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Cholesterol-lowering medicines, statins 

Introduction 

Cholesterol

Too much cholesterol in the body causes coronary disease such as angina, heart attack and stroke. Dr Jonathan Morrell explains who is at risk and the treatments available.

Statins are cholesterol-lowering medicines. They may be used to treat:

  • primary hypercholesterolaemia, a high level of cholesterol in the blood due to lifestyle factors such as a high-fat diet or not doing enough exercise
  • familial hypercholesterolaemia, a high level of cholesterol in the blood due to inheriting a gene that causes your liver to make lots of cholesterol

Statins may also be used to reduce your risk of having a heart attack or stroke if you have:

  • angina (chest pain) or have previously had a heart attack
  • transient ischaemic attacks ('mini strokes') or have previously had a stroke
  • peripheral vascular disease (narrowing of blood vessels, usually in the legs)
  • diabetes and are over 40
  • diabetes and are under 40 but have other risk factors for heart disease, such as poor blood sugar control, high blood pressure or a family history of heart disease in a relative younger than 40

How statins work

Statins reduce the production of cholesterol by the liver.

In particular, they reduce the production of 'bad' cholesterol called low density lipoprotein (LDL).

If you have a high amount of LDL cholesterol in your blood, it can form fatty deposits in the lining of your arteries (blood vessels). This causes furring and narrowing of the arteries, known as atherosclerosis, which in turn restricts the blood flow and can increase your risk of having heart disease or a stroke.

The liver makes most of your body's cholesterol at night. For this reason, it is recommended that many statins (fluvastatin, pravastatin, simvastatin and simvastatin with ezetimibe) are taken in the evening so the amount of statin in your body will be highest when the liver is producing the most cholesterol.

Names

There are several different statins. Names include:

  • atorvastatin (brand name Lipitor)
  • fluvastatin (brand name Lescol)
  • pravastatin (brand name Lipostat)
  • rosuvastatin (brand name Crestor)
  • simvastatin (brand name Zocor)
  • simvastatin combined with ezetimibe (brand name Inegy)

Last reviewed: 01/04/2010

Next review due: 01/04/2012

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vernon39 said on 20 January 2011

Doesn't yet note contents of Choice News item News 19/1/2011

http://www.nhs.uk/news/2011/01January/Pages/cholesterol-lowering-statin-drugs-examined.aspx

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brianfromenfield said on 01 December 2009

I am surprised that no reference is made to the risks of statins (I actually wanted to find out about these).

Also it is notable that Mr Parker (and most of the literature concerning cholesterol reducing foods/drugs/exercises) does not quantify the benefits - i.e. how much can I expect to reduce my cholesterol by doing various things? I believe I read once that diet can give a maximum reduction of only about half a micromole whereas my cholesterol needs reducing by several micromoles so special diets may well be an unpleasant waste of effort! But no one tells you.

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laryparker said on 01 October 2009

Some changes in your diet that may reduce your cholesterol. Oats, in the unprocessed form have been proven to reduce cholesterol. Using soy products such as soymilk can reduce your cholesterol. Exercise, as little as half an hour; thrice a a week, has been shown results of lower cholesterol. Ateronon, is a one a day food supplement, which contains 7mg of Lycopene.It is proven to reduce ‘bad cholesterol’ which causes fatty deposits and blocks arteries.

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