To take or not to take statins for cholesterol. Should I take cholesterol pills: harm or benefit of taking statins? Active ingredient: Atorvastatin

One of the most important organic compounds produced by our body is cholesterol. This hydrocarbon is necessary for almost all tissues. Without this connection, the normal existence of not a single living cell is possible. And most importantly, cholesterol is the main raw material for the production of sex hormones. Its deficiency leads to sexual dysfunction in men and amenorrhea in women.

But cholesterol molecules are heterogeneous, high-density cholesterol (healthy cholesterol) is useful and necessary. And molecules with low density (bad cholesterol) have an atherogenic effect, and become the main cause of diseases such as:

• atherosclerosis (see),
• ischemia,
• angina pectoris
• hypertension,
• obliterating endarteritis,

If elevated levels of bad cholesterol are detected in blood tests, the doctor will definitely recommend a course of treatment with drugs that lower cholesterol and prevent the development of cardiovascular pathologies. The main groups of drugs for lowering cholesterol are fibrates and statins.

When prescribing statins, the doctor will definitely warn the patient that this drug will now become an integral part of his daily diet for the rest of his life. And also that almost all drugs in this group have quite a lot of side effects. A person has to decide for himself how to reduce cholesterol. Take medications, and whether it’s worth it, or change your usual lifestyle.

In addition to fibrates and statins, drugs containing fatty acids are prescribed, these are Omega 3 (fish oil) and lipoic acid. The decision about the advisability of taking statins or refusing them cannot be made independently. Only a doctor can do this. If in doubt, consult with several doctors. This will help you find the right decision about how much the benefits of their action on your body will exceed the risk of unwanted pathologies.

Statins – drugs that lower cholesterol levels

In pharmacology, statins are drugs whose main action is aimed at reducing the production of enzymes responsible for the production of cholesterol in liver cells and adrenal glands. Instructions for the use of statins speak about the following abilities of the drugs:

Possible side effects from taking statins

Regular use of statins during the treatment of high cholesterol often causes the development of such side effects as:

Quite often, patients taking static drugs complain of such types of ailments as:

• myalgia (muscle pain),
• abdominal (stomach) pain,
• diarrhea, constipation,
• nausea to vomiting,
• constant headaches,
• state of chronic fatigue.

Nervous system disorders:

• amnesia (memory loss),
• general malaise,
• frequent dizziness,
• attacks of hypertension,
• paresthesia (feelings of numbness, tingling and goosebumps),
• neuropathy of peripheral nerve endings (impaired conduction of impulses in the limbs).

Digestive tract disorders:

• pancreatitis,
• cholestatic jaundice,
• anorexia (sharp, pathological weight loss),
• hepatitis,
• diarrhea,
• vomit.

Disorders in the musculoskeletal system:

• joint arthritis,
• myopathy (skeletal muscle dystrophy),
• cramps in the calf muscles,
• sharp back pain,
• myositis (inflammatory damage to skeletal muscles).

Immune system disorders (allergic manifestations):

• exudative erythema (allergic inflammation affecting the skin and mucous membranes),
• Lyell's syndrome (severe form of allergic dermatitis, accompanied by damage to internal organs),
• hives,
• numerous skin rashes.

Disorders in the hematopoietic system:

• thrombocytopenia (pathological decrease in platelet production).

Endocrine system disorders:

• diabetes mellitus type 1,
• hypoglycemia (low blood sugar levels),
• obesity,
• swelling of the limbs,
• sexual dysfunction.

Absolute indications for taking statins as a means of prolonging life

Instructions issued for advertising purposes for cholesterol-lowering drugs of the statin group confidently convince that these drugs effectively reduce the likelihood of a heart attack or stroke, and also help improve the quality of life.

In addition, it says that statins have almost no side effects and cannot harm the body, but are a wonderful way to prevent cardiovascular pathologies. The most common slogan of advertising companies is: “Take statin drugs constantly, and you will feel how bad cholesterol goes away, and good cholesterol increases your level.” Under no circumstances should you trust such advertising claims unconditionally. Most of these categorical statements are simply advertising bait for the purchase of expensive drugs.

In practice, the situation looks much more complicated. For example, cholesterol-lowering statin tablets are prescribed with great caution to elderly people. In general, the attitude of doctors towards the use of statins today is quite controversial and ambiguous.

• According to some sources of specialized literature, taking statins is mandatory for all people with high cholesterol levels - this is guaranteed to reduce the risk of cardiovascular pathologies.
• Other, no less competent scientific publications argue that, first of all, the ratio of possible harm to intended benefit should be taken into account. And in older people, in the vast majority of cases, the potential harm far outweighs the therapeutic effect.

Standard methods for treating cardiac pathologies include the inclusion of statins in the therapeutic regimen. This increases the effectiveness of treatment and significantly reduces mortality. But medical practitioners believe that cholesterol pills, specifically statins, should not be prescribed to every patient with hypertension or coronary artery disease. And it is also impossible to prescribe statins to all elderly patients with high cholesterol without prior examination.

Absolute indications for prescribing statins are the following conditions:

• For prevention after a recent stroke or heart attack.
• During the preparatory period and postoperative recovery during reconstructive surgical interventions on the heart and central vessels. For example, setting up a grand stand for coronary artery bypass grafting.
• Myocardial infarction or acute coronary syndrome.
• Severe coronary heart disease with an increased risk of heart attack or stroke.

Relative indications for statins, in which the benefit of taking them is very doubtful, are observed in patients with conditions such as:

• low risk of heart attack;
• women before menopause;
• patients with a history of type 1.

