Dr. Wang, I have been taking atorvastatin for several years and now my blood sugar is high. Should I stop or change my medication?

Dr. Wang said:All statins may induce new onset diabetes, so, so other statins are basically the same and may cause an increase in blood sugar. To stop or not to stop that would depend on why the atorvastatin was taken in the first place.

Let's take a look at the first clear, statin is not only lipid-lowering drugs, statin can lower cholesterol, LDL, triglycerides and other bad blood lipids, but also able to elevate HDL the good blood lipids. We all know that bad blood lipids are the culprit of coronary heart disease, good blood lipids can prevent coronary heart disease, so friends with coronary heart disease need to take statin.

What's more statin is not just lipid regulating, it's anti-inflammatory and plaque stabilizing, what does that mean?

Statin is the drug that stabilizes plaque, prevents plaque rupture, and even reverses plaque, so as long as you have coronary artery disease, you need to take a statin for a long time, regardless of whether your blood lipids are high or not!

But our focus is primarily on the three most common.

First, the use of atorvastatin has the potential to increase transaminases.Elevated aminotransferases are correlated with the dose of the drug, when the aminotransferases are elevated, reduce the dose, the aminotransferases may fall back. When atorvastatin causes elevated transaminases, the dose can be adjusted or the drug can be discontinued in time, and the liver function can basically return to normal. The main thing is to monitor the liver function, especially in the first month.

Second, it is easy to cause muscle damage.This is a common side effect of all statins. This side effect is more troublesome and sometimes has serious consequences. During use, when there is muscle soreness and muscle weakness you should stop the drug immediately and go to the hospital to have your serum muscle enzymes checked.

Third, it may cause blood sugar abnormalities, but the guidelines make it clear that the increase in blood glucose caused by atorvastatin is essentially insignificant relative to the benefits atorvastatin provides to patients. During long-term use, blood glucose can be monitored regularly to detect and correct the problem, but in general it is not recommended to stop taking statins because of concerns about blood glucose. This is because the benefits that statins can bring to patients who must take them far outweigh the risk of bringing on diabetes.

Theoretically common side effects of atorvastatin also include: headache, insomnia, depression (central side effects may be more pronounced because atorvastatin is fat-soluble and easily crosses the blood-brain barrier), dyspepsia, abdominal pain and diarrhea.

Statin drugs, including atorvastatin, are playing an increasingly important role in the prevention of cardiovascular and cerebrovascular diseases. Although statins have side effects in terms of:liver function, muscle enzymes, blood glucose, etc., this does not affect the benefits that statins bring to more patients.

So, taking atorvastatin is inevitable for some of you to experience elevated blood glucose, but if it is necessary to take the statin, then it naturally provides more benefit to the patient, and even if diabetes occurs, we need to continue to take it, and the blood glucose problem needs to be treated as diabetes!

People who have taken atorvastatin for a few years basically belong to those who have hypertension combined with hyperlipidemia, diabetes combined with hyperlipidemia, because both can accelerate the process of atherosclerosis, and those who already have coronary atherosclerosis, carotid plaques, etc., which are used to reduce the risk of cardiovascular and cerebral vascular risks, such as heart attacks and cerebral infarcts. If it is simple high blood fat with no need to eat for several years.

1、What is the reason for high blood glucose when taking atorvastatin for a long time?

Do I need to stop taking my medication when my blood lipids are normalized and I develop high blood sugar? This concern mainly stems from the fact that taking statins can cause elevated blood glucose and increase the risk of new-onset diabetes, but the large clinical study in question proved that the chance of this occurring is only 9%, and does not occur in everyone. And of all the statins, studies have shown that simvastatin, atorvastatin, resuvastatin, and fluvastatin have a relatively greater effect on blood sugar, while pitavastatin and pravastatin have a lesser effect on blood sugar.

Possible mechanisms for the development of high blood glucose after taking statins are that statins increase other diabetogenic risk factors, damage pancreatic beta cells, and decrease insulin sensitivity. There are also related clinical studies that show that taking statins inhibits cholesterol synthase and causes weight gain. Another study showed that taking higher doses of statin (atorvastatin 40mg or 80mg per day, and Rosuvastatin 20mg or 40mg per day) increased the risk of new-onset diabetes by 12% more than moderate doses of statin, suggesting that the increased risk of new-onset diabetes is related to the dose of statin.

2. The benefits of statins against cardiovascular disease are much greater than the increased risk of new-onset diabetes!

Atorvastatin, a hypolipidemic drug, is able to lower both cholesterol and triglycerides. In addition, this type of drug can improve the function of the vascular endothelium, increase the reactivity of the vascular endothelium to vasodilating substances, which is conducive to lowering blood pressure. They can also inhibit the proliferation of endothelial smooth muscle cells, reduce the formation of macrophages and foam cells in the arterial wall, have anti-atherosclerotic effects, and can stabilize and shrink atherosclerotic plaques. It is also able to reduce the C-reactive protein in plasma, thus reducing the inflammatory reaction in the process of atherosclerosis. In addition, there are anti-platelet