Statins: what are the side effects of these drugs?

Statins: what is it?

Before talking about statins, we must take a detour to the cholesterol. Cholesterol is a lipidic substance (that is to say: fatty) necessary for the proper functioning of the body: in fact, it participates in the construction of cell membranes, is involved in the synthesis of sex hormones and plays a role in the process of digestion.

In the blood, cholesterol is transported by lipoproteins: LDL (for Low Density Lipoprotein or Low Density Lipoprotein) which transports cholesterol to the organs and HDL (for High Density Lipoprotein or High Density Lipoprotein) which recovers the oxidized cholesterol, i.e. used by the body.

One third of the cholesterol which circulates in the blood is provided by food; the remaining two-thirds are manufactured by the organization. This process is enabled by enzymes, and in particular thanks to the enzyme HMG-CoA reductase.

Statins, kezako? Statins are a family of drugs which inhibit the action of the HMG-CoA reductase enzyme, thereby reducing the endogenous production of cholesterol in the body and (mechanically) the level of cholesterol in the blood (this is called “cholesterolemia”). : they therefore have a lipid-lowering effect.

Statins: in which cases are they prescribed?

Lipid-lowering statins are prescribed in primary prevention in people with an excessively high blood cholesterol level (that is to say: hypercholesterolemia) associated with a significant cardiovascular risk (this concerns smokers, diabetics, the elderly, etc.).

In addition, statins are prescribed in secondary prevention in people who have suffered a myocardial infarction (also known as a “heart attack”), a cerebrovascular accident (stroke), an arteritis of the lower limbs or after the placement of a stent (this is an angioplasty) .

The main drugs of the statin family are:

  • Atorvastatin: Tahor®,
  • Rosuvastatin: Crestor®,
  • La pravastatine: Pravachol®,
  • La fluvastatine : Lescol®,
  • Simvastatin: Zocor®.

Statins: side effects and contraindications

Statins: what are the contraindications? Medicines from the statin family are contraindicated in people suffering from serious hepatic disorders (liver cirrhosis, hepatitis, etc.) as well as in people suffering from serious muscular disorders (myopathies, etc.).

Statins: what are the side effects? Statins are responsible for an elevation of heart enzymes, which can lead to destruction of some liver cells and therefore liver damage.

In addition, by increasing the blood level of creatine phosphokinase (CPK), statins can be responsible for muscle lysis (that is, destruction of certain cells in the muscles), which results in specifically by cramps, muscle pain (myalgia) and / or tendonitis.

To know. Fluvastatin (Lescol®) is the only drug among the statin family to be “sustained release”. However, the side effects associated with statins are (according to some specialists) caused by the sudden delivery of the drug into the body: fewer side effects and better tolerance are thus observed in patients treated with fluvastatin.

And also. Red yeast rice is a natural statin, which also inhibits the action of the enzyme HMG-CoA reductase. It therefore has exactly the same side effects (on the muscles and the liver) as the drugs of the statin family.

Statins: Are They Really Helpful? The cardiologist’s opinion

Dr.’s answer. Mathieu Bernard-Le Bourvellec, cardiologist at the Institut Cœur Paris Center (ICPC) and author of The heart our other brain (ed. Larousse).

Regarding cholesterol, two theories clash in the medical community: some specialists consider that cholesterol is deposited on the walls of the arteries, which forms atheromatous plaque – therefore the first step towards myocardial infarction, while others believe that atheroma plaque fills with cholesterol but this substance is not the cause.

Beyond this controversy, statins do not only lower blood cholesterol levels: these drugs also have an anti-inflammatory effect (known as a pleiotropic effect) which “protects” the atherosclerotic plaque and prevents its rupture. – because by breaking, the atheroma plaque leads to the sudden formation of a blood clot, and it is a heart attack.

Since prescribing statins for patients with high cardiovascular risk, I have seen a decrease in cardiovascular mortality, especially from myocardial infarction. Statins therefore constitute, in my opinion, a good shield against these pathologies.

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