The old gao is 55 years old this year, and the blood lipids were found to be high during the physical examination a few days ago, but the doctor said that he did not need to take medicine for the time being, went back to adjust his diet and lifestyle, and observed it for a period of time.
"High blood lipids do not take medicine, blood is easy to clott, there is a risk of cerebral thrombosis" Hearing his friend say so, Lao Gao was a little scared, so he went to the pharmacy to buy a few bottles of statin to take. A month later, when Lao Gao checked the blood lipids again, he found that the indicators not only did not drop, but rose a lot.
He wondered: Doesn't it mean that statins can lower blood lipids? Why eat it and don't fall but rise?
With the popularization of health awareness, some middle-aged and elderly people will regularly measure blood pressure, blood lipids, blood sugar, and once they find that they exceed the standard, they will rush to take medication to control. But in fact, the drug is not a panacea, whether you need to take the drug, you need to combine the specific situation.
<h1 class="pgc-h-arrow-right" data-track="5" >, blood lipids are elevated, must eat statin</h1>
As the basis for the treatment of cardiovascular and cerebrovascular diseases, statin has important clinical applications. Statins inhibit the synthesis of cholesterol in the liver and reduce serum total cholesterol and LDL cholesterol concentrations. In addition to lowering lipids, statins can also fight inflammation, stabilize plaque, and prevent diseases such as blood clots, myocardial infarction and cerebral infarction.
Dyslipidemia does not refer to a single indicator, but refers to an increase in serum levels of total cholesterol, triglycerides, and LDL cholesterol and a decrease in HDL cholesterol levels.
According to the Chinese Guidelines for the Prevention and Treatment of Dyslipidemia in Adults, the normal blood lipid standard is total cholesterol <5.2 mmol/L, LDL cholesterol < 3.4 mmol/L, triglycerides less than 1.7 mmol/L, and hdL lipoprotein cholesterol > 1.0 mmol/L for men and 1.3 mmol/L for women >.
In general, it is necessary to take lipid-lowering drugs when the following conditions occur:
1. Clinically diagnosed cardiovascular and cerebrovascular diseases, such as coronary heart disease, ischemic stroke and peripheral atherosclerotic vascular disease;
2. LDL cholesterol > 4.9mmol/L;
3. Diabetic patients are under 75 years old, not complicated by coronary heart disease, and LDL cholesterol is between 1.8-4.9mmol/L;
4. Age 40-75 years old, no coronary heart disease and diabetes, LDL cholesterol between 1.8-4.9mmol/L, and the risk of cardiovascular disease within 10 years is more than 7.5%.
Although statin is widely used, some side effects of "three poisons of medicine" will be inevitable, such as nausea, vomiting, bloating and other gastrointestinal discomfort; damage to liver function, making transaminases slightly elevated; rhachyrolysis, muscle soreness, severe cases and even kidney failure.
<h1 class="pgc-h-arrow-right" data-track="61" > comparison of several statins</h1>
Statin is a large family, and the clinical commonly used ones are simvastatin, atorvastatin, rosuvastatin, lovastatin, pravastatin, fluvastatin, pitvastatin and so on. So, what is the difference between these statins?
Generations
Simvastatin, pravastatin, lovastatin belong to the first generation, fluvastatin belongs to the second generation, and atorvastatin, rosuvastatin, and pitvastatin belong to the third generation.
Indications
Lovastatin and simvastatin are suitable for primary hypercholesterolemia, combined hypercholesterolemia and hypertriglyceridemia, mainly hypercholesterolemia;
The cholesterol-lowering effect of pravastatin is obvious, but the effect of lowering triglycerides is not obvious;
Fluvastatin is indicated for hypercholesterolemia in which dietary control is ineffective;
Atorvastatin is indicated for primary hypercholesterolemia, mixed hyperlipidemia, or heterozygous family hypercholesterolemia with ineffective dietary control;
Rosuvastatin is indicated for hyperlipidemia and hypercholesterolemia;
Pitvastatin is indicated for hypercholesterolemia and familial hypercholesterolemia.
