Hyperlipidemia is an important chronic disease that causes atherosclerosis and increases the risk of cardiovascular disease, and with age, the proportion of hyperlipidemia problems will become higher and higher, survey data show that among adults in China, about 40% of them have the problem of dyslipidemia, and want to minimize the health risks caused by hyperlipidemia, in terms of drug treatment, statins are still one of the most widely used basic drugs, especially in regulating LDL cholesterol standards, Statins remain the drug of choice for the vast majority of people.
"What if I eat this medicine for a long time, can't cure the problem, and eat a bunch of side effects?" This is what many friends often say, because of the fear and dare not use the drug situation is actually not uncommon, how to rationally use statins to strengthen blood lipid control? And how to minimize the possible drug safety risks caused by long-term medication? Today's popular science article, let's talk about this topic with you.
Long-term use of statins may bring adverse reactions
Statins achieve a lipid-lowering effect by inhibiting the synthesis of cholesterol in the liver and are a hypolipidemic drug with a clear effect. At the same time, it is necessary to know that the effect of statins is not to take drugs for a period of time to "cure" hyperlipidemia, and if you want to stabilize and control blood lipid levels, you generally need to take drugs for a long time. In the process of long-term medication, the following adverse reaction risks should be worth noting -
Impaired liver function: Taking statins, some patients will have adverse reactions of elevated transaminases, and if this situation is not adjusted in time, it may even bring irreversible drug-induced liver damage.
Muscle pain: Muscle pain or muscle weakness caused by statins tends to be symmetrical and may occur in larger muscle groups such as the hips, back, thighs, calf muscles, etc.
Elevated blood sugar: In the process of long-term use of statins, it is also possible to have a certain adverse effect on blood glucose metabolism, which in turn leads to the problem of elevated blood sugar.
Do a good job in 5 aspects to reduce the risk of statin medication
After reading the above risks of adverse reactions, it is estimated that many friends are even more afraid to take drugs, but we first need to make it clear that there is a certain probability of adverse reactions to any drug, most patients take drugs, are safe to tolerate, only a small number of patients take adverse reactions, such drugs may be used in the clinic for a long time. Therefore, for all kinds of statins that have been used for many years, their safety is no problem for most people.
Of course, the occurrence or absence of adverse reactions is the difference between the patient himself or herself, so it is very important to understand the precautions for the application of statins for medication safety. If you want to do a good job in the long-term medication safety of statins, the following 5 precautions are worth our understanding and attention.
1. Reasonable selection of statins
Reasonable choice of drugs can not only better control blood lipid levels, but also better reduce the risk of adverse reactions. There are many types of statins, from the structural properties of the drug can be divided into lipophilic and hydrophilic statins, for the elderly, it is recommended to use rosuvastatin, pravastatin and other hydrophilic statins, which help to reduce the risk of adverse drug reactions.
From the metabolic pathway, there are atorvastatin, simvastatin metabolized by the liver drug enzyme CYP3A4, there is also rosuvastatin metabolized by CYP2C9, and pravastatin that is not metabolized by liver drug enzymes, etc. For friends who take a variety of drugs, attention should be paid to the reasonable choice of drugs to avoid the risk of adverse reactions caused by drug interactions.
2. Reasonably set the goal of lowering blood lipids
The dosage of statins is closely related to the incidence of adverse drug reactions, and the dose of drugs is high, the intensity of lipid reduction is large, but the risk of adverse reactions is also higher. Therefore, we should first understand our own cardiovascular risk situation, combine specific risk assessment and stratification, and set reasonable lipid control goals.
In patients with existing cardiovascular disease problems, the control goal of LDL cholesterol should be less than 1.8 mmol/L, which is better if the problem is more serious or the body can easily tolerate it to drop below 1.4; but for those without cardiovascular disease, the assessment is high-risk, and this value can be controlled to less than 2.6 mmol/L.
Therefore, after understanding their own blood lipids and reasonable blood lipid control goals, on the basis of controlling blood lipids, try to choose low-dose statins to take to reduce the risk of side effects of statins.
3. Combined medication to strengthen blood lipid control
If you take a low-dose statin and your lipid control is not up to standard, is it necessary to further increase the dose of statins or add another lipid-lowering drug? In most cases, statins plus another lipid-lowering will be a better choice, statin dose doubled, will further reduce blood lipids by about 6%, and if statins combined with eschermebu, Haibomaibu and other cholesterol absorption inhibitor drugs, it will strengthen the lipid-lowering effect of about 10% to 15%, but also reduce the risk of adverse reactions that may be brought about by increasing the dose of statins.
4. Pay attention to life conditioning intervention
Do a good job of blood lipid regulation, it is not as simple as taking medicine every day, if you want to control the level of blood lipids, try to reduce the dose of drugs, but also be able to protect cardiovascular health, maintain a reasonable and healthy lifestyle is particularly important. Low-fat and low-sugar diet, active exercise, reasonable sleep, attention to maintain a peaceful and optimistic attitude, etc., are the aspects that should be paid attention to in life, for blood lipid regulation, protection of cardiovascular health, have a clear long-term benefit, and it is safer than taking medicine.
5. Pay attention to regular inspections
During the long-term administration of statins, attention should be paid to regular examinations -
Regular check of liver function, if problems are found in time, when the aminotransferase is increased by more than 3 times, the drug is stopped in time, and liver function can be quickly restored after stopping the drug;
Statins cause muscle pain, if timely examination, found that the level of creatine kinase has exceeded the upper limit of 5 times or more, timely discontinuation, muscle pain can also be relieved in time;
Statins taken for a long time, regular check blood glucose, if found to be elevated, actively through diet adjustment and strengthening exercise, do a good job of active control of blood sugar, will also reduce the risk of blood sugar rise to progress to new diabetes.
Therefore, long-term use of statins, regular health examinations, especially with age, for liver and kidney function to do a good job of related examinations, is the top priority to reduce the risk of medication, early detection of problems, early adjustment of medication regimens, can greatly reduce the risk of serious adverse reactions caused by long-term medication.
Statins remain the fat-lowering agent of choice for Chinese
The reason why he says so much is because his statins are still very important for many friends of hyperlipidemia patients, although there are currently some new types of lipid-lowering drugs that continue to come out, but for our Chinese hyperlipidemia patients, statins are still the basic drugs, why so, there are 2 reasons.
First of all, from the perspective of long-term drug costs, statin prices are relatively low, especially through the implementation of the drug collection policy, through the consistency evaluation of the winning generic drugs, the price has dropped to a very low level, many patients only need a few yuan per month for medication costs, it can be said that the cost performance is very high.
Secondly, we Chinese of abnormal blood lipid characteristics, in most cases, the increase in LDL cholesterol is not too large, through the regulation of statins, generally can be controlled to the corresponding level of standards, usually take low and medium doses of statin drugs, can make blood lipids up to standard, and low doses of statins, its safety is still very high, long-term medication brought about by the health benefits, far greater than the risk of adverse reactions.