Increased blood cholesterol levels are one of the factors leading to the development of heart and vascular diseases. After all, it is this organic substance, present in excessive quantities in the body, that forms atherosclerotic plaques in the capillary cavities, interfering with proper blood flow.
Cholesterol statins are a group of medications designed to treat and prevent many diseases that often accompany high cholesterol. Today we will talk about what statins generally are, how they act on the body, what are the beneficial and harmful properties of these medications.
What are statins and who are they prescribed to?
Before starting a conversation about the benefits and harms of statins, you need to find out what they are and how drugs in this group act on the human body. In the twentieth century, doctors recognized atherosclerosis as a disease that in many cases is the cause of heart attack and stroke.
Before this, for a long time it was mistakenly believed that atherosclerosis develops and progresses due to the natural aging of the body, and this process is irreversible. However, the discovery of statins had a revolutionary effect in medicine. It has been proven that they are indeed capable of lowering blood cholesterol levels.
The mechanism of action of statins will be described in more detail below, but the general principle of action of these drugs is to accelerate and regulate cholesterol, as well as to reduce the concentration of the substance by slowing down HMG-CoA reductase. As a result, the damaged inner vascular layer is improved at that stage of atherosclerosis when it cannot yet be diagnosed, but the accumulation of cholesterol plaques inside the capillaries has already begun.
If statins are taken correctly, following medical instructions and not stopping the drugs without permission, the concentration of low-density lipoproteins (LDL) decreases, the volume of high-density lipoproteins (HDL) increases, and the risk of heart attack and stroke is prevented.
Who should take statins:
- patients diagnosed with hypercholesterolemia of primary and hereditary forms of homozygous and heterozygous pathology;
- people suffering from cardiac ischemia, regardless of whether they have high cholesterol in the blood;
- patients who have had a heart attack, with diagnosed angina pectoris and coronary syndrome;
- for diabetics to monitor total cholesterol levels in the blood plasma;
- hypertensive patients who regularly suffer from pressure surges and are at risk for the development of cardiovascular pathologies;
- patients diagnosed with atherosclerotic changes in capillaries in various organs and systems - with atherosclerosis of the lower extremities, renal arteries, cerebral vessels, carotid artery.
A specialist can recommend statins to a person who does not suffer from heart pathologies, but at the same time has high cholesterol levels. It must be remembered that many medications, including lipid-lowering ones, cause side effects, so they should only be prescribed by a doctor.
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All other medications
Your doctor may recommend taking dietary supplements (dietary supplements).
However, natural remedies such as Omega 3 , Tykveol , flaxseed oil , and lipoic acid lower cholesterol levels slightly.
It should be borne in mind that dietary supplements are not drugs, therefore such drugs are inferior to statin drugs in terms of preventing cardiovascular diseases.
List of dietary supplements that are used for this purpose and contain natural components:
- Omega Forte;
- Doppelhertz Omega;
- Tykveol;
- Lipoic acid;
- SitoPren.
Omega 3
Tablets containing fish oil ( Omega 3 , Oceanol , Omacor ) are recommended for people who want to lower cholesterol. Fish oil protects the body from the development of vascular and heart diseases, as well as from depression and arthritis. But you need to drink fish oil very carefully, since taking it increases the risk of chronic pancreatitis .
Tykveol
Pumpkin seed oil is indicated for use by those who suffer from cholecystitis , cerebral atherosclerosis hepatitis . The product provides choleretic, anti-inflammatory, antioxidant, hepatoprotective effects.
Lipoic acid
This remedy is an endogenous antioxidant , it is used for the prevention and treatment of coronary atherosclerosis. There is a positive effect of the drug on carbohydrate metabolism. When taken, the trophism of neurons improves, and glycogen levels in the liver increase.
Vitamins
Vitamins help normalize cholesterol levels, increase hemoglobin , etc. The body needs vitamin B12 and folic acid , nicotinic acid . At the same time, it is very important that these are natural vitamins, that is, it is important to eat those foods that contain these vitamins.
SitoPren
Dietary supplement – fir foot extract, it contains beta-sitosterol, polyprenols. Should be taken for hypertension , atherosclerosis , high levels of triglycerides and cholesterol.
Policosanol
Dietary supplement – plant wax extract. Helps reduce low-density cholesterol levels and helps prevent atherosclerosis.
