Cardiac Medications

Cholesterol and Lipid Lowering Drugs: Statins

Statins are a group of medications, which block the internal production of cholesterol in the liver by blocking the enzyme HMG CoA reductase, an essential step in cholesterol production. They also increase the rate of LDL (bad cholesterol) receptor turnover in the liver. These medications may lower the LDL cholesterol by anywhere from 20% to as much as 60% depending on medication and dose. They also have a modest effect on raising HDL (good cholesterol) and lowering triglycerides.

There have been many large scale studies of the benefits of STATINS in patients after a heart attack. These show significant reductions in the risk of death, cardiac events, strokes, and the need for angioplasty and bypass surgery in patients with CAD. The benefit is in the range of 25-40%. As well aggressive cholesterol lowering with statins in post-bypass patients has been shown to reduce the rate of coronary disease developing in the bypass grafts.

Currently available STATINS include:
Rosuvastatin (Crestor)
Lovastatin (Mevacor)
Pravastatin (Pravachol)
Simvastatin (Zocor)
Fluvastatin (Lescol)
Atorvastatin (Lipitor)

These medications are generally well tolerated with infrequent side effects. Side effects to monitor include the development of muscle pains and liver abnormalities. While on these medications, liver function tests and the cardiac muscle enzyme CPK should be checked periodically (at 2-3 months after starting the medication and then every 6-12 months. If you develop muscle pains on these medications, report your symptoms to your physician.

If your cholesterol improves on these medications, it means the medication is working. It does not mean you no longer need the medication. Unless you are experiencing side effects do not stop your medications without checking with your doctor.

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