In retail pharmacy chains today, statins are represented by drugs of varying cholesterol-lowering activity, these are:

• Lovastatin – lowers bad cholesterol by up to 25%;
• Fluvastatin – reduces to 29%;
• Simvastatin – up to 38%;
• Atorvastatin – up to 47;
• Rosuvastatin – up to 55%.

Statin-based drugs

Active ingredient: Lovastatin

• Cardiostatin
• Holetar

Active ingredient: Fluvastatin

• Lescol Forte

Active ingredient: Simvastatin

• Syncard
• Simlo
• Simgal
• symbol
• Simvastol
• Simvastatin
• Simvacard
• Simwahexal
• Owencore
• Zokor
• Basilip

Active ingredient: Rosuvastatin

• Tevastor
• Roxera
• Rozulip
• Rosecard
• Rosuvastatin
• Mertenil
• Crestor
• Akorta

Active ingredient: Atorvastatin

• Liptonorm
• Tulip
• Torvacard
• Liprimar
• Atoris
• Atorvastatin Canon
• Atomax

Principles of drug selection

A person must make the decision to take medications independently, based on the recommendations and prescriptions of the attending physician. If the patient agrees with the specialist’s arguments and is ready to constantly take medications, the choice of the appropriate drug, dosage and course of administration remains entirely with the doctor. The doctor bases his decision on the patient’s health status, the presence and nature of chronic diseases, as well as taking into account the individual tolerance of the body.

Self-prescribing and uncontrolled use of cholesterol-lowering medications is strictly prohibited. The fact is that instead of improving your condition, you can cause irreparable harm to yourself. If the test results show any abnormalities in lipid metabolism or a significant deviation from normal values, you should immediately contact a cardiologist or therapist.

The doctor will assess the situation and the possible risk of side effects, taking into account such indicators as:

• the patient’s weight in relation to height, his gender and age category;
• presence of bad habits;
• existing chronic heart or vascular diseases, as well as pathologies of the liver and endocrine system.

After a statin is prescribed, it should be taken strictly in recommended dosages and with constant monitoring of blood tests for biochemistry. In the event that the prescribed drug cannot be purchased due to its high cost, its substitute is discussed with the attending physician. Practice shows that it is better to try to purchase original drugs. Generics supplied to Russian pharmacies are significantly inferior in quality and effect not only to the originals, but also to imported generics.

When prescribing drugs from the statin group to elderly patients, the doctor takes into account the fact that the risk of developing myopathy doubles when taking these drugs together with medications for diseases such as:

• gout,
• diabetes,
• hypertension.

The presence of chronic liver diseases in a patient inclines the doctor to choose Ruvastatin drugs in reduced dosages. It is also possible to opt for drugs such as Pravaxol or Pravastatin. These medications do not have a negative effect on the liver, but are absolutely incompatible with alcohol or antibiotics.

For patients with persistent muscle pain or an increased risk of muscle damage, Pravastatin is also prescribed. Not only is it gentle on the liver, but it is also non-toxic to muscle tissue.

The presence of chronic kidney disease prohibits the use of Fluvastin - Lescol and Atorvastatin - Lipitor. These drugs have increased toxicity to the kidneys.

In cases where it is necessary to reduce low molecular weight cholesterol and there are no concomitant diseases, statins cannot cause harm. Therefore, the doctor can prescribe any drug from this group, for example, Ruvastatin or Atorvastatin.

There is no exact data on the possibility of simultaneous use of statins and nicotinic acid. Although there is evidence that nicotinic acid, together with statins, provokes a sharp drop in blood sugar, sudden gastrointestinal bleeding, exacerbation of gout and the development of myopathy.

Studies of harm from side effects of statins

Some time ago, statins were used to treat almost all cardiac diseases to lower cholesterol, but the harm of the drugs was not fully studied. Statins were prescribed for all stages of ischemia, hypertension, and even with a low risk of developing cardiovascular pathology. This attitude was based on the recommendations of American scientists, who also advised the use of increased concentrations of drugs, reaching up to 80 mg.

After the British medical publication published the results of a study that showed that in 20% of cases, patients treated with statins developed adverse symptoms. An independent commission confirmed these indicators, and the practice of prescribing statins was revised.

To be fair, it should be noted that not a single independent study of the side effects of statins has been conducted on the territory of the Russian Federation. And many cardiologists still actively prescribe statins, despite the risk of harm to the health of patients with underlying diseases. Similarly, in the United States, doctors often and frequently prescribe statins to lower cholesterol, guided only by economic benefits and not by the risk of harm to health. In 2007 alone, the sale of statins generated profits of more than $40 billion.

Recent studies by Canadian scientists have shown that taking statins in patients increases the risk of rapid development by 57%, and if the patient also has diabetes, the risk increases to 82%. This means that older people with a history of diabetes are 5.6 times more likely to develop cataracts.

An analysis of 14 studies found that statins do reduce the risk of developing cardiovascular disease, and specifically heart attack or stroke. But the presence of a huge number of side effects does not recommend prescribing these drugs to patients who do not have a history of cardiac pathologies and have never suffered a heart attack or stroke. It has also been noted that people who constantly take statins develop liver dysfunction, kidney failure, cataracts, and muscle myopathy. These patients also suffer from depression, sudden mood swings and short-term memory loss.

Irrefutable facts about the importance of cholesterol in the life of the body and reducing its level with statins

German scientists, after conducting a series of studies, came to the following conclusion: low cholesterol is much more dangerous for humans than high levels or statins, which can, moreover, reduce cholesterol levels to critical levels.

German specialists have proven that low cholesterol contributes to the development of such pathologies as:

• oncological tumors,
• nervous diseases,
• strokes,
• anemia,
• suicidal tendencies,
• premature death.

