Statins reduce cholesterol biosyntesis (production of cholesterol), mainly in the liver, due to their effect of inhibition upon HMG-CoA reductase. The antiatherosclerotic effect comes due to decrease in LDL cholesterol. In addition, they can exert antiatherosclerotic effects independently of their hypolipidemic action. HMG-CoA reductase inhibition (reduction) has beneficial pleiotropic effects and reduce tumor cell growth. Consequently, statins reduced the rate of mortality in coronary patients.
Lovastatin was the first effective HMGCR inhibitor commercially made available in 1987 by Merck.
You can think of stopping the medicine or decrease the dose If you reduce risk factorsYou have to do it on the advice of the doctor only. It can be thought of only if the level of cholesterol is under control for significant time.
Unless risk factors are significantly modified to reduce weight, increase exercise, control hypertension and diabetes, and stop smoking, cholesterol levels are likely to return to previous values if statin therapy is discontinued.
Statins are safe medicines - They have to be given to people with risk of vascular diseases.
But we are collecting data to investigate the reported problems due to statin use.
Statins Benefit many. A meta-analysis of 27 large statin trials shows that statin treatment is clearly beneficial and has to be given for many with a 10% risk of vascular events in next 10 years (Lancet, 2012b). Then we may avoid 10,000 events, including 2,000 deaths every year.
The meta-analysis, published in 2012 in the Lancet, was conducted by the Cholesterol Treatment Trialists’ (CTT) Collaborators. They analyzed data from 175,000 individuals by grouping them into five categories based on high to low cardiovascular risk. Results of the based on 27 research studies, showed that statins reduced the risk of serious vascular events by around 21% for each 1-mmol/L reduction in LDL cholesterol in all groups, including the lowest risk group.
According to Colin Baigent (Clinical Trial Service Unit, Oxford, UK), the relative reduction in risk of cardiovascular events with a statin is good even in the lowest-risk group and the benefits greatly exceeded the harms due to the drug.
Half of cardiac deaths happen in people the first time an adverse cardiac event occurs, so there is a limit to what can be achieved secondary prevention (which is treatment after the event and knowledge of the disease). Primary prevention, which is giving drugs to prevent the disease is needed and therefore a threshold is to be set.
At the moment, the public and many doctors think that statins are necessary only if a patient has high cholesterol. The thinking has to be changed and new view that statin is needed if you are at any increased risk of heart disease has to be accepted and promoted.
Press release on research
NHS 'should consider giving statins to healthy people'
By James Gallagher, Health and science reporter, BBC News, 17 May 2012
Colin Baigent - Wider Stating use saves life