

• Some people may experience side effects from statins, like muscle pain or stomach upset. However, statins are safe for most people to take for many years.

Use of Statins In Special Populations:

• Liver Problems: Statins must be avoided with active liver diseases. In certain cases, statins may increase liver enzymes. However, this is harmless and may often disappear on its own. In people suffering from chronic liver diseases, pravastatin or rosuvastatin is advisable.

• Kidney Problems: As kidney function worsens, statins that are less dependent on kidney function should be used. Atorvastatin should be used in severe kidney diseases. Fluvastatin may also be used, provided appropriate dose adjustment is made.

• Children: Children with familial hypercholesterolemia, i.e., increased levels of cholesterol as an inherited condition, may require moderate to strong doses of statins.

• Pregnancy: Statins are usually avoided during pregnancy. However, for patients who are pregnant and have genetic cholesterol abnormalities or heart diseases, doctors can now consider using these drugs since 2021.

• Older Adults: In those over 75 years, the value of taking statins should be discussed, taking into account overall health and lifespan.

How to Take Cholesterol-Lowering Medicines Safely

• It is crucial to take the drugs as directed by the doctor. If not, it could have serious effects.

• Follow the doctor's directions exactly, and don't lower the dose without talking to the doctor first.

• While you're traveling, keep the medicines with you.

• If you forget to take a dose, do it as soon as you remember. If not, skip the dose and move on to the next one. Do not take two doses of medicine at the same time.

What Are the Lifestyle Changes to Be Adopted Along With the Medication?

To lower cholesterol levels, you need to make some modifications to your food and lifestyle. This will also assist in lowering the dose or stopping the medicine (only upon the doctor’s recommendation).

• Cut back on how much red meat, full-fat dairy, and fried foods you eat.

• Eat foods that are good for your heart.

• Quitting smoking.

• At least 150 minutes of exercise per week, or as per the doctor’s advice.

• Reduce alcohol intake.

• Maintain body weight.

Conclusion

Statins help lower cholesterol and reduce the risk of heart attacks and other heart-related problems. Healthy lifestyle choices such as staying active, eating nutritious foods, and exercising regularly are the first step in managing cholesterol. If these measures are not enough, statins may be prescribed based on your physician’s advice.