Lipid-lowering range
Atorvastatin and rosuvastatin are high-intensity statins that reduce LDL cholesterol by more than 50% at daily doses. Simvastatin, lovastatin, pravastatin, fluvastatin, pitvastatin, etc. are medium-intensity statins, and the daily dose can reduce LDL cholesterol by between 25% and 50%.
Time to take the drug
The half-life of lovastatin and simvastatin is 3 hours, and it is recommended to take the drug at dinner. The half-lives of pravastatin and fluvastatin are 1.5 hours and 1.2 hours, respectively, and the recommended time to take the drug is before bedtime. Atorvastatin, rosuvastatin, and pitvastatin have half-lives of more than 12 hours and can be taken at any time of the day.
Hydrophilic/lipophilic
Simvastatin, lovastatin, fluvastatin, and pitvastatin are lipophilic, rosuvastatin and pravastatin are hydrophilic, and atorvastatin is amphiphilic. The more lipophilic it is, the higher the risk of muscle-related side effects.
Effects on liver and kidney function
Patients with liver history and abnormal liver function should use simvastatin, lovastatin, atorvastatin, and pitvastatin with caution, and patients with mild and moderate renal insufficiency do not need to adjust the dose. Pravastatin is indicated for patients with liver or renal insufficiency. Rosuvastatin is indicated in patients with mild hepatic and renal insufficiency.
<h1 class="pgc-h-arrow-right" data-track="62" > third, what are the precautions for eating statins</h1>
In addition, during the period of taking statins, patients should be aware of some common problems.
First of all, because statins have the side effects of blurred vision and dizziness, patients should avoid driving after taking the drug; secondly, they should be light in their diet, reduce cholesterol intake, and avoid alcohol and grapefruit juice.
If serious adverse reactions such as myalgia and weakness occur during taking the drug, they should be reviewed in time. Liver function and muscle enzymes should be measured for the first month after taking the drug, and if there are no abnormalities, liver function and muscle enzymes should be checked every six months.
<h1 class="pgc-h-arrow-right" data-track="63" >4. Rumors about statin</h1>
In the process of using statins, many rumors have arisen, and it is easy to be misled if you do not polish your eyes. Common rumors about it are:
Myth 1: Adverse reactions are large, and the disadvantages outweigh the benefits
As long as the drug is used rationally, the risk of statin adverse reactions is very low, and the benefits to patients far outweigh the risks.
Myth 2: You can stop the drug at will
Taking statin should be done carefully according to medical advice and should not be discontinued at will, otherwise it will increase the risk of myocardial infarction or stroke.
Myth 3: High levels of LDL cholesterol do not increase the risk of myocardial infarction
On the contrary, the study found that people aged 35-55 years, if they have hypercholesterolemia, have a 39% increased risk of heart disease every 10 years.
Myth 4: Eating high-cholesterol foods isn't that serious, statin is just a "conspiracy"
With long-term intake of foods high in cholesterol, the risk of dyslipidemia increases, and the higher the chance of sudden fatal cardiovascular disease.
Myth 5: Imported statin is better than domestic statin
The two have an equivalent therapeutic effect, the incidence of adverse reactions is low, and more importantly, the price of domestic statins is lower than that of imported statins, which can greatly reduce the medical burden.
Of course, lowering blood lipids is far from enough to eat statins, but also to adjust the lifestyle, only the combination of the two, both prongs, in order to reduce the risk of death, live a wonderful life.
Resources:
[1] Four types of human statins are more effective in lowering lipids. Life Times.2016-08-05
[2] Six rumors of Statin. Health Times.2019-12-27
[3] 7 pictures summarize the difference between 7 statins, hurry up and collect! , Cardiovascular Channel of the Medical Community, 2021-04-03
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