Other means
Bile acid sequestrants ( Kolesevelam , etc.) are medications that are used in complex treatment as an auxiliary component for lowering cholesterol. They suppress its synthesis in plasma.
Ciprofibrate Lipanor - suppresses cholesterol synthesis in the liver, lowers its level in the blood, reducing the level of atherogenic lipoproteins.
Mechanism of action
How do statins help lower blood cholesterol? 80% of this organic substance is produced by the human liver from the component mevalonic acid. In order for this acid to be intensively produced, an enzyme called HMG-CoA reductase is required.
It is precisely to reduce its production that the action of statins is aimed. The more the production of the enzyme and, as a result, mevalonic acid decreases, the lower the cholesterol level will be. In such a situation, the only source of organic matter is food, if your own cholesterol ceases to be produced.
Having lost the ability to produce cholesterol, the liver seizes the opportunity to obtain it through other methods. For example, it increases the uptake of cholesterol from the blood, where it ends up after being taken in with food. To achieve this, the synthesis of receptors sensitive to “bad” cholesterol increases. The liver produces a large amount of fats, which are excreted in bile, and these functions require enormous resources from the organ.
Instead of removing toxins and harmful substances from the body, the liver has to constantly replenish cholesterol reserves, as a result of which the concentration of the compound in the blood decreases. According to statin manufacturers, such processes stop the growth of atherosclerotic plaques and serve to prevent the formation of blood clots in capillaries.
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Beneficial features
It is impossible to do without prescribing statins for some conditions, often life-threatening. The drugs help not only in treatment, but also in the prevention of various pathologies that often accompany high cholesterol levels. The pleiotropic effects of statins represent an effect on several targets at once, triggering different biochemical processes in the body.
Doctors identify the following pleiotropic properties of lipid-lowering drugs:
- are an addition to diet and a healthy lifestyle in patients with severe heart and vascular diseases;
- help to recover after a heart attack - during this period, elevated cholesterol levels are most dangerous, and statins prevent the re-development of a life-threatening condition for the patient;
- prevent implant rejection and deterioration in the well-being of a patient who has just undergone stenting or coronary bypass surgery by lowering con-cholesterol in the blood;
- serve as a stroke prevention - they help restore normal blood flow after a hemorrhage and prevent the formation of cholesterol plaques in the vessels;
- prevent blockage of blood vessels with severe circulatory disorders in obese people;
- stop progressive atherosclerosis.
With a hereditary form of hypercholesterolemia, many children need to take statins daily. This is necessary to prevent the development of coronary disease. Scientists have found that such a measure can prevent premature death by 93%.
Choosing the best product
The effectiveness of drugs of different generations differs significantly: this becomes especially noticeable if a comparison is made immediately between the first and fourth. The quality of Crestor's work is 4 times higher than the capabilities of the best of the first drugs - Simvastatin. The higher the generation, the lower the likelihood that the treatment will cause harm, and the better the tolerability. Therefore, the search for the best medicine should be carried out between the leaders of the last two groups.
Liprimar wins on price: treatment is relatively inexpensive. In general, atorvastatin has been used more widely and has a greater track record of predictable results. Since the patient must take statins daily for many months, the choice of Liprimar helps to reconcile the effectiveness of treatment, safety and budget. Nevertheless, the drug takes a long time to start working: the rate of development of the initial effect is almost 2 times behind that of rosuvastatin.
Crestor, on the other hand, is more effective and can help in difficult cases. Most often, rosuvastatin is better tolerated, and the high rate of influence on cholesterol synthesis allows it to win the competition for the quality of the result and the reduction of consequences. The only question remains is the price.
Harm and side effects
Doctors confirm that with long-term use, non-compliance with instructions and a predisposition to various pathological conditions, statins can indeed cause harm. For this reason, experts first prescribe diet, exercise, and cessation of bad habits to patients with high cholesterol, and, if such measures have no effect, they prescribe lipid-lowering drugs.
