Statins: How the drug prevents heart attacks and strokes
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Statins are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is often referred to as “bad cholesterol” because it contributes to heart disease risk. Statins reduce the production of it inside the liver.
Mounting suggests there is an optimal time of day to take statins.
“Most manufacturers of statins recommend that they are taken at night, on the basis of physiological studies which show that most cholesterol is synthesised when dietary intake is at its lowest,” wrote researchers in a study published in the Benha Medical Journal.
The researchers set out to determine whether administration of atorvastatin in the morning had “significant different efficacy” from its administration in the evening.
The study was conducted on forty patients of both sex of age range 44-72 years.
Patients were randomised on either 10 or 20 mg a day of atorvastatin in the morning or evening for six consecutive weeks each.
The researchers found that neither sex nor daily doses variation (10 or 20 mg/day) produced significant changes in lipid profiles between baseline and follow up data in all groups.
However, “switching dosing atorvastatin from in the morning to in the evening resulted in statistically significant decrease in total cholesterol, LDL cholesterol and triglyceride and non-significant increase in HDL cholesterol value”, the researchers wrote.
HDL cholesterol is branded the “good” cholesterol because it counters the negative impact of LDL cholesterol and triglycerides are another type of fat (lipid) found in your blood.
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Why is it preferable to take statins in the evening?
Statins block an enzyme that helps the liver make cholesterol.
As Harvard Health explains, in most people, cholesterol production peaks late in the evening.
The health body continues: “The body breaks down fluvastatin (Lescol), lovastatin (generic, Mevacor), pravastatin (generic, Pravachol), and simvastatin (generic, Zocor) fairly quickly.
“So taking them in the evening ensures that you have enough medicine on board when you need it the most.”
It adds: “Two other statins, atorvastatin (Lipitor) and rosuvastatin (Crestor) aren’t broken down as readily, so you can take them any time.”
Are there any side effects associated with taking statins?
Like all medicines, statins can cause side effects. But most people tolerate them well and do not have any problems.
According to the NHS, you should discuss the benefits and risks of taking statins with your doctor before you start taking the medicine.
Side effects can vary between different statins, but common side effects include:
- Headache
- Dizziness
- Feeling sick
- Feeling unusually tired or physically weak
- Digestive system problems, such as constipation, diarrhoea, indigestion or farting
- Muscle pain
- Sleep problems
- Low blood platelet count.
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine you’re taking.
It’s run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA).
The risks of any side effects also have to be balanced against the benefits of preventing serious problems.
A review of scientific studies into the effectiveness of statins found around one in every 50 people who take the medicine for five years will avoid a serious event, such as a heart attack or stroke, as a result.
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