US scientists, after a number of studies, affirm with all responsibility that: the development of heart attacks and strokes does not depend on the level of cholesterol, but on the low content of magnesium in the blood serum. Its deficiency causes an increase in cholesterol levels, which leads to diseases such as:

• diabetes,
• hypertension,
• arrhythmia,
• angina pectoris.

It is a well-known scientific fact that statins can suppress the main function of cholesterol - the repair of damaged tissue.

All tissues of the body, and especially vascular tissue, contain large quantities of cholesterol molecules. When the walls of blood vessels are damaged by the accumulation of proteins or under the influence of amino acids, cholesterol cells immediately begin to repair this damage. In addition, for normal muscle growth and the functioning of the body as a whole, low molecular weight fat cells containing bad cholesterol are required. The lack of this element affects muscle pain, swelling and general weakness, up to the appearance of muscular dystrophy.

Is constant reduction of cholesterol beneficial for the body?

Statins suppress the production of cholesterol by inhibiting the production of mevalonate, a cholesterol derivative. How does its deficiency affect the body? Mevalonate is not only a source of cholesterol production, it is necessary for the body to produce many other useful and important components with the help of which important functions are performed. If this does not happen due to a lack of the original substance, many serious diseases develop.

Statins can contribute to the development of endocrine diseases, specifically diabetes, the manifestations of which contribute to an increase in bad cholesterol. Taking statins increases the risk of developing diabetes mellitus in patients with various pathologies from 10% to 79%. It has also been found that diabetics have a 4-fold increased risk of developing various heart pathologies, such as:

• ischemic disease,
• stroke,
• heart failure,
• angina pectoris.

Statins reduce the concentration of Glutamine 4 at the cellular level. This component is responsible for the quantitative content of glucose in the blood stream. In Britain, more than 10,000 women over the age of 60 were examined. Two groups were identified. The first group of women took statins, the second did without them. The result showed that in the group taking statins, the risk of developing diabetes increased by 70%. Therefore, scientists concluded that taking statins by women during menopause increases the risk of diabetes by up to 70%.

The danger of side effects of statins lies in their slow development, almost imperceptible to a patient who has been taking these drugs for a long period. It has also been found that statins affect the mental abilities of patients who take them for a long time.

The human body is a single coordinated system. The work of all organs is connected by physiological and biochemical factors. Constant interference in the process of natural functioning leads to completely unexpected results. By suppressing cholesterol metabolic enzymes, statins negatively affect liver function. For obese people, this can result in a temporary improvement in the condition of blood vessels. Or for patients with normal weight - the development of anorexia. And constant forced adjustment of internal systems leads to more serious violations. In particular, mental deficiency is noted in older people.

Many scientists have come to the conclusion that increased cholesterol levels cannot be considered the cause of the disease. This is rather an indicator of the presence of disorders in the digestive system and carbohydrate metabolism. High cholesterol is an indicator of the health of the body. It signals that work is underway to restore, and not destroy, internal organs. Moreover, the hypothesis about the influence of high cholesterol on the formation of atherosclerosis still has no confirmation.

Many developed countries have introduced programs to reduce bad cholesterol levels, which included such areas as:

• adjustment of diet;
• giving up alcohol and smoking;
• physical education and therapeutic exercises;

The results exceeded all expectations. During the period of this program, the mortality rate from heart disease in Europe and the USA decreased by 50%. Medical scientists have wondered if maybe leading a healthy lifestyle, eliminating alcohol and tobacco, switching to consuming foods that help lower cholesterol, and regular physical activity is a more effective and safe way to normalize cholesterol and prolong life. As opposed to constantly taking medications that have serious side effects, the effects of which have not been fully studied.

Fibrates for lowering cholesterol levels

Another group of cholesterol-lowering drugs are fibrates. They are derivatives of fibric acid. These substances bind to bile and reduce the active production of cholesterol in liver cells. In addition, they reduce lipid content, which leads to a decrease in bad cholesterol.

Clinical studies have shown that fenofibrates can reduce cholesterol by 25%, triglycerides by 45%, and increase high molecular weight cholesterol by up to 30%. Fenofibrates prevent the formation of extravascular deposits and reduce the amount of triglycerides and cholesterol in people suffering from hypercholesterolemia.

However, just like statins, they have just as many side effects. In most cases, manifested as digestive disorders:

• dyspepsia,
• diarrhea,
• nausea and vomiting.

Fibrate group drugs

• Thaicolor
• Lipantil
• Exlip
• Ciprofibrate
• Gemfibrozil

Side effects of fenofibrates:

• Digestive system disorders:
  • pancreatitis,
  • hepatitis,
  • diarrhea,
  • formation of gallstones.
• Disorders in the musculoskeletal system:
  • weakness of muscle tissue,
  • myalgia,
  • myositis,
  • spasm of leg muscles.
• Cardiovascular disorders:
  • pulmonary embolism,
  • venous thromboembolism.
• Allergic manifestations:
  • photophobia,
  • skin rashes,
  • itching and burning,
  • hives.

Other cholesterol-lowering drugs

In uncomplicated cases or with a slight increase in cholesterol, it is recommended to take safer drugs. These can be dietary supplements that do not cause dangerous side effects and help to slightly reduce the level of bad cholesterol. These are tools such as:

• Omega 3 (Doppelhertz),
• Omega forte Evalar;
• SitoPren (dietary supplement),
• Lipoic acid,
• Tykveol.

These drugs protect against cardiac disorders and vascular pathologies. They are also an excellent prevention of depression and arthritis.

Cardiovascular diseases are a major medical problem. They are the ones that most often lead a person to death, and it is for them that scientists around the world are tirelessly looking for cures.

