(Cholesterol Lowering Drugs)
Annette (Gbemudu) Ogbru, PharmD, MBA
Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.
- What are statins and how do they work?
- For what conditions are statins used?
- Are there differences among statins?
- What are side effects of statins?
- What are the drug interactions with statins?
- What are some examples of statins approved by the FDA in the U.S.?
What are statins and how do they work?
Statins (or HMG-CoA reductase inhibitors) are a class of drugs that reduce cholesterol in individuals who have dyslipidemia (abnormal fats in the blood) and thus are at risk for cardiovascular disease. Dyslipidemia may involve an elevation of total cholesterol, a reduction of low density lipoprotein (LDL) cholesterol and/or triglycerides, or a reduction of high density lipoprotein (HDL) cholesterol in blood. Statins work by blocking the enzyme in the liver that is responsible for making cholesterol. This enzyme is called hydroxy-methylglutaryl-coenzyme A reductase (HMG-CoA reductase).
Cholesterol is described as a soft wax-like fatty substance that is found in the blood stream and in cells. It is important to note that cholesterol is a naturally existing substance in all individuals from birth and its presence is actually necessary for promoting an overall healthy body. About 75% of cholesterol is produced by the liver and other cells in the body, and 25% comes from food.
Cholesterol can have a negative impact on health, when there is too much bad LDL cholesterol circulating in the blood system. Contributing factors to high LDL levels may be unhealthy foods, genetics, lack of physical activity, and smoking. Triglycerides are a form of body fat that increases due to being overweight or obese, and physical inactivity, amongst others factors. High triglycerides levels may contribute towards heart disease and diabetes. HDL cholesterol is known as good cholesterol as it protects the heart against heart attacks: it is important to have an HDL level greater than 40 mg/dL.
As previously mentioned, cholesterol contributes to cardiovascular disease as well as neurological and peripheral vascular disease. The way this occurs is by atherosclerosis, a condition, where over a course in time, cholesterol builds up in arteries and forms hardened plaques. If plaques rupture, blood clots may form on the plaque and block the arteries. The clots also may dislodge and circulate within the body, block distant arteries, and ultimately reduce the flow of blood and oxygen through the arteries and to organs. Clots situated in the coronary arteries may give rise to angina or a heart attack. Clots in the carotid artery (the artery that supplies blood to the brain) may result in a stroke, and clots affecting the lower extremities such as the legs may result in peripheral arterial disease.
Tips to keep it under control.