After the blood test for cholesterol, the doctor prescribes the patient expensive pills for cholesterol, prevent diseases of the cardiovascular system - statins.
This doctor should also explain to the patient that now the drugs he has to take the time.Any tablet - to lower cholesterol or other diseases - all without exception, have their own set of side effects.
And the doctor should warn their patients about all the possible side effects of statins.How can you lower your cholesterol pills and whether to do it?Of course, every person who raised blood cholesterol thinks - whether to take drugs need?
cholesterol there are 2 main groups of pharmacological agents - statins and fibrates, it is also recommended to consume Omega 3 and lipoic acid.In this article we take a closer look, there are some tablets from cholesterol, they harm and benefit.
The information in this article does not call for self-administration of drugs or cancellation of statins, prescribed by the doctor.If you have any doubts about the wisdom of their admission should contact to several specialists and pass a comprehensive examination.Risks and benefits of the drugs should be evaluated by a doctor in each specific clinical case, taking into account the presence of chronic diseases of the patient and the state of the cardiovascular system.Statins
- drugs for lowering cholesterol
Statins - chemicals that reduce the body's production of enzymes that are required for cholesterol synthesis in the body.The instructions to these drugs, tablets, lowering cholesterol in blood indicated the following:
- Statins lower cholesterol concentration in the plasma due to inhibition of HMG-CoA reductase reduce cholesterol synthesis in the liver.
- reduce cholesterol concentrations in patients with homozygous familial hypercholesterolemia, are not treatable lipid-lowering drugs.
- lowers total cholesterol by 30-45%, "harmful" cholesterol - by 40-60%.
- increases the concentration of HDL-cholesterol (good cholesterol) and apolipoprotein A.
- reduces the risk of ischemic events by 15%, including myocardial infarction and the risk of angina pectoris with evidence of myocardial ischemia - 25%.
- not mutagenic and carcinogenic effects.
Side effects of statins
use of statins for lowering cholesterol leads to a lot of side effects:
- Very often: insomnia, asthenic syndrome, headache, nausea, constipation, diarrhea, abdominal pain, flatulence, myalgia.
- Nervous system: amnesia, malaise, dizziness, hypoesthesia, paresthesia, peripheral neuropathy.
- Digestive system: vomiting, diarrhea, hepatitis, anorexia, holestatitcheskaya jaundice, pancreatitis.
- Musculoskeletal: myositis, back pain, muscle cramps, myopathy, arthritis of the joints.
- Allergic reactions: skin rash, hives, itchy skin, anaphylaxis, Lyell's syndrome, erythema multiforme.
- Agencies hematopoiesis : thrombocytopenia.
- Metabolism : diabetes gipoglikemiya- or decrease in blood sugar levels.
- impotence, weight gain, obesity, peripheral edema.
To statins required to prolong life?
instructions and advertising of medicines for lowering cholesterol convince people that statins significantly improve quality of life, reduce the risk of heart attack and stroke.Numerous studies suggest that statin use has almost no side effects on the body and is effective in preventing heart attacks and strokes."Drink them constantly, and will decrease the level of bad cholesterol and increase good cholesterol."Can you trust such claims, and is not this just advertising expensive drugs?
In fact, not everything is so simple and the need statins for the elderly remains a very controversial issue.To date, related to statins did not quite unambiguous:
- Some studies support the need for statins at very high levels of cholesterol and at the same time there is a decrease the risk of cardiovascular disease.
- Others argue that the side effects and potential harm to the health of the elderly person is not comparable with the possible use of such prophylaxis of diseases of the cardiovascular system.
Today in Russia statins included in the standards of treatment of a large number of cardiac pathologies.Their purpose is to reduce mortality.This does not mean that statins need to treat each patient with hypertension or ischemic heart disease.You also can not assign them to all who are over 45 years old or who have just increased blood cholesterol levels.
- for secondary prevention after myocardial infarction, or stroke
- as they are shown in reconstructive operations on the heart and major blood vessels (for example, coronary artery bypass grafting)
- acute coronary syndrome or myocardial infarction
- coronary disease with a high risk of stroke or heart attack - as a reason to take statins.