It is now known that the key cause of heart attacks is the adhesion of cholesterol plaques to the walls of blood vessels and the formation of blood clots from the same cholesterol. To combat low-density lipoproteins (cholesterol), back in the 70s of the last century, Japanese scientist Akiro Endo developed a special drug. True, he did not receive any money for his discovery, but pharmaceutical companies, which, based on the scientist’s invention, began to produce synthetic statins, became rich.

To date, 6 types of statins are known. These are Atorvastatin and Rosuvastatin, Pravastatin and Fluvastatin, Simvastatin, as well as a combination of Simvastatin and Ezetimabe. Thanks to extensive advertising, these incredibly popular drugs are considered the best remedies for vascular problems and the development of heart attacks. It’s no wonder that today every 4th person in the world who has reached the age of 45 takes them!

But statistics show that an increase in statin intake has not led to a decrease in heart attacks and strokes. On the contrary, the number of people facing complications of cardiovascular diseases is steadily growing. All this leads to the idea that statins are not able to resist vascular damage and even worsen the existing situation. And today there are many prerequisites for refusing to take statins. Let's study them.

Why you shouldn't take statins

1. Does not relieve cardiovascular diseases
The main purpose of statins is to reduce cholesterol levels, which is a serious factor in the development of cardiovascular pathologies. However, high cholesterol, although important, is by no means the only cause of heart disease. These diseases are caused by the development of diabetes, constant stress, lack of physical activity, arterial hypertension, smoking and many other serious factors. Is this why taking statins does not improve statistics on reducing heart and vascular diseases?

Medical experts have even come to the conclusion that only 1% of patients benefit from taking statins. That is, out of 100 patients who regularly take these drugs, the risk of heart attack or stroke is seriously reduced in only one person! The fact is that when advertising these pharmacological agents, manufacturers appeal to indicators of the so-called “relative risk”, which say absolutely nothing about the actual danger threatening them.

2. Reduce Coenzyme Q10 levels
It turns out that long-term use of cholesterol-lowering drugs leads to depletion of Coenzyme Q10 reserves. But this enzyme is called the element of health and youth, since thanks to Coenzyme Q10, the energy level in the body is maintained and cellular respiration is carried out. But as the reserves of this enzyme are depleted, serious changes occur in the body: muscles become flabby, skin gradually fades, hair dries out, and nails break.

But this is not the most dangerous thing. Few people understand that the so-called “bad” cholesterol does not exist in nature! Problems for the body are created by the oxidized version of low-density lipoproteins, and cholesterol oxidation occurs only when the level of a powerful antioxidant called Coenzyme Q10 decreases in the body. That is, by taking statins, we not only do not prolong our life, but on the contrary, we provoke dangerous conditions that can lead to death! Can this be avoided? Of course, you can, but to do this, you need to take nutritional supplements containing Coenzyme Q10 at the same time as statins. And people who have crossed the 40-year mark should replace Coenzyme Q10 with the drug Ubiquinol.

3. Reduce vitamin K2 levels
The results of the studies published in the journal Clinical Pharmacology surprised and puzzled the scientific community. If previously there was no doubt that statins remove “bad” cholesterol from the body and reduce the likelihood of atherosclerosis, then a study by Swedish scientists showed that this is not so. Moreover, evidence has emerged that statins provoke the development of heart failure! And the main physiological mechanism leading to such consequences is a decrease in the level of vitamin K2 in the body.

It turns out that vitamin K2 is the main regulator of calcium. It not only delivers calcium to our bones and teeth, but also removes excess of this trace element from the arteries and soft tissues. A decrease in the level of this vitamin can create serious problems for the body, triggering the development of calcification - a condition in which liquid calcium salts turn into a solid state. Thus, vitamin K2 deficiency leads to the appearance of kidney stones, the development of osteoporosis, cardiovascular diseases, heart attack and stroke. This problem should be combated by supplementing statin treatment with taking a multivitamin complex containing vitamin K2.

4. Reduce the production of ketone bodies
Statins lower cholesterol levels by inhibiting the liver's production of certain enzymes. However, this process also has a reverse, extremely negative side. From these enzymes, the body produces the substance Coenzyme Q10, which is much needed by the body, as well as ketone bodies, which nourish the components of the body’s cells - mitochondria. These same mitochondria are real energy storehouses that support our vitality. With a reduction in their number, metabolic processes slow down significantly, which leads to serious health problems and the gradual decline of the body. And if to replenish Coenzyme Q10 during treatment with statins, it is enough to take supplements with this enzyme, then to replenish the reserves of ketone bodies you will have to go on a special ketogenic diet.

5. Increase the risk of pathologies
Given that statin use seriously depletes the body of nutrients by minimizing levels of Coenzyme Q10, vitamin K2 and ketone bodies, this process leads to the development of serious diseases over time. Let's list some of them.

Cancer
A study by Israeli scientists showed that taking drugs from this group for 10 years or more doubles the risk of breast cancer and carcinoma. Moreover, with an increase in the accumulated dose of the drug, the likelihood of developing prostate cancer significantly increases.

Diabetes
If you take statins for a long time, the likelihood of developing diabetes increases 10 times. Moreover, these drugs trigger several pathogenic mechanisms at once, leading to this dangerous disease. In particular, they increase glucose levels, because as a result of inhibition of enzyme production by the liver, this organ is forced to send sugar back into the body. Moreover, by removing vitamin D from the body, statins increase insulin resistance.

Neurodegenerative pathologies
Our brain is approximately 25% cholesterol and constantly needs to be fed with this lipoprotein to maintain connections between neurons. And if, with long-term use of statins, the amount of cholesterol in the body decreases, a person begins to have memory problems. However, that's not all. To date, it has been proven that ketone bodies protect the body from serious neurodegenerative diseases (Alzheimer's disease or Parkinson's disease). Accordingly, taking statins, which reduce the production of these bodies, significantly increases the risk of each of these diseases.

