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February 6, 2012
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Statins

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Statins

What are statins, and how do they work?

"Statins" are a class of drugs that lower the level of cholesterol in the blood by reducing the production of cholesterol by the liver. Statins block the enzyme in the liver that is responsible for making cholesterol. This enzyme is called hydroxy-methylglutaryl-coenzyme A reductase (HMG-CoA reductase). Scientifically, statins are referred to as HMG-CoA reductase inhibitors.

Cholesterol is critical to the normal function of every cell in the body. However, it also contributes to the development of atherosclerosis, a condition in which cholesterol-containing plaques form within arteries. These plaques block the arteries and reduce the flow of blood to the tissues that arteries supply. When 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 angina (chest pain) or a heart attack. If the clot occurs on plaques in the brain, the result is a stroke. If the clots occur on plaques in the leg, they cause intermittent claudication (pain in the legs while walking). 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 may also stabilize plaques and make them less prone to rupturing and promoting the development of clots.

The important role of cholesterol in atherosclerosis is widely accepted by scientists. Research from the last few years shows that aggressive cholesterol reduction is more beneficial than modest reductions.

Atherosclerosis is a complex process that involves more than just cholesterol. For example, scientists have discovered that inflammation in the walls of the arteries may be an important factor in atherosclerosis. In addition to lowering cholesterol levels, statins also reduce inflammation, which could be another mechanism by which statins beneficially affect atherosclerosis. This reduction of inflammation does not depend on statins' ability to reduce cholesterol. Furthermore, these anti-inflammatory effects can be seen as early as two weeks after starting statins.

For what conditions are statins used?

Statins are used for preventing and treating atherosclerosis that causes chest pain, heart attacks, strokes, and intermittent claudication in individuals who have or are at risk for atherosclerosis.

Risk factors for atherosclerosis include:

  • abnormally elevated cholesterol levels,

  • a family history of heart attacks (particularly at a young age),

  • increasing age, and

  • diabetes.

Most individuals are placed on statins because of high levels of cholesterol. Though reduction of cholesterol is important, heart disease is complex and, as discussed previously, other factors such as inflammation may play a role. Thirty-five percent of individuals who develop heart attacks do not have high blood cholesterol levels, yet most of them have atherosclerosis. This means that high levels of cholesterol are not always necessary for atherosclerotic plaques to form.




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  • Related Diseases & Conditions

    • Liver Disease
      • Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause; however, common symptoms may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
    • Stroke
      • A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
    • Cholesterol
      • Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, conversely, high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
    • Heart Attack
      • Heart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
    • Rhabdomyolysis
      • Rhabdomyolysis is a rapid deterioration and destruction of skeletal muscle. Some of the causes of rhabdomyolysis include severe burns, muscle trauma, coma, seizures, electrolyte imbalance, medications (statins), viruses, bacteria. Treatment of rhabdomyolysis depends on the cause.
    • Claudication
      • Intermittent claudication, or pain and cramping in the lower leg is caused by inadequate blood flow to the leg muscles. This lack of blood flow causes a decrease in oxygen delivered to the muscles of the legs. Claudication is generally felt when walking and decreases with rest. In severe cases, claudication may be felt at rest. Narrowing of arteries cause claudication. Treatment includes exercise, medication, and in some cases surgery.
    • Your Cholesterol Profile - In Depth
      • Cholesterol is the most common type of steroid in the body. The treatment of elevated cholesterol involves not only diet but also weight loss, regular exercise, and medications. By understanding your cholesterol profile you can better manage your cholesterol levels.
    • Heart Attack Prevention Overview
      • Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack is also a significant cause of heart failure. Learn the risk factors for heart attack such as high blood pressure, diabetes, and other heart conditions. Lowering your risk factor, lifestyle changes, and in some cases medication are the most effective way of preventing a heart attack.
    • Stroke Prevention
      • Stroke is the third leading killer in the United States. Some of the warning signs of stroke include sudden confusion, trouble seeing with one or both eyes, dizziness, loss of balance, and more. Stroke prevention and reatable risk factors for stroke include lowering high blood pressure, quit smoking, heart disease, diabetes control and prevention.
    • High Cholesterol: Frequently Asked Questions
      • Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
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Statins

What is claudication?

Claudication is pain and/or cramping in the lower leg due to inadequate blood flow to the muscles. The pain usually causes the person to limp. The word "claudication" comes from the Latin "claudicare" meaning to limp. Claudication typically is felt while walking, and subsides with rest. It is commonly referred to as "intermittent" claudication because it comes and goes with exertion and rest. (In severe claudication, the pain is also felt at rest.)

What causes claudication?

Several medical problems can cause claudication, but the most common is peripheral artery disease. Peripheral artery disease (PAD) is caused by atherosclerosis, which is a hardening of the arteries from accumulation of cholesterol plaques form on the inner lining of the arteries. This is especially common at branching points of the arteries in the legs. Blockage of the arteries from these plaques cause low blood flow to the muscles in the legs. ...

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