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Public Science Insights: Why take statins?

Posted Wed, Mar, 08,2017

Statins, currently the most widely prescribed drugs, are the drugs of choice for treating patients who have high cholesterol levels and are at high risk for developing cardiovascular disease. Statins have been shown to significantly lower cholesterol levels and thereby reduce both the risk of cardiovascular disease and mortality.  
 
Statins work by inhibiting an enzyme called HMG-CoA reductase and, as a result, reduce the ability of the liver to produce cholesterol. The beneficial effects of statins are maximized when their use is accompanied by an active and healthy lifestyle, which includes a well-balanced diet and regular exercise.  At least seven different forms of statins are available which vary in their ability to lower a patient’s cholesterol level, their costs, and the negative effects associated with their use.    
 
Like many disease-modifying medications, the use of statins is accompanied by negative or “adverse” effects such as muscle toxicity and increased blood glucose levels. The effect of statins on the muscle can range from relatively minor muscle tenderness to muscle weakness and pain. The most severe form of muscle toxicity, severe myopathy, is unusual and occurs in a very small subset of patients. While patients who use statins may develop diabetes, this risk is thought to be quite small and is out-weighed by the beneficial effects of statins. Patients can vary widely with respect to how they respond to both the beneficial and negative effects of statins. Some of these differences in patient response to statins are due to their family history. Genetic testing has revealed that people who express a defective form of a protein called SLCO1B1, which transports statins into the liver, are more prone to developing muscle pain when they take statins. Other patients who are at a higher risk of developing negative effects to statins are patients who are organ transplant recipients and are taking medications to suppress their immune systems or patients who are taking medications to treat infectious diseases like HIV.  
 
Since cholesterol plays an important role in cellular events that extend beyond our cardiovascular system, statins may be useful in treating other disease states. Many laboratory-based studies indicate that the administration of statins may prevent or reduce the risk of developing diseases such as cancer, Parkinson’s, and Alzheimer’s diseases as well as diseases involving chronic inflammation or autoimmunity. However, the majority of human population studies have thus far failed to provide convincing evidence that statins should be administered to treat these diseases. It is also unclear whether patients taking statins for an extended period of time are protected from developing chronic diseases associated with aging, such as cancer. Since so many people are now taking statins, these questions will continue to be debated, but can only be adequately addressed using well-designed clinical trials.
 
Dr. Hollie Swanson is the author of the recently published paper Current and Emerging Uses of Statins in Clinical Therapeutics: A Review, available for download now in Lipid Insights.

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