Diseases of the musculoskeletal system
When taking the medications in question systematically, the likelihood of developing myalgia, seizures, or even autoimmune muscle diseases increases. According to scientists, the cause of such pathologies may be a violation of protein metabolism, which prevents oxidative processes in muscle tissue.

Is there an alternative to statins?

You need to understand that taking statins is by no means the only way to lower cholesterol levels and strengthen the cardiovascular system. There are several useful recommendations that, if followed, will protect you from cholesterolemia and atherosclerosis. Here are some of them:

• completely avoid foods containing fructose, avoid sugar and light carbohydrates if possible, and minimize the consumption of grains containing gluten;
• try to eat mostly raw foods;
• give up vegetable oils and harmful trans fats, replacing them with healthy olive and coconut oil. Remember, olive oil should only be consumed cold;
• Try to eat fermented foods daily, such as sauerkraut, sour cucumbers, kefir, whey or yogurt. This will increase overall immunity and improve the digestive process, which means it will contribute to heart health;
• Get outside more often in sunny weather to maintain your vitamin D levels. This vitamin plays an important role in preventing the formation of cholesterol plaques;
• Regularly consume sea fish, shrimp, krill oil and other foods rich in Omega-3 polyunsaturated fatty acids. Research shows that 500 mg of Omega-3 per day can reduce the level of “bad” cholesterol in the blood and increase the level of beneficial HDL;
• take care of proper rest so that your sleep lasts approximately 8 hours a day;
• stop smoking and drinking alcohol;
• exercise regularly, and introduce high-intensity exercises performed at intervals into your exercise program;
• Practice stress management techniques.

These simple rules will allow you to prevent an increase in the level of bad cholesterol without taking statins, which in fact turned out to be not such safe drugs.
Health to your heart!

This information is provided for informational purposes only, and does not serve as a basis for making any drastic decisions without consulting your doctor.

Statins are powerful medications that help lower cholesterol levels. The latest generation of statins, unlike other groups of drugs, act not only to lower cholesterol, but also increase the production of so-called “good” cholesterol.

They are most often prescribed in severe cases, when there is a risk of developing myocardium due to elevated cholesterol levels, and the effect of their use is noticeable after a month of regular use.

What are statins: indications for use

Drugs in the statin category affect lipid metabolism, namely, they inhibit the enzyme that contributes to the formation of cholesterol. In addition, statins improve the condition of the inner layer of vessel walls at an early stage - when it has not yet been diagnosed, but cholesterol deposition has already begun.

The indication for prescribing statins is high cholesterol levels (hypercholesterolemia), subject to the ineffectiveness of the use of non-drug drugs and the risk of developing and, as well as hereditary hypercholesterolemia when the diet is ineffective.

Note! The main indications for the use of statins are the active development of atherosclerosis and an increased risk of blockage of blood vessels.

Despite the effectiveness of the statin series of drugs, there is still no reliable information on the safety of patients taking such drugs. Some studies suggest that the side effects outweigh the benefits of statins used to prevent cardiovascular disease.

However, there are certain groups of patients for whom taking statins is mandatory:

• For the purpose of secondary prevention after a stroke or heart attack;
• For coronary artery disease to prevent the development of heart attack or stroke;
• In acute coronary syndrome;
• Condition after reconstructive operations on the heart or blood vessels;
• At .

Statins are prescribed for preventive purposes to people over 40 years of age who have pathologies of the cardiovascular system, as well as to people who have relatives who died suddenly from heart disease.

Anticholesterol drugs are prescribed to patients in order to increase their life expectancy. However, this does not mean that statins should be prescribed to all patients without exception who suffer from arterial hypertension or. Only if, within several months, it is not possible to reduce cholesterol through diet and lifestyle adjustments, the doctor decides to use statins.

Classification of statins

The drugs of the statin series can be classified in several ways: by origin, by generation and by the number of dosages.

Statins are divided by generation:

• First generation: Lovastatin, Cardiostatin.
• Second generation: Fluvastatin, Simvastatin, Pravastatin.
• Third generation: Atorvastatin, Cerivastatin.
• Fourth generation: Rosuvastatin, Pitavastatin.

Based on their origin, statins are divided into natural and those made from synthetic raw materials:

• Synthetic: Fluvastin, Cerivastatin, Atorvastatin, Pitavastatin, Rosuvastatin.
• Semi-synthetic: Pravastatin, Simvastatin.
• Natural: Lovastatin.

All statin drugs are prescribed in a certain dosage:

• High-dose (40-80 mg) – Lovastatin, Atorvastatin, Fluvastin.
• Medium dose (10-40 mg) – Pravastatin, Simvastatin, Rosuvastatin.
• Low dose (up to 8 mg) – Pitvastatin.

High-dose drugs have the best effect and are usually quite well tolerated.

Medium-dose Rosuvastatin, if necessary, can be prescribed in high dosages, although its use gives a good effect in lowering cholesterol and most often no increase in doses is required.

Pitavastatin is prescribed in minimal doses, which is why the risk of side effects is much lower than that of its class analogues.

Statins: review of popular drugs

The latest generation of statins can be divided into five groups, which differ in the active substance underlying the drug.

The cost of the latest generation statins can vary from 200 rubles. up to 2000 rubles, but it is worth noting that cheaper analogues are often in no way inferior to more expensive drugs. Therefore, if it is impossible to buy an expensive medicine prescribed by a doctor, you just need to ask the therapist to replace it with a drug that is more suitable for the patient in terms of cost.

