It is well known that there is a positive correlation between the levels of cholesterol in
the blood and the risk of heart attacks and strokes. The higher the cholesterol count, the
higher the chances of the arteries in the body, especially those supplying the heart and the
brain, getting clogged up with plaques, leading to narrowing of the lumen and subsequently
death of the organ supplied by the vessels due to poor blood flow.
This problem of raised cholesterol in the blood, most of which is contributed to by synthesis
of the
substance in the liver (the balance
being taken in through the diet as high cholesterol foods such as egg yolk, fatty meats
and butter), is solved very well by the usage of potent chemical substances known
collectively as statins. Statins function by inhibiting the enzyme HMG CoA reductase in
the liver which is involved in the biosynthesis of cholesterol. As the production of
cholesterol by the liver is a continual ongoing process, this results in the statin being
recommended for continual long term use to lower high cholesterol.
Examples of statins in common use are: Mevacor (lovastatin), Pravachol (pravastatin), Zocor
(simvastatin), Lipitor or Lipator (atorvastatin), and Crestor (rosuvastatin). Currently the
most popular statin in use in the world is Lipator.
All is not well in the world of treatment of high cholesterol levels with statins, however.
While statins are extremely effective in the treatment of cholesterol levels, the problem
arises of statin side effects. These statin side effects are common to statins as a group, but
can be more for certain members of the statin family, and less for others. The incidence of
statin side effects also varies depending on the individual taking the statin, and whether the
statin is taken alone or in conjunction with other drugs. Statin side effects, while minimal,
can be sometimes potentially disturbing and can be serious enough to warrant discontinuation of
the drug.
Following is the list of the most common statin side effects.
Muscle pain. This is said to be the most common side effect. This comes on as soreness,
weakness or tiredness of your muscles. This may be so mild as to be a simple discomfort when
walking or can be so severe that it causes pain when climbing stairs. Very rarely, the
condition of rhabdomyolysis may occur, where there is severe muscle damage, leading to liver
and kidney failure and death.
Liver Damage. Sometimes statins cause a rise in liver enzymes. If the increase is mild, it is
said to be safe to continue the drug. Moderate rises usually can be reversed by discontinuing
the drug. Because the effect is different in different people and in different statins, the
doctor may recommend a different statin. Continued use of the drug in the face of a marked rise
of liver enzymes may lead to liver damage. Liver damage may be totally asymptomatic. It is thus
advisable for one to have liver function tests done about 6 week after starting a course of
statins, and monitor these every 3 to 6 months or so.
Gastrointestinal Symptoms. The usual symptoms are nausea, abdominal discomfort, diarrhea or
constipation. These statin side effects, although very common as a whole for all users of all
medicines, are said to be rather rare with statin therapy. It is suggested that statins be
taking in the evening or nights to reduce the incidence of these side effects.
In view of the potential of getting the above side effects, should one then just avoid them
altogether? The answer is no. Currently statins are by far the best and most effective
treatment for the lowering of the blood cholesterol to normal cholesterol levels, far more than
any other measure. If one weighs the pros and cons of statin treatment, it will be obvious that
the risks of getting heart attacks and strokes in an untreated high cholesterol patient far
outweigh the risks of side effects of statin therapy. It is thus suggested that statins be
recommended strongly still for the treatment of high cholesterol, but with the proviso that
there be regular monitoring of blood for liver function tests as well as levels of creatine
kinase, a rise of which indicates muscle damage. We find Lipator or Lipitor to have much less
side effects compared to other statins.
By: tonywong