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Study Confirms The Beneficial Role Of Statins

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A meta analysis published online in The Lancet confirms the beneficial role of statins in the prevention of vascular disease. Research has shown that statins may be beneficial even in patients without any history of vascular disease. This demonstrates again that the benefits of these drugs far outweigh their adverse effects.

Statins are drugs that reduce cholesterol by inhibiting HMG-CoA reductase, an enzyme with a role in the production of cholesterol in the liver. So far statins were recommended as secondary prevention in patients treated with other cardiovascular protective drugs (betablockers, etc.). Moreover, studies have shown that statins reduce mortality and morbidity in patients with cardiovascular disease. But use of these drugs as primary prevention has been so far controversial.



Researchers have conducted a survey in which they enrolled 175,000 individuals in 27 randomized trials. Scientists then observed the effect in patients treated with statins and those without statins. Results showed that for every 1 mmol / L reduction in LDL cholesterol, the risk of a cardiovascular event decreased by 21% in individuals with 5-year risk of major vascular events. This new finding will involve changing the current treatment guidelines for patients with cardiovascular disease risk.

Like any drug, statins have different side effects. These include rhabdomyolysis (breakdown of skeletal muscle), myalgia, hyperglycemia, cancer, neuropathy, increased levels of liver enzymes, etc.. The authors noted that administration of statins was not associated with risk of death from cancer or non-vascular causes. The conclusion was that although statins increase the risk of  hemorrhagic stroke and diabetes side effects do not outweigh the benefits.

The mechanism of action of statins is to block an enzyme involved in cholesterol production in the liver, ie the HMG-CoA reductase. There was some controversy regarding the administration method of statins, since cholesterol production takes place during the night. Therefore, since statins have a short half-life, it is recommended to administer them before sleeping to have maximum effect. However, it seems that this only applies for simvastatin. There is no difference in terms of administration for atorvastatin for example.

The major role of statins is to combat atherosclerosis, the leading cause of cardiovascular disease. Studies have shown that statins prolong the lives of patients through several mechanisms, such as improved endothelial function, modulation of inflammatory responses, maintain plaque stability and prevent thrombus formation. Moreover, it appears that statins have a beneficial role in other situations, such as lung cancer, prostate cancer, cataracts, dementia. Studies regarding the beneficial role of statins in these diseases are undergoing.