Contraindications and side effects

Statins, like any medications, have a number of contraindications for which taking them is strictly prohibited:

• For kidney pathologies;
• With cataracts or prerequisites for its development;
• In case of dysfunction of the thyroid gland;
• In case of individual intolerance to the components of the drug;
• During pregnancy, as well as during its planning;
• In cases of liver dysfunction;
• In case of disruptions in the endocrine system.

Important! You cannot take the drug for preventive purposes on your own without a doctor’s prescription and preliminary research.

Side effects from taking statins occur in a small number of patients, provided that the dosage prescribed by the doctor is followed. There may be:

• Drowsiness;
• Increased heart rate;
• Memory impairment;
• Stool disorder (either);
• Pain in muscles and joints;
• Itching of the skin.

Note! You cannot take statins with juice, because it contains substances that slow down the breakdown of the drug in the blood, which can lead to toxic reactions.

Combining statins with alcohol and certain groups of antibiotics is not recommended to avoid toxic effects on the liver.

Harm and benefits of statins

There is still debate in medical circles about the dangers and benefits of statins. There are many advantages that speak in favor of statins, but some researchers question the effectiveness of statins against the background of the occurrence of disorders in the body.

However, the latest generation of statins have a number of advantages that make them the most effective drugs for combating atherosclerosis:

• Reducing mortality from heart pathologies in patients by 40% already in the first five years of taking the drug.
• Reduces cholesterol by up to 50% with regular use.
• Reducing the risk of heart attack and stroke by 30%.
• The latest generation of statins does not have a significant toxic effect on the body, and the level of side effects is extremely low.
• A large selection of drugs, which allows the patient to purchase medicine at an affordable price.

Statins can cause harm if the drugs are taken incorrectly - non-compliance with the dosage, independent uncontrolled use, etc. Only a doctor can assess and minimize the risks when taking statins, who must monitor the cholesterol level in the blood throughout the course of treatment and prevent it from falling below normal.

How to choose statins

The decision about which statins should be taken and whether to take them at all must be made by the patient himself, but always guided by the opinion of doctors. Reviews from other patients when evaluating any particular drug are not indicative, because Taking generic drugs does not affect the well-being of patients in any way. Improvements in cholesterol levels are visible only on a lipid profile, so only specialists can give an accurate answer about how certain generics work.

Only a doctor can prescribe statins for high cholesterol, guided by the patient’s general condition, age, gender, weight, bad habits and diseases of the cardiovascular system.

If the doctor prescribes drugs that are too expensive, you can ask him to select cheaper analogues. But it is still recommended to take original imported drugs, because domestic generics are of lower quality.

When prescribing statins to older people, it should be taken into account that their use can provoke myopathy if taken together with medications for gout.

In case of chronic liver diseases, it is better to give preference to Rosuvastatin or Pravastatin, because these medications do not have a toxic effect on the liver.

Despite some side effects from taking statins, the benefits of using these drugs are quite obvious for patients with progressive atherosclerosis of the coronary vessels, because According to statistics, generics actually prolong life. If a patient has elevated cholesterol levels without obvious signs of vascular damage, then it is better for him to adjust his diet and adjust his lifestyle rather than take potent medications.

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Today, 5 main classes of drugs are used to treat conditions that are accompanied by the accumulation and deposition of cholesterol (C). Among them, cholesterol statins deserve special attention, the benefits and harms of which have been debated since the 50s of the twentieth century. The passions around them do not subside to this day, and the history of the creation of the drugs resembles an exciting adventure novel.

It was said back in the middle of the last century that drugs that block cholesterol synthesis will do more harm to the body than good. After all, cholesterol is a plastic component - it is part of the cell membrane, participates in the synthesis of sex hormones and adrenal hormones, cholic acids. Skeptics doubted that it was possible to create drugs that would be strictly controlled, capable of eliminating only excess cholesterol, without interfering with lipid metabolism.

General information

Statins for lowering cholesterol are blockers of HMG-CoA reductase, a “bioactivator” of the initial stages of the reaction of cholesterol synthesis from precursor substances. A group of scientists from Japan, under the leadership of Akira Endo, conducting experiments to improve penicillin, noticed back in 1971 that some types of microscopic fungi produce not only antibiotics, but also substances that interfere with the creation of cell membranes in bacteria and disrupt the metabolism of lipids necessary for their growth and vital activity. Thus, a component of bioactive substances called Compactin was obtained from mold that produces antibiotics. It took more than 15 years before the first commercial statin, Lovastatin (Mevacor), which was a specific inhibitor of HMG-CoA reductase, appeared on the world pharmaceutical market. Almost simultaneously with Akira Endo, statins were also obtained in a research laboratory, the British pharmaceutical company Beecham, famous for its work on improving penicillin.

But in 1980, the Japanese pharmaceutical company Sankyo Co stopped all research, without explanation. On Wednesday, rumors leaked to scientists that intestinal cancer was discovered in experimental animals as a result of ongoing trials of statin therapy. The possible carcinogenic effect of statins forced the conservative Japanese company to curtail development.

The company's decision to stop introducing statins into medical practice could cost the lives of patients with familial hypercholesterolemia, the most common hereditary disease in the world. Without treatment of the disease, patients experience early and rapid development of atherosclerosis, heart attacks, strokes, aortic stenosis (narrowing) and sudden death.

According to Professor John J.P. Kastelein (Netherlands), who has been dealing with the problem of treating familial hypercholesterolemia for many years, without statins the outcome of the disease is as bad as in patients with AIDS.

It was only thanks to the support of practicing clinicians who saw firsthand the effectiveness of statins, and research from Merck, that statins were championed.