The harm of statins to the body has been discussed more and more often lately, and many patients are simply afraid to take drugs in this group, having heard a lot about the large list of side effects
Why are statins dangerous and what negative effects can they have on the human body:
- weakness and pain in muscle tissue - this phenomenon occurs in different degrees of severity. Under the influence of the active substances of statins, muscle fibers age prematurely and stop renewing. As a result, if the specialist does not stop the drug in time, the patient may suffer from partial muscle breakdown, leading to kidney dysfunction and kidney failure (rhabdomyolysis);
- premature death of liver cells - the organ experiences double stress under the influence of statins, and it needs a break of at least 10 days between courses of therapy;
- sleep disturbances and insomnia – drugs from the statin group contain substances that cause nervous overexcitation. In everyday life, a person may simply not notice this, and at night it is difficult for him to sleep. The doctor can adjust the dose of the medicine downwards or at the same time prescribe safe drugs to improve sleep;
- development of obesity - in some cases, with long-term use of statins in the body, metabolic functions are disrupted, which is why a person gains excessive weight;
- overload of the pancreas - with weakness of the organ and constant exposure to statins, some patients develop acute pancreatitis with the formation of foci of necrotization;
- changes in blood sugar levels down and up - manifests itself due to the inability of the pancreas to adequately cope with insulin production. It is produced either too much or less than normal, for this reason it is necessary to constantly monitor sugar levels;
- fragility of bones - many statins promote too rapid removal of cholesterol from the body, as a result of which bone tissue suffers. It becomes thinner, and a new one forms more slowly, the patient is susceptible to injuries and bone fractures;
- decreased immunity - already 4-5 months after starting to use statins, a person begins to suffer more often from viral and bacterial infections due to the defective functioning of immune system cells;
- decreased blood clotting – statins affect the number of platelets in the blood.
In addition to the listed side effects, cases of sexual dysfunction in men and the development of gynecomastia in women have been recorded with long-term use of lipid-lowering drugs.
Due to the effect on cell membranes, the skin becomes dry, and premature wrinkles may appear on the face. Experts also noted cases of the development of cataracts, glaucoma, and kidney inflammation. More often, such side effects are observed in patients over 60–65 years of age, so they need constant medical supervision during statin therapy.
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Contraindications to treatment
Like other medicines, statins have contraindications, in the presence of which they should not be taken:
- pregnancy and breastfeeding - the active substances of statins penetrate the placental barrier and can cause congenital malformations and fetal death. There is no specific data on whether the drugs change the composition of mother's milk, so it is better to refrain from using them during lactation;
- severe liver diseases - hepatitis, cirrhosis;
- alcohol abuse;
- special sensitivity to the components of the drug;
- severe dysfunction of the nervous system;
- osteoporosis;
- thyroid diseases;
- high risk of developing myopathy.
At the stage of prescribing statins, it is important what drugs the patient is already taking. The specialist must take into account the cross-interaction of drugs in order to avoid a sharp negative reaction of the body to their simultaneous use.
Prices
The cost of the medicine depends on the dose chosen, the country of origin and the quality of the raw materials. Below is a list of medicines and the price range of statins in Russian pharmacies.
| Drug name | Price |
| "Rosuvastatin" | 150-360 rub. |
| "Roxera" | 340-1600 rub. |
| "Crestor" | 730-5600 rub. |
| "Tevastor" | 360-1400 rub. |
| "Rozulip" | 200-1300 rub. |
| "Livazo" | 520-1000 rub. |
Generations of statins
What are the types of statin drugs? They are divided into several generations - the very first were isolated from natural components and are called lovastatins. Other drugs are made from synthetic substances, but it is a mistake to believe that drugs based on natural products are safer.
Synthetic drugs are less likely to cause side effects, so it is believed that the most effective and safe statins are those belonging to the second, third and fourth generations. The second generation is represented by fluvastatins. These medications contain sodium salt and are considered effective and safe.
They quickly reduce the concentration of cholesterol in the blood and are prescribed even to children under 18 years of age with a hereditary form of hypercholesterolemia. However, doctors rarely prescribe fluvastatins, preferring more modern drugs of the latest generations. Prominent representatives of fluvastatins are the classic medicine Lescol and the same in an enhanced formula (Forte).
The third generation of statins is the substance atorvastatin, on its basis the original drug of the same name, Atorvastatin, was created. A feature of this group of drugs is considered to improve the activity of the heart and blood vessels while reducing the concentration of cholesterol in the blood. Atorvastatin-based drugs are also prescribed for the prevention of diabetes mellitus, coronary heart disease, heart attack and stroke.