Thus, all severe coronary patients, statins are simply necessary to prolong life, there is no alternative .To reduce side effects - the doctor should choose the right medication to control the biochemistry (1 every 3 months), with a 3-fold increase of transaminases should be lifted statins.The most serious complication of statin treatment - rhabdomyolysis is rare.
questionable benefit in the appointment of patients:
- low risk
- women before menopause
- in patients with diabetes
In Russia, the pharmacy chains, you can find the following types of statins with different activity on cholesterol lowering:
- Rosuvastatin - lowers cholesterol by 55%
- Atorvastatin - 47%
- simvastatin - 38%
- Fluvastatin - 29%
- Lovastatin - 25%
|name drug||product form|| |
average price in pharmacies (summer 2013)
|Atomaks||10 mg.Table.30 pcs||360-380 rubles.|
|Canon||atorvastatin 20 mg.Table 30 pcs.||260 -280 rubles.|
|Atoris||10 mg.Table 30 pcs.||330-350 rubles.|
|Lipitor 10 mg.tabl100 pieces.||1800 rub.|
|Torvakard||10 mg.Table 30 pcs||270-300 rubles.|
|Tulip||10 mg.Table.30 pcs||190-210 rubles.|
|Liptonorm||20 mg.Table.30 pcs||260-280 rubles.|
|AKORT||10 mg.Table 30 pcs||450 rubles.|
|Crestor 10 mg.Table.7 pcs||400 rubles.|
|Crestor 10 mg.Table.28 pcs||1400 rub.|
|Merten||10 mg.Table.30 pcs||700 rubles.|
|Rosuvastatin 10 mg.Table.28 pcs||450 rubles.|
|Rozukard||10 mg.Table.90 pcs||1100 rub.|
|Rozulip||10 mg.Table.28 pcs||550 rubles.|
|Roxer||10 mg.Table.30 pcs||600 rubles.|
|Tevastor||10 mg.Table.30 pcs||430 rubles.|
|Vasilip||10 mg.Table.14 pcs||160 rubles.|
|Zocor 10 mg.Table.28 pcs||530 rubles.|
|Ovenkor||10 mg.Table.30 pcs||310 rubles.|
|Simvageksal||20 mg.Table.30 pcs||330 rubles.|
|Simvakard||10 mg.Table.28 pcs||220 rubles.|
|simvastatin 10 mg.Table.20 pcs||180 rubles.|
|Simvastol||10 mg.Table.28 pcs||200 rubles.|
|Simvor||10 mg.Table.30 pcs||210 rubles.|
|Simgal||10 mg.Table.28 pcs||300 rubles.|
|Simla||10 mg.Table.28 pcs||180 rubles.|
|Sinkard||10 mg.Table.30 pcs||350 rubles.|
|Cardiostatin||20 mg.Table.30 pcs||230 rubles.|
|Holetar||20 mg.Table.20 pcs||320 rubles.|
|Cardiostatin||40 mg.Table.30 pcs||400 rubles.|
|Forte||Lescol 80 mg.Table.28 pcs||2150 rubles.|
Some principles for the selection of statins
take or not take statins - human individual decision based on the advice of a doctor.And if the decision on statins, the choice of the drug should be carried out taking into account existing physician patient's chronic diseases.
Self can not take any drugs that reduce cholesterol.At disturbances of lipid metabolism and changes in the analysis, it is necessary to address to the cardiologist or physician.Let them evaluate your risks, taking into account:
- sex, age, weight
- bad habits
- existing cardiovascular diseases and adverse pathology (especially diabetes).
If appointed a statin, it should take the dosages are recommended doctor handing blood biochemistry as often as he appoints.If that is recommended to receive, too expensive, it is worth to discuss the possibility of replacing a cheaper, but better than the original drug.Unfortunately, the Russian generics still inferior in terms of quality, not only the original imported drugs, but also to foreign generics.
the appointment of statins to elderly people should bear in mind that the simultaneous reception of drugs for gout, hypertension, diabetes increases the risk of myopathy in 2 times.
- If the patient has chronic liver disease, so patients taking rosuvastatin is better, but only in low doses, can be used pravastatin (Pravaksol).These two types of statins protect the liver, but at their reception in no case can not drink alcohol and take antibiotics.
- If a patient persistent pain in the muscles, or the risk of muscle damage, the use of the same pravastatin more appropriate, since it is less toxic to the muscles.
