Statins for Cholesterol

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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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• Statins for cholesterol overview
• What are examples of available statins on the market?
• How do statins work?
• Who should not use statins?
• Statins and drug or food interactions
• Statin side effects
• Synonyms and Keywords
• Authors and Editors

Statins for cholesterol overview

Statins, also known as HMG-CoA reductase inhibitors, are effective cholesterol-lowering medications and increase clearance of low-density lipoprotein (LDL). Statin use decreases the risk of heart attack, stroke, and other arterial diseases that are related to high cholesterol levels in the body. The majority of physicians and researchers support the use of statins but there are some investigators that suggest they may be "overused".

Cholesterol is a soft, waxy substance found in the blood and in all cell membranes; it is also used to form some hormones. It is an integral part of a normal person's body. Cholesterol can be absorbed from food and also synthesized in the liver. High levels of cholesterol in the blood is referred to as hypercholesterolemia. Hypercholesterolemia is a major risk factor for cardiac, stroke, and other diseases because high levels of cholesterol in the blood cause cholesterol to be deposited in arteries, which then forms plaque, and eventually may participate in artery blockage.

Statins are not the only treatments used to lower cholesterol; for example, nicotinic acid, fibric acid, and cholesterol absorption inhibitors are prescribed to lower cholesterol levels.

In addition to medication, risk modifiers to lower cholesterol include the following:

• a balanced diet low in cholesterol and saturated fat;



• increased physical activity,



• smoking cessation; and



• weight loss.

Often, a health care practitioner may ask the patient to try to modify these risks factors for a few months before prescribing the statin medication to see the impact of lifestyle changes on cholesterol, triglyceride, and other levels. Statins do not replace making positive lifestyle changes to lower blood cholesterol levels; they work together in decreasing cholesterol levels and results are usually seen after 4-6 weeks of taking statins.

What are examples of available statins on the market?

Commonly prescribed statins include the following:

• atorvastatin (Lipitor),



• fluvastatin (Lescol),



• lovastatin (Mevacor, Altocor)



• pravastatin (Pravachol),



• pitavastatin (Livalo)



• simvastatin (Zocor), and



• rosuvastatin (Crestor).

Statins come in tablet or capsule forms and are usually taken with the evening meal or at bedtime.

How do statins work?

Statins may lower cholesterol levels by 20% to 60% by slowing the production of cholesterol and by increasing the liver's ability to remove LDL (low density lipoprotein) or bad cholesterol. Statins lower LDL levels more effectively than other types of drugs. They also modestly increase HDL (high-density lipoprotein) or good cholesterol levels and decrease total cholesterol and triglyceride levels.