In recent days, several friends have asked Huazi the same question, after taking statins, low-density lipoprotein cholesterol (LDL-C) dropped to 1.8mmol/L, should we reduce the dosage?
Huazi said that it is not recommended to reduce the amount of medication, because the vast majority of people's dyslipidemia can not be cured, and continuous medication is needed to control cholesterol and keep it within a safe range. If the amount of medication is reduced without authorization, it is likely to cause cholesterol to rise again, especially for people with atherosclerosis, the effect of statins is not as simple as reducing blood lipids.
First, the harm of elevated LDL-C
In the body's blood lipids, low-density lipoprotein cholesterol (LDL-C) is a very important indicator, and its level can predict the risk of cardiovascular and cerebrovascular diseases. Because LDL-C is the "raw material" of atherosclerosis, when the level rises, it will promote the formation and progression of hardened plaques, which is the pathological basis for coronary heart disease, cerebral infarction, myocardial infarction and other diseases.
Therefore, controlling LDL-C levels can reduce the risk of cardiovascular and cerebrovascular diseases. For healthy people, LDL-C needs to be controlled below 3.4mmol/L; in people with chronic diseases, LDL-C needs to be controlled below 2.6mmol/L; in people who have had cerebral infarction, myocardial infarction, and coronary heart disease, LDL-C needs to be controlled below 1.8mmol/L to prevent disease recurrence.
Second, LDL-C that needs to be controlled by medication
Many people think that LDL-C is the fat in the blood, so eating less or not eating fat, eating vegetarian every day, you can reduce LDL-C. There is nothing wrong with this idea, but only 30% of LDL-C in the human body comes from diet, while the other 70% is synthesized by the human body itself, which is related to human genes and has little to do with being fat and thin. Therefore, many vegetarian and thin people, LDL-C will also exceed the standard.
When strict dietary control is carried out, the body's own LDL-C will increase, so most people with dyslipidemia cannot be reduced by simple dietary control, and must use drugs.
Third, statins can not only reduce blood lipids
Statins are often used to lower cholesterol, which can directly inhibit the synthesis of cholesterol and reduce LDL-C levels in the blood. The vast majority of people have primary elevated blood lipids, can not find a specific cause, can not be cured, can only be controlled by continuous medication LDL-C levels.
But what many people don't know is that statins can not only reduce blood lipids, but also have anti-inflammatory, antioxidant, and improve the metabolism of the arterial lining. Long-term use of statins in people with atherosclerosis can reduce the likelihood of plaque rupture, reduce thrombosis, and even reverse plaque to avoid cerebral infarction and myocardial infarction.
To play the role of statins in reversing plaque, two things need to be done.
The first point is to achieve LDL-C control standards. If statins alone are not up to standard, they need to be combined with cholesterol absorption inhibitors, PCSK9 inhibitors, and other drugs.
Second, to ensure the duration of use, most people need to continue to take it for 2 to 4 years before observing plaque reversal. Based on the current research results, the longer you take it, the better the protective effect on cardiovascular and cerebrovascular diseases.
Therefore, it is precisely because statins have the effect of protecting cardiovascular and cerebrovascular diseases, so some people, although the blood lipids are not high, but have the risk of cardio-cerebral diseases, will also be required by doctors to take statins.
Fourth, when statins need to be reduced
The reduction of blood lipids to normal is not a sign of reduction in statins, but to continue to adhere to regular medication and keep LDL-C under safe control. The dose reduction of statins is considered only if the LDL-C level is below 1.4 mmol/L.
If there are serious adverse reactions during the medication process, it is also necessary to reduce the dose or stop the drug. If the aminotransferase (ASL, ALT) exceeds the upper limit of 3 times the normal limit, or if the creatine kinase (CK) exceeds the upper limit of 5 times the normal limit, the drug needs to be discontinued.
It should be noted that statins may cause blood sugar to rise, but discontinuation is not recommended because the benefits of statin protection of cardiovascular and cerebrovascular disease far outweigh the risks of affecting blood sugar. People with elevated blood sugar can add hypoglycemic drugs or choose statins that have little effect on blood sugar, such as pitvastatin, pravastatin, etc.
To sum up, taking statins, after the blood lipids reach the standard, it is not recommended to reduce the amount of medication, but to continue to take. Only when LDL-C is low or if there are serious adverse reactions, it is necessary to reduce the dose or stop the drug. Medications should be used under the guidance of a doctor, if you have any doubts about medication, please consult a doctor or pharmacist. I am a pharmacist Huazi, welcome to follow me and share more health knowledge.