Statins

Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton  

Introduction

Schematic mechanism of action of statins

Statin medications (also known as HMG-CoA reductase inhibitors) are a class of lipid-lowering medications that reduce illness and mortality in those who are at high risk of cardiovascular disease. They are the most common cholesterol-lowering drugs.

1. Statins are designed to lower low-density lipoprotein (LDL) cholesterol in the blood. They do this by lowering the amount of cholesterol plaque that forms in the arteries.
2. Statins may also inhibit many of the structural and functional components of the arteriosclerotic process. Structural effects include reductions in vascular smooth muscle hypertrophy and proliferation, fibrin deposition, and collagen cross-linking. Among the functional effects are improvements in endothelial function, reduction in inflammatory cytokines and reactive oxygen species, and down-regulation of angiotensin II and endothelin receptors.

There are several different types of statins. The main difference between them is their potency.

Uses

Atherosclerosis diagram

Clinicians use statin medications for the treatment of

• Hypercholesterolemia,
• Hyperlipoproteinemia
• Hypertriglyceridemia
• Atherosclerosis
• Myocardial infarction prophylaxis
• Stroke prophylaxis

Adverse Effects

Grapefruit

Statins are usually well-tolerated, with myopathy, rhabdomyolysis, hepatotoxicity, and diabetes mellitus being the most common adverse reactions.

1. The incidence of myopathy is dose-dependent and may present as diffuse myalgias or otherwise unexplainable muscle tenderness or weakness with reversal upon medication discontinuation.
2. Rhabdomyolysis is the most serious complication of statin use, but its occurrence is rare.

Avoid mixing statins with grapefruit. Grapefruit causes an increase to the side effect of the drugs. This could put you at risk for muscle breakdown, liver damage, and kidney failure. More mild cases can cause pain in the joints and muscles.

Smoking cigarettes should also be avoided when taking statins. Smoking decreases the positive effects of statins. Smokers had a 74 to 86 % higher risk of events.

Physiotherapy Implications

Statins may increase the incidence of exercise-related muscle complaints and in some studies augment the exercise-induced rise in muscle enzymes, but statins do not consistently reduce muscle strength, endurance, overall exercise performance or physical activity.