Statins are a class of drugs often prescribed to patients to lower LDL levels, also known as the bad cholesterol. They work by inhibiting an enzyme, HMG-CoA reductase, which controls the production of cholesterol in the liver. The medication works by slowing down the production of cholesterol and therefore increasing the number of LDL receptors. These receptors bind to LDL in the liver, thus reducing LDL levels in the blood stream.
Studies have found statins can be very effective at lowering cholesterol and reducing the risk for a heart attack and other cardiovascular events. In recent years, statin use has climbed, while cholesterol levels have dropped, according to national data from the National Center for Health Statistics. “Statin medications are one of the most important advances in medicine in the last century,” says Dr. Brendan Cavanaugh, who works at the Heart Hospital of New Mexico at Lovelace Medical Center.
However, research also indicates that of the 1 in 4 people prescribed statins over the age of 45, as many as half quit taking the drug at some point. While side effects of statins including increased risk for stroke, diabetes and memory loss have fueled a negative sentiment for this therapy, health care providers like Dr. Cavanaugh, cautions patients not to discontinue use. “These medications have helped save countless lives from fatal cardiovascular events in those with a diagnosis of coronary artery disease, peripheral vascular disease, or cerebrovascular disease,” he says. “As cardiologists have been saying for years, there is no trial that shows any permanent side effects from statins in those who are routinely followed by their physicians and who get routine blood work.”
To address the risk of adverse side effects compared to the added benefit of decreasing the risk of cardiovascular events, investigators reported this week in Circulation: Cardiovascular Quality and Outcomes, that statin medication as a class therapy are “well tolerated.” Comparing individual statins in the analysis of trials including more than 200,000 patients, simvastatin and pravastatin were reported to have the best safety profiles and therefore “should be favored in clinical practice.”
The study which included data from more than 130 randomized trials gives health care providers and patients a reassuring message regarding statin use and safety. “The bad press around statins has been unjustified and has led to many patients inappropriately stopping their medications,” says Dr. Cavanaugh. “In some cases, this has led to life altering medical events.”
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