How Do Statins Work?
The liver produces cholesterol using a complex process of enzyme activity. Statin drugs block the enzyme that makes cholesterol, HMG-CoA reductase, and are classified as HMG-CoA reductase inhibitors. By slowing the rate of cholesterol production, statin drugs help slow the formation of plaques and may help reduce the size of existing plaques. They can also help the body reabsorb cholesterol plaques that have built up on artery walls. Statins also seem to help stabilize plaques and make them less prone to rupturing and forming clots.
Cholesterol build up in an artery
Other Benefits of Statins
Statins have anti-inflammatory properties, which help stabilize blood vessel linings.This helps relax blood vessels, which lowers blood pressure. Some doctors prescribe statins to their patients before and after open heart surgery and after certain types of strokes. Although much more research is needed, statins could have such far-reaching effects as reducing the risk of certain cancers, kidney disease, dementia and Alzheimer’s, and arthritis.
Differences Among Statins
There are many types of statins, and they vary in their ability to reduce cholesterol. Atorvastatin (Lipitor) and rosuvastatin (Crestor) are the most potent, with fluvastatin (Lescol) being the least potent. Statins also differ in how they interact with other drugs. Crestor and pravastatin (Pravachol) are less likely to be elevated by other drugs. Elevated levels of statins can lead to toxicity in the body, with potentially serious side effects.
Why Are They Prescribed?
Most people are prescribed statins to lower their cholesterol, which is one of the risk factors for developing atherosclerosis (commonly called hardening of the arteries). Left untreated, atherosclerosis can lead to chest pain, heart attacks, strokes, and peripheral vascular disease. A patient may also be prescribed statins if they have certain risk factors, such as a family history of heart disease (especially at a young age), older age, or diabetes. Obesity, smoking, high blood pressure, and a sedentary lifestyle are other risk factors to consider.
It is important to note that heart disease is complex, and 35 percent of people who have heart attacks do not have high cholesterol levels, but most of them have atherosclerosis. In these cases, plaques still formed without cholesterol levels being high. For this reason, a physician may prescribe statins to prevent the risk of heart attacks, heart disease, and stroke. The dosage and exact drug ordered depend on if the LDL (bad) cholesterol is extremely high, which requires a higher dose.
Most statin side effects are mild, such as diarrhea, nausea, constipation, and muscle or joint aches. Serious side effects are less common, but include liver damage, especially if other medications that affect the liver are taken with statins. Muslce pain can be severe and result in rhabdomyolysis, in which muscle breaks down and releases a protein, myoglobin, into the bloodstream. Myoglobin can cause kidney damage, especially if statins are combined with niacin, antifungal medications, erythromycin, and cyclosporine. It is important that your healthcare provider has a list of all medicines, herbs, and supplements you take.