It has been scientifically proven that statins:

• do not exhibit side effects, much less carcinogenic properties, if the therapeutic dose of the drug is observed;
• lower cholesterol to target values ​​much faster than diet therapy and drug therapy with other types of lipid-lowering agents;
• reduced mortality from heart failure by 42%;
• even aggressive therapy with statins does not disrupt the body’s lipid balance;
• helps stop the progression of atherosclerosis;
• reduce the absorption of exogenous cholesterol;
• affect inflammation and immune activation responsible for the progression of chronic heart failure.

Long-term studies have proven the need for early use of statins, the use of high doses of drugs and long-term treatment.

Indications for use

Statins are prescribed for hereditary or acquired high cholesterol levels.

Hypolipidemics are prescribed for:

• prevention of chronic heart failure and stroke in risk groups;
• rehabilitation after myocardial infarction;
• rehabilitation in the postoperative period (bypass surgery, stenting, angioplasty);
• treatment and prevention of ischemic heart disease;
• reducing the rate of development of atherosclerosis;
• treatment of non-alcoholic fatty liver disease;
• metabolic disorders (obesity, diabetes);
• therapy for hypercholesterolemia – high hereditary or heterozygous.

In modern treatment of chronic heart failure and familial hypercholesterolemia, statins are included in a comprehensive treatment regimen.

How to use?

The dosage and duration of use of statins varies between generations. On average, the recommended daily dose of drugs is 20-40 mg. An increase in the amount (~ 80 mg) is indicated when high cholesterol levels are reduced. The table shows daily doses for modern statins:

Since statins have varying degrees of lipophilicity, their ability to penetrate cell membranes is also different. This factor causes side effects, which affects the dose of the drug.

Since the synthesis of cholesterol depends on the time of day, it is recommended to take the drugs after dinner, before bed.

If the expected effect when using a therapeutic dose is not achieved, then:

• the dosage is increased;
• treatment is supplemented with a special diet and other medications;
• replace one statin with another, stronger one.

There are therapeutic and maintenance dosages. After the cholesterol level has returned to normal, the patient is transferred to a maintenance dose of a statin.

It interacts with medications in different ways. Therefore, it is prescribed individually, depending on many factors, including the drugs that the patient must take simultaneously with statins. You cannot take the drug under discussion with drugs for the treatment of HIV infection (protease inhibitors, Cyclosporine, Gemfibrozil); they increase the statin dose by 5-6 times.

They may increase the effect of the anticoagulant Warfarin. Their effectiveness is reduced by the simultaneous use of Erythromycin. It enhances intestinal motility and accelerates the elimination of statins from the body.

Mechanism of action

Pharmacodynamics (mechanism of action) of statins is the blocking of a glycoprotein that catalyzes the production of cholesterol in cells capable of synthesizing it (in the reproductive organs, gastrointestinal tract, liver, adrenal glands). They also increase the number of low-density lipoprotein (LDL)-sensitive receptors in hepatocytes, thereby reducing the activity of these lipoproteins in the blood. Statins lower cholesterol by blocking the synthesis of LDL precursors - very low density lipoproteins. Statins inhibit triglyceride synthesis to a somewhat lesser extent. Since their amount in the blood decreases, the level of anti-atherogenic substances - high-density lipoproteins - increases accordingly. This mechanism determines the activity of statins as a lipid-lowering and atherosclerotic drug.

The great advantage of using statins is that they do not affect the synthesis of steroid hormones in the adrenal glands and gonads.

In addition, statins reduce the absorption of cholesterol in the gastrointestinal tract, which enters the human body with food. In addition to the pronounced lipid-lowering effect, statins have an effect on the endothelium (inner surface) of blood vessels. Statins improve migration and balance the process of “creation/destruction” of smooth muscle cells and epithelium, thereby improving the mechanical and plastic characteristics of the vascular wall.

The drugs not only improve the structure of the endothelium, but also affect the synthesis of cytokines - substances that contribute to the occurrence of inflammatory processes. The anti-inflammatory mechanisms of action of statins reduce the risk of adherence and growth of cholesterol plaques. The agent under discussion also inactivates macrophage cells, which synthesize substances that loosen cholesterol plaques and increase the risk of their rupture and vascular thrombosis.

Statins indirectly affect the volume and speed of blood flow, eliminating the factor in the development of tissue ischemia. The mechanism of their anticoagulant action is complex and multi-stage. Such a variety of positive effects of statins on the body have made the drugs leaders in the fight against hypercholesterolemia.

Classification of statins for cholesterol

There are several principles for grouping statins, depending on:

1. The origin of drugs is divided into:

• natural, obtained from lower fungi Aspergillus terreus;
• semi-synthetic, obtained as a result of chemical modification of natural compounds;
• synthetic, obtained as a result of chemical reactions, analogues of natural statins.

2. For drugs that have a chemical structure in their structure:

• decalin ring;
• a fluorophenyl group;
• methyl group.

Drugs are also divided by generation, but some scientists consider dividing statins into generations incorrect, since they are very similar in their properties and effectiveness, and group them depending on the chronology of release.

List of drugs - statins

All drugs have not only an international name, but also trade names:

Statins are gradually losing ground. Clinical studies of new lipid-lowering drugs are already being conducted, the pharmacodynamics of which are based on completely different mechanisms.

But for now, statins are indispensable. In order to increase their effectiveness and reduce side effects, scientists from Amsterdam proposed to supplement the treatment regimen for familial hypercholesterolemia with the new drug Praluent (Alirocumab). However, statins still lead in terms of sales and frequency of prescriptions.

Statins for cholesterol - benefits

The main benefit of using statins is their ability to lower cholesterol.

