The statin class of drugs represents a potent way to decrease cholesterol.  Of all drugs, they are the most potent in lowering LDL cholesterol: bad cholesterol. Other compounds like niacin are the most potent HDL booster and triglyceride lowering agent known.  If life style changes like low cholesterol diets, exercise and supplements do not alter the lipid profile adequately, then statins should be considered. However, they are not without problems. They must be used under physician direction.

The statin class of compounds was discovered by the Japanese over forty years ago.  Statin drugs inhibit the synthesis of cholesterol by inhibiting an enzyme in the liver.  The liver cell senses the decrease and produces a protein, the LDL receptor, which trans-locates to the cell membrane.  It attaches to low and very low density lipoproteins that carry cholesterol in the blood.  The lipo-proteins are absorbed by the liver cell and digested.  Thus, cholesterol is removed from the blood and broken down.

Lowering cholesterol, particularly LDL, and raising HDL improve cardiac risk.  Atherosclerosis, heart attack, stroke and peripheral artery disease are lowered in those with high cholesterol. However, there is a minority view that cholesterol has not been linked to cardiac disease.  They would point to studies comparing several statins with placebo, and no differences are noted in morbidity and mortality.   They question the use of statins. Variability in results may be due to end points.  We need to look at this area to determine what therapy, if any, is really effective.

Statins may also have positive effects on cataracts, hypertension, cancer and inflammatory responses.  Colorectal cancer and prostate cancer and BPH are lowered in those patients taking statins.

There are many statin drugs and they are derived from fermentation or synthetically produced. We do not yet know which the most effective agent is nor which is most cost effective. Side effects are generally benign and few. However, there are some serious ones that occur.  Muscle aches and myalgias are common. Abnormal liver function tests may also be observed and last for quite awhile. GI upset may be seen. The most serious problem is rhabdomyolysis, or myositis.  Here, there is significant damage to skeletal muscles. If massive enough, kidney failure can occur.  These complications are very rare. Nonetheless, there are drug interactions that can increase the risks greatly.  Grapefruit juice and fibrates may increase the risk levels and should be discussed with your physician.

The statins can lower cholesterol and help decrease cardiovascular risk.  Combined with other means, cholesterol can be lowered and atherosclerosis progression slowed.