- In patients with chronic kidney disease can not be used Fluvastin - Lescol and atorvastatin calcium (Lipitor), since they are highly toxic to the kidneys.
- Patients who seek to reduce the level of low density cholesterol can accept different types of statins, such as atorvastatin can be taken or rosuvastatin.
At present there is no conclusive data on the feasibility of the combination of statins with nicotinic acid.In addition, niacin can cause a drop of sugar in patients with diabetes, provoke bleeding from the gastrointestinal tract, cause acute gout and increase the risk of myopathy and rhabdomyolysis when taken with statins.
little on research and the potential dangers of statins
Earlier, referring to American experts, our cardiologists inclined to statin therapy in all cases of coronary artery disease, and in hypertension and low risk seredechno-vascular pathologies in adults . Americans also recommend high enough dosages (about 80 mg).
However, in the autumn of 2013 the British Medical Journal (The BMJ) in the person of its editor Fiona Godley initiated a scandal by publishing two comments on statins.They were links in the observational study, to prove that in 20 percent of patients taking statins developed adverse events.
Group Chairman studies of statins, Rory Collins, who received money from the manufacturers of these drugs, demanded to withdraw the article data.However, an independent commission confirmed BMJ data.
In Russia, there have been no one independent research in this area, and doctors are actively prescribe these drugs to patients.In the US, doctors prescribe statins to lower cholesterol is very common, only in 2007, world trade statins was 40 billion. Dollars.
According to Canadian scientists using statitnov patients by 57% increased risk of developing cataracts (symptoms, treatment), when + statin to a patient also suffers from diabetes, this risk increases by 82%, this was confirmed by statistical analysis.That is, in elderly people with diabetes taking statins, 5.6 times the processes leading to cataracts occur faster.
analyzed the results of 14 clinical trials, aimed at studying the effect of statins (34 000 patients), the experts made the following conclusion - statins reduce the risk of strokes and heart attacks, but in view of the serious side effects, they are not recommended for people who have not had any previous illnessescardiac or stroke was not.Those who regularly takes statins observed liver function abnormalities, cataracts, kidney failure, as well as depression, mood swings, short term memory loss, muscle myopathy.
Next, we express the same point of view about cholesterol and lowering statin medication:
- Low cholesterol is much more dangerous than high, and statins can significantly reduce it.
Research in Germany show that a low level of cholesterol increases the risk of cancer, liver disease, the same stroke, nerve disorders, anemia, and even suicide, and early mortality.
- low magnesium levels - the risk of stroke and heart attack
Studies in the United States argue that it is not high cholesterol, and low levels of magnesium culprit of heart attacks and strokes in humans.Deficiency of this trace element just leads to cholesterol increase, the development of diabetes, hypertension, angina pectoris and Artim.
- most important cholesterol function to restore disorders in the tissues of the body can be suppressed statins
Science knows that any scar tissue of the body, in the arteries, including, incorporates a large amount of cholesterol, and when the walls of blood vessels are damaged by accumulationand protein by acids, cholesterol actively eliminates these lesions.For muscle growth and healthy functioning of the body of low density is necessary fat cells (bad cholesterol), which occurs when a lack of myalgia (muscle pain, weakness, swelling), and even muscular dystrophy.
- Statins reduce cholesterol, and whether it is good for the body?
HMG CoA reductase inhibitors inhibit the production of cholesterol, reducing the production of mevalonate and - cholesterol precursor, but is it any good?Mevalonate - is a source of not only cholesterol, but also a host of other very important substances that perform necessary biological functions in the body, the lack of which leads to other diseases.
- Statins increase the risk of diabetes, which in turn provokes a rise in cholesterol
If the patient is constantly taking statins - this increases the likelihood of his diabetes (according to different sources from 10 to 70%).It is known that diabetes are 2-4 times higher risk of coronary heart disease and stroke, and heart disease.Statins reduce the protein concentration in the cell GLUT4, which is responsible for blood glucose levels.The group of British scientists released a study which was conducted among 10,242 women over 63 years.They were divided into two control groups, one group used statins, the other is not.The study found that taking statins by 70% increases the risk of diabetes in women after menopause.in Week.30 pcs.caps.