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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