What is the difference between Atorvastatin and Rosuvastatin?
List of statins in this class:
- Atorvastatin,
- Atoris,
- Lipitor,
- Atomax,
- Torvacard,
- Liprimar.
The latest generation of statins are rosuvastatins and pitavastatins. They are the latest pharmaceutical development to lower blood cholesterol levels faster, more effectively and safely. They are prescribed for progressive atherosclerosis, cardiac ischemia, dyslipidemia, and during the rehabilitation period after operations to restore vascular patency.
There is currently only one drug based on pitavastatin. This is Livazo. The following medications contain rosuvastatin:
- Roseart,
- Rosuvastatin,
- Roxera,
- Tevastor,
- Mertenil,
- Akorta,
- Rozulip.
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Experienced specialists prefer to prescribe safe drugs from the group of statins to their patients in a minimum therapeutic dose and a long-lasting effect. Such medications include Rosucard, Crestor, Roxera, Akorta, Mertenil and Livazo. They should be taken once a day in the morning or evening, regardless of meals.
Even the best statins have contraindications and side effects, so prescribing them yourself or replacing one drug with another is unacceptable. Many patients who are about to take them are interested in how long to take lipid-lowering drugs.
Each case is individual, the doctor relies on the results of laboratory tests, general health, the presence of concomitant pathologies and many other factors. In many cases, you have to take statins for high cholesterol for life.
Representatives of the statin group
At the same time, it is necessary to take breaks between courses to restore liver tissue. How to use statins correctly, is it possible every other day? Experts recommend taking the prescribed tablets once a day every day, rather than taking a double dose every other day. This reduces the effect of taking the drug and is fraught with the development of side effects.
Reception features
Despite the unpleasant effects of treatment, statins are quite capable of extending a patient’s life by ten years. For each patient, the dosage is selected individually: it is important to find the line between benefits and side effects. When trying to understand how to take statins correctly, at what time and under what conditions, patients can follow certain tips.
For better absorption, tablets should be taken once a day, a couple of hours before bedtime.
Statins are swallowed with water or any juice other than fresh grapefruit: this can cause serious complications.
Another important recommendation is to avoid alcohol. Sometimes, to reduce the chances of a side effect, the doctor may recommend a course of treatment with short breaks.
Myths about the drugs of the group
Today, there are many ways to lower cholesterol levels, from following a diet, normalizing your lifestyle, giving up bad habits, to taking various medications. Many drugs are under development, but 99% of doctors' prescriptions come down to statins. What explains this?
The fact is that drugs of the statin group are hypolipidemic, that is, they lower the level of bad cholesterol in the blood and increase the level of good cholesterol. Medicines also prevent complications, reduce the level of vascular inflammation (this is key in the development of atherosclerosis), and reduce the risk of heart attack and stroke.
Statins stabilize atherosclerotic plaques that have already formed in the capillary cavities, which is why the life expectancy of patients who take the drugs as prescribed by a specialist increases. But this particular group of drugs is surrounded by a lot of myths common among people.
We need to figure out whether the rumors about statins are true, based on the opinions of practicing doctors:
- If you constantly use statins, it will no longer be possible to quit them. Indeed, people with elevated levels of lipophilic alcohol in the blood will have to take statins to lower cholesterol constantly. When the drugs are discontinued, especially in patients with a hereditary form of hypercholesterolemia, the indicators return to their original levels. But statins are not addictive in the drug sense.
- In addition to their benefits, statins also cause irreparable harm to health. With the constant use of lipid-lowering drugs, the capillaries are cleared, but the risk of developing cancer, liver and muscle tissue diseases, and diabetes increases. But when prescribing this or that drug, experts weigh the pros and cons. And for one new case of diabetes to occur, 250 patients must be treated over 4 years. Without treatment, 6 patients will simply die from a heart attack. Thus, an increase in the activity of liver transaminases during therapy with standard doses is recorded in two out of a thousand people. Much greater damage to the liver is caused by drinking alcohol and fatty foods.
- Cholesterol drugs do not have a positive effect on the body, they are just a ploy by pharmaceutical companies. Yes, taking statins does not directly affect a person’s well-being. But it is much more effective to take drugs with a long-term effect, which improve the prognosis of survival, rather than giving a momentary insignificant result.
