Introduction
Statins are a group of drugs used to lower 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 its benefits outweigh the risks for most patients with high cholesterol levels, heart problems, and stroke.
What Is Cholesterol?
Cholesterol is a waxy substance found in the cells of the body. It is needed for healthy cells and to synthesize hormones, vitamin D, and other substances to digest food. The body produces the cholesterol that it requires, and it is also found in food.
High levels of cholesterol in the blood results in plaque formation (atherosclerosis) in the blood vessels. This plaque sticks to the walls of the blood vessel and results in reduced or no blood flow in the artery. Such plaque formation in the blood vessels of the heart causes reduced blood flow to the heart, which can result in coronary artery disease, heart attack, and stroke.
What Are the Types of Cholesterol?
The different types of cholesterol are:
- HDL (high-density lipoprotein) - It is also called “good cholesterol” as it carries cholesterol from other parts of the body to the liver, from where it is removed from the body.
- LDL (low-density lipoprotein) - It is also called “bad cholesterol” because high levels of LDL causes plaque formation.
- VLDL (very low-density lipoprotein) - It carries triglycerides in the body and also contributes to the formation of plaque.
What Causes High Cholesterol Levels?
The common causes include:
- Unhealthy eating.
- Lack of physical activity.
- Genetic.
What Health Problems Does High Cholesterol Cause?
- High blood pressure.
- Carotid artery disease.
- Stroke.
- Peripheral arterial disease.
How Do Statins Lower Cholesterol?
Statins, a class of drugs used to manage cholesterol levels, function as selective and competitive inhibitors of hydroxymethylglutaryl-CoA (HMG-CoA) reductase, an enzyme pivotal in converting HMG-CoA to mevalonate within the cholesterol synthesis pathway. This inhibition curtails hepatic cholesterol production, leading to a cascade of effects. Specifically, it triggers an upregulation of low-density lipoprotein (LDL) receptors, augmenting the hepatic uptake of LDL-cholesterol from the bloodstream. Moreover, statin treatment contributes to the reduction of hepatic production of apolipoprotein B100 (apo B100) containing lipoproteins, resulting in decreased concentrations of both cholesterol and triglycerides.
What are the Different Types of Statins Available?
The statins that are commercially available are:
- Atorvastatin.
- Fluvastatin.
- Lovastatin.
- Pitavastatin.
- Pravastatin.
- Rosuvastatin.
- Simvastatin.
When are Statins Prescribed?
The guidelines for the use of statins are:
- People who are at risk of developing cardiovascular problems and have a high chance of a heart attack in the next 10 years.
- People who already have atherosclerosis.
- Adults with cholesterol levels more than 200 mg/dL.
- Diabetic patients that are older than 40 years, who are also at risk for developing heart problems.
What are the Side Effects of Taking Statins?
Most people do not experience any side effects while taking statins. But depending on the patient, it can cause mild to severe side effects. Some of the side effects are as follows:
Common Side Effects - Constipation, diarrhea, headache, sleep disturbances, dizziness, abdominal cramps, rash, and nausea.
Muscle Damage - This medication, if taken in higher doses, can cause muscle breakdown. This causes the release of a protein called myoglobin into the blood, and can seriously damage your kidneys. This condition is called rhabdomyolysis. The chances of this happening increases if you take antifungal drugs, Cyclosporine, Erythromycin, Gemfibrozil, Nefazodone, and Niacin, along with statins.
Liver Damage - Statins are contraindicated for patients with chronic liver diseases. Statins can damage your liver and cause symptoms like yellowish discoloration of your skin, dark urine, upper abdominal pain, and your liver enzymes will be elevated.
Myalgia - Myalgia or muscle pain is very common with the use of statins. This can be alleviated by the use of concomitant vitamin D preparations.
Diabetes - The association between statins and diabetes is not conclusively proven, but it is believed to increase the risk of type 2 diabetes by increasing the blood sugar level.
Memory Problems - In some patients, statins cause confusion and memory problems.
Conclusion
If you notice any of the above side effects, consult your doctor immediately. They might alter the dosage or might prescribe some other statin. The best way to lower your cholesterol is to lead an active lifestyle, eat a healthy and balanced diet, and exercise regularly. If your cholesterol levels are not reduced even after trying this, then your doctor might prescribe statins for you, as they will reduce the risk of you developing any heart problems.
