Q:Why is it important to monitor use of a statin drugs with regular blood test?
A: Statin (a type of drug used to lower cholesterol levels) use should always be monitored for bad side effects. Possible side effect include liver injury, muscle pain and kidney failure. [1]
What is a statin drug?
The statins (or HMG-CoA reductase inhibitors) form a class of lipid lowering agents, used as drugs to lower cholesterol levels in people with or at risk for cardiovascular disease.
Statins lower cholesterol by slowing-down the enzyme HMG-CoA reductase enzyme. Slowing down this enzyme (HMG-CoA reductase) slows down the production pathway of cholesterol synthesis.
Slowing-down this enzyme (HMG-CoA reductase) in the liver invigorates LDL receptors. The LDL- receptors increase elimination of cholesterol (low-density lipoprotein = LDL) from the bloodstream. Resulting in a decrease in blood cholesterol levels. The first results can be seen after one week of use and the effect is maximal after four to six weeks. [2]
Atherosclerosis and heart disease?
Cholesterol is needed for the normal function of every cell in the body. However, cholesterol also lends to the hardening and narrowing of arteries (artherosclerosis).
Atherosclerosis is a condition in which cholesterol-containing plaques form inside the arteries. These plaques block or narrow the arteries and reduce the flow of blood to the tissues that the arteries supply.
When atherosclerotic plaques rupture, a blood clot forms on the plaque, thereby further blocking the artery and reducing the flow of blood. When blood flow is reduced sufficiently in the arteries that supply blood to the heart, the result is chest pain (angina) or a heart attack (MI).
If the clot occurs on plaques in the brain, the result is a stroke.
Plaques and clots occurring on plaques in the leg causes pain in the legs while walking (intermittent claudication).
By reducing the production of cholesterol, statins are able to slow the formation of new plaques and occasionally can reduce the size of plaques that already exist. In addition, through mechanisms that are not well understood, statins also stabilize plaques and make them less prone to rupturing and forming clots. [3]
Should I be on a statin?
Whether you need to be on a statin depends on your cholesterol level along with your other risk factors for cardiovascular disease. If you have high cholesterol, the numbers alone won’t tell you or your doctor the whole story. The decision to start a statin drug depends, in part, on how high your cholesterol is and what your individual cardiovascular risk is over the next 10 years.
Heart Attack Risk Factors?
High cholesterol is only one of a number of risk factors for heart attack and stroke. Your cholesterol level is considered along with other factors including:
* Family history
* Lifestyle
* Blood pressure
* Age
* General health
* Presence of diabetes
* Excess weight
* Smoking
If the only risk factor you have is high cholesterol, you may not need medication because your risk of heart attack and stroke is probably already low. [5]
Bibliography
1.Maron DJ, Fazio S, Linton MF. Current perspectives on statins. Circulation. 2000 Jan 18;101(2):207-13.
2.http://en.wikipedia.org/wiki/Statin
3.http://www.medicinenet.com/statins/article.htm
4.http://www.medicalnewstoday.com/medicalnews.php?newsid=66099
5.http://www.mayoclinic.com/health/statins/CL00010