Also, many believe that there are no drugs in medicine that can reduce high cholesterol levels. And to maintain a normal level of lipophilic alcohol in the blood, it is enough to consume certain foods daily.
Of course, proper nutrition is a good help in cleansing blood vessels, but no product or dietary supplement can effectively prevent the progression of atherosclerosis as well as medications prescribed by a doctor. Therefore, if a specialist recommends taking statins, you should not neglect the prescription.
Combined lipid-lowering therapy
In some cases, doctors prescribe a combination of lipid-lowering drugs with different mechanisms of action. The most common indication is severe hyperlipidemia. Most often, fibrates are used in combination with statins. Nicotinic acid is combined with other hyperlipidemic drugs very carefully, under the supervision of a physician [6].
If a two-component treatment regimen is ineffective, three drugs can be used at once, for example, statins, cholesterol absorption inhibitors and nicotinic acid [3].
Sources
- Kharkevich D.A. Pharmacology. 10th ed. M.: GEOTAR-Media, 2010. – 908 p.
- Morris Brown, Peter Bennett. Clinical Pharmacology 11th Edition, 2012.
- Clinical pharmacology and pharmacotherapy: textbook. – 3rd ed., add. and processed / ed. V.G. Kukesa, A.K. Starodubtseva. – M.: GEOTAR-Media, 2012. – 832 p.
- Bardal SK, Waechter JE, Martin DS Applied pharmacology. – Elsevier Health Sciences, 2011.
- Goodman and Gilman's The Pharmacological Basis of Therapeutics, Twelfth Edition
- Janashia P.Kh. et al. Drug lipid-lowering therapy. Medi.ru URL: https://medi.ru/info/3448/ (access date 05/29/2020).
How to replace statins
The question of how to replace statins at home in order to minimize the side effects of medications worries many people with high cholesterol. There are natural substances that help reduce this organic substance in the blood:
- ascorbic acid - natural products that contain large quantities of vitamin C include rose hips, currants, sauerkraut, bell peppers, citrus fruits, etc.;
- soy enzymes present in Asian products - tofu, miso, tempeh;
- pectins – present in apples, cabbage, bran, buckwheat and rolled oats, beans, carrots, lentils;
- resveratrol – dark grapes and cranberries;
- polyunsaturated fatty acids – vegetable oils, red fish, caviar, chicken eggs;
- curcumin
The only side effect of this diet is overeating. In everything you need to observe moderation, consuming a variety of foods containing natural statins every day. Garlic also contains them. By regularly eating the root vegetable, the capillaries are cleansed and the level of lipophilic alcohol in the body naturally decreases.
Natural statins
Reviews
Patients who have been taking statins for a long time as prescribed by doctors or have just started a course of treatment with this group of drugs leave different reviews.
Pavel, 61 years old: I never thought that high cholesterol could be dangerous until I was examined in the hospital. It turned out that my figure was almost twice as high as normal, and atherosclerotic plaques had already begun to accumulate on the walls of my blood vessels. The doctor prescribed me Livazo tablets. They are not cheap, but a month later blood tests showed a clear improvement. I will continue to drink until the doctor stops them or replaces them with others.
Alexey, 47 years old: I had to visit a doctor because recently I began to worry about pain in my legs when walking for a long time. It turned out that cholesterol plaques accumulate in the arteries of the lower extremities and it is necessary to urgently take statins, in addition to the main treatment. They gave me Roxer tablets. There are no side effects, I take 20 mg once a day.
Ekaterina: The doctor prescribed me Atorvastatin 20 mg once a day, because I have high cholesterol in my blood. But after reading articles about the side effects and dangers of this group of drugs, I decided not to take statins for now. I will try to lower my cholesterol through diet and lifestyle changes. I haven’t eaten fatty foods for a week now, I go jogging in the morning, and I quit smoking. A month later I will donate blood again for testing. If cholesterol does not decrease, you will still have to take pills, no matter how much you want.
Drawing conclusions
Statins are a group of drugs created to reduce the concentration of cholesterol in the blood, prevent the serious consequences of heart and vascular diseases, surgical operations and diabetes.
Despite a lot of rumors about these drugs, if the attending physician considers it appropriate to prescribe statins, this recommendation should not be neglected. You can supplement therapy at home by eating healthy foods, but it is unreasonable to perceive this as the only correct method of treatment.
