Cholesterol-lowering medicines, statins

Statins are cholesterol-lowering medicines. They may be used to treat:

• primary hypercholesterolaemia, a high level of cholesterol in the blood due to lifestyle factors such as a high-fat diet or not doing enough exercise
• familial hypercholesterolaemia, a high level of cholesterol in the blood due to inheriting a gene that causes your liver to make lots of cholesterol

Statins may also be used to reduce your risk of having a heart attack or stroke if you have:

• angina (chest pain) or have previously had a heart attack
• transient ischaemic attacks ('mini strokes') or have previously had a stroke
• peripheral vascular disease (narrowing of blood vessels, usually in the legs)
• diabetes and are over 40
• diabetes and are under 40 but have other risk factors for heart disease, such as poor blood sugar control, high blood pressure or a family history of heart disease in a relative younger than 40

How statins work

Statins reduce the production of cholesterol by the liver.

In particular, they reduce the production of 'bad' cholesterol called low density lipoprotein (LDL).

If you have a high amount of LDL cholesterol in your blood, it can form fatty deposits in the lining of your arteries (blood vessels). This causes furring and narrowing of the arteries, known as atherosclerosis, which in turn restricts the blood flow and can increase your risk of having heart disease or a stroke.

The liver makes most of your body's cholesterol at night. For this reason, it is recommended that many statins (fluvastatin, pravastatin, simvastatin and simvastatin with ezetimibe) are taken in the evening so the amount of statin in your body will be highest when the liver is producing the most cholesterol.

Names

There are several different statins. Names include:

• atorvastatin (brand name Lipitor)
• fluvastatin (brand name Lescol)
• pravastatin (brand name Lipostat)
• rosuvastatin (brand name Crestor)
• simvastatin (brand name Zocor)
• simvastatin combined with ezetimibe (brand name Inegy)