In addition, the drugs have an effect on:

• vascular endothelium, maintaining its integrity and smoothness, which prevents cholesterol from “clinging” to surface irregularities and forming plaques;
• synthesis of inflammatory cytokines. By eliminating inflammation, statins reduce the risk of destruction of the vascular endothelium, the formation of blood clots, dysfunction of the heart muscle, and reduce the level of soluble protein, which is associated with the relapse of chronic cardiac pathologies and the progression of atherosclerosis;
• blood composition. By normalizing the blood clotting process, statins reduce the risk of blood clots;
• synthesis of nitric oxide. This compound has a relaxing effect on the muscle layer of the blood vessel wall, increasing blood flow;
• condition of cholesterol plaques. Statins have a stabilizing effect on the condition of atherosclerotic plaques, preventing their destruction and separation with the formation of a blood clot. The body adapts to the presence of dense plaques by creating additional blood flow pathways. With long-term statin therapy, the size of the plaques gradually decreases.

There are a number of other positive properties of statins, but they are rarely listed in articles, since the mechanism has not yet been sufficiently studied, and the facts have not been confirmed by scientific research. For example, a number of articles noted the effectiveness of statin therapy in the complex treatment of diabetes mellitus. The drugs not only reduced glucose activity, but also minimized the risk of developing coronary artery disease and other pathologies of the circulatory network. The drugs, by increasing blood flow, restored tissue trophism, eliminating oxygen starvation and necrosis. It is noted that when patients with diabetes are treated with statins, the risk of developing diabetic retinopathy is reduced.

In addition, scientists in separate publications note the positive effects of statins. This:

• reducing the likelihood of coronary artery spasm;
• stimulating the formation of new coronary blood vessels (angiogenesis);
• antioxidant;
• inhibition of the progression of Alzheimer's disease and cyanotic dementia;
• antiarrhythmic and antihypertrophic;
• immunosuppressive.

In addition, statins have an inhibitory effect on some tumors by interfering with DNA reproduction and cell proliferation. The drugs stimulate the synthesis of osteoblast growth factor and have a beneficial effect on the condition and function of the thyroid gland.

But, since statins are long-term drugs, when they were created, not only the effectiveness of treatment was taken into account, but also their safety.

Side effects and harm

In addition to benefits, statins also cause harm, which is most often caused by non-compliance with the duration of use and exceeding the dosage of drugs. The first generation statins, despite the fact that they were of natural origin, had an impressive list of side effects and contraindications.

Generation III and IV statins have fewer side effects and, with the exception of isolated cases of muscle cell necrosis (rhabdomyolysis) and myopathy, according to some scientists, their use is no more dangerous than aspirin treatment.

However, with long-term treatment with high doses of statins, the following side effects are observed.

1. From the gastrointestinal tract:

• dyspeptic manifestations;
• defecation disorders;
• loss of appetite;
• inflammation of the pancreas;
• flatulence;
• fatty and fibrous degeneration of the liver;
• anorexia;
• increased levels of liver enzymes in the blood;

2. from the nervous system:

• mood swings;
• sleep dysfunction;
• memory impairment;
• dizziness and headache;
• convulsions;
• increased risk of developing Parkinson's and Alzheimer's diseases;

3. from the musculoskeletal system:

• muscle pain;
• myopathy;
• rhabdomyolysis;

4. from the genitourinary system:

• sexual dysfunctions;
• tubulopathy;
• proteinuria;
• renal failure.

However, these side effects do not occur so often (1-2% of cases) to refuse treatment with statins, and for many patients these drugs are the only option for prolonging life. In addition, the side effects of statins can be significantly reduced or completely eliminated if you take 200-300 mg/day of Conzym Q10 with them.

List of contraindications for use

The instructions for each drug contain a list of contraindications, complete or partial.

• pregnancy;
• under the age of 16-18 years. As an exception, for hereditary hyperlipidemia, statins are allowed to be used from 8-9 years of age;
• persistent increase in the level of kidney enzymes in the blood;
• acute renal failure;
• allergic reactions to drugs.

Statins are not a panacea and, with normal cholesterol levels, their use causes side effects of varying severity.

Since the benefits and harms of the drugs under discussion are still being debated in scientific circles, there are many recommendations on how to lower cholesterol without statins. As an alternative, natural cholesterol statins and drugs that have a similar effect are offered.

Natural statins for cholesterol

Some plants and foods have effects similar to statins. For example, red yeast rice is sold as a dietary supplement, which contains natural statins, but also has side effects.

A good alternative to statins is:

• low carbohydrate diet;
• eating varieties of sea fish rich in Omega 3 fatty acids;
• fiber-rich vegetables and fruits;
• greens rich in niacin;
• berries and fruits containing a natural antioxidant - vitamin C;
• garlic and turmeric, containing natural analogues of statins.

In all these products, the proportion of natural statins is quite high. With strict adherence to diet therapy in combination with drug therapy, you can count on the same effect in the absence of side effects.

In addition to useful foods, natural statins are found in such medicinal plants as:

• plantain;
• fenugreek;
• Dioscorea Caucasica;
• golden mustache or fragrant conflict;
• mistletoe;
• Sophora japonica fruits;
• blue cyanosis;
• dandelion root, etc.

Diet therapy and herbal remedies cannot quickly normalize cholesterol levels in the blood, so they are used as elements of complex therapy together with other drugs that have the ability to inhibit the cholesterol synthesis enzyme.

How to lower cholesterol without statins?

In addition to the methods listed above to naturally lower cholesterol, you can use the following lipid-lowering drugs:

• fibrates – Lipantil 200M, Traykor, Lipanor;
• sequestrants - Kolestyramine, Colestipol, Colesevelam;
• niacins - Nicotinic acid, Nicotinamide.

The decision on the choice of drugs to lower cholesterol levels is made only by the doctor. The effectiveness of statins has been proven by long-term (more than 5 years) randomized studies conducted in a number of countries. Therefore, if your doctor has prescribed statins, you should not replace them with similar drugs yourself.