Statins and their role in lowering blood fat and protecting the heart

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Article written by Doctor Duong Thu Huong, Faculty of Pharmacy - Vinmec Times City International Hospital

Statins are the first class of drugs used to lower blood lipids. Statins have been shown to be effective in the primary and secondary prevention of cardiovascular diseases. For that reason, statins are the preferred drug class of choice for treating lipid-lowering as well as preventing cardiovascular events for at-risk subjects. The following article will provide some useful information about statins and the blood lipid effects of statins

First of all, to understand the use of statins, it is necessary to understand the basic concepts of blood fat in the body. A complete blood lipid test kit will tell us the parameters of 4 types of lipoproteins:
Total cholesterol: includes all types of good and bad cholesterol; LDL cholesterol ("bad" cholesterol): when accumulated in the walls of blood vessels, it has the ability to create plaque, cause atherosclerosis and reduce blood circulation. These plaques can rupture leading to myocardial infarction or cerebral infarction; HDL cholesterol ("good" cholesterol): works to remove LDL cholesterol from the body and protect blood vessel walls; Triglycerides: are fats in the blood that are converted from excess energy in the body, with variable concentrations. High rates of triglycerides are associated with obesity, a high-carbohydrate diet, drinking alcohol, smoking, sitting a lot, or having uncontrolled diabetes.The most important role of statins is to help reduce LDL Statins can reduce LDL cholesterol by 30-63% In addition, statins also reduce triglycerides (10-30%) and increase HDL cholesterol (5-15%). Statins work by competitively inhibiting cholesterol at the enzyme HMG CoA reductase, which is an important enzyme in the synthesis of cholesterol in the liver. This leads to a decrease in cholesterol synthesis in the liver, helping to strengthen the vessel wall, fix atheroma and reduce inflammation.
One thing It should be noted that different statins have different LDL-lowering potency Rosuvastatin and atorvastatin have strong LDL-lowering potency, while Other statins such as simvastatin, lovastatin, pravastatin or fluvastatin can only moderate LDL reduction. In cases where the maximum tolerable dose has been used and the LDL is still not reduced to the target, statins can be combined with other drugs such as ezetimibe or PCSK9 inhibitors.

Dosage Usually, to reduce high LDL levels, a minimum of rosuvastatin 20 mg/day or atorvastatin 40 mg/day is required. However, Asians may have a better response to statins at lower doses than Europeans, so rosuvastatin is recommended at a lower dose in Asians, with a starting dose of 5 mg. There is no evidence of dose reduction with other statins. Dosage may vary depending on the response and tolerability of each specific subject.
How to take Most cholesterol is synthesized in the evening, so a short-acting statin such as simvastatin is generally recommended at night or at bedtime. However, for long-acting statins such as atorvastatin, rosuvastatin, time of day dosing does not significantly affect drug efficacy. Note that lovastatin increases absorption efficiency when taken with meals, so it should be taken with breakfast or dinner.
Side effects One of the main reasons many people wonder about taking statins is the side effects of this drug. Side effects of statins are lower than with other lipid-lowering drugs. Myalgia is the most important side effect of statins. Impaired liver function is one of the concerns, but the risk is very small.
Muscle: The muscle side effects of statins are dose-dependent and patient-related factors such as advanced age (>65 years). Hypothyroidism or vitamin D deficiency are also factors that increase the likelihood of statin-induced myalgia. In case of bilateral muscle pain not due to other objective causes (such as exercise) or dark yellow urine, it is necessary to report to the doctor for timely monitoring.
Liver: liver enzymes may fluctuate within the first 3 months of taking the drug with a probability of 0.5 - 3% and is dose dependent. Very rare cases of severe liver injury have been observed with statins and many studies have not shown an increase in damage compared with the general population. Elevation of liver enzymes in statin users was similar to that in the non-statin group, however liver enzyme testing should be performed prior to initiating statins, at 4-12 weeks, and 3-12 months after statin administration.
In the case of muscle and liver side effects, depending on clinical judgment and weighing the benefits and risks of taking a statin, your doctor may recommend a dose reduction, change to a statin, or alternate statins. day.
Kidney: In addition to muscle and liver side effects, statins can cause proteinuria by inhibiting the active transporter of small protein molecules. However, this effect is temporary and does not have a serious effect on kidney function.

The increased side effects of statins are increased especially when taken with drugs or foods that have a high risk of interaction such as inhibitors of the enzyme CYP3A4, found in blood pressure drugs, organ transplant drugs, HIV drugs, etc. drugs for gout, etc... Statins are contraindicated in cases of acute hepatitis, pregnant and lactating women.
Conclusion: Statins are a highly effective drug used to prevent cardiovascular events through lowering LDL cholesterol, strengthening vessel walls and preventing plaque rupture. The use of statins is relatively safe, but it is necessary to recognize abnormal signs when using statins to take timely measures. Side effects of statins can increase depending on the dose as well as interactions with other drugs.
To protect your health, you should regularly check your general health, monitor your blood fat index for early treatment. Currently, Vinmec International General Hospital has general health checkup packages suitable for each age, gender and individual needs of customers with a reasonable price policy, including:
Health checkup package general Vip Standard general health checkup package Patient's examination results will be returned to your home. After receiving the results of the general health examination, if you detect diseases that require intensive examination and treatment, you can use services from other specialties right at the Hospital with quality treatment and services. outstanding customer service.

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