LDL Cholesterol Lowering Drugs: The Statins

June 20, 2008

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Continuing from yesterday’s theme, I thought I would write a short explanation of the statin family of drugs, that are used for treating bad levels of cholesterol. Statins are the most prescribed drugs in the US. In fact, Atorvastatin (Lipitor), much of the time, has been the most prescribed drug for the last couple of years. (It was toppled by Viagra for a while, but came back.)

It is important to remember that your body has to have cholesterol. The major uses are; as part of the membranes of cells, and in the formation of a number of hormones.

No matter how much cholesterol you eat, your body (mainly the liver) will always make some cholesterol.

LDL (low density lipid) cholesterol contains cholesterol that is made by, or reprocessed by the liver. It is transported by the blood throughout the body, and cells that need some cholesterol will take what they need from the blood. So you need to have LDL cholesterol circulating in your blood. It is just that when there is too much that there may be problems.

Currently, the standard for treating high LDL cholesterol levels are the statins. The statins include lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), fluvastatin (Lescol), atorvastatin (Lipitor) and rosuvastatin (Crestor). The first name of each pair is the name of the drug, the second name in brackets is the commercial name for that drug. Yesterdays post about red yeast rice involves lovastatin.

These drugs are all inhibitors of the enzyme HMG CoA reductase. This enzyme is a major enzyme in the process of making of cholesterol by cells. When the enzyme is inhibited, cells in the body make less cholesterol. Then, when the cells get short of cholesterol they start to take up cholesterol from the blood to meet their requirements, then the level of LDL cholesterol in the blood drops.

(Statins are thought to have a number of other good effects too, independent of their cholesterol lowering ability. These are wide ranging and the subject of much research and controversy.)

To summarize, statins decrease the amount of cholesterol that the body can make, so then to meet requirements cells take up LDL cholesterol from the blood, which cause the level of LDL cholesterol in the blood to decrease.

photo credit: tellumo The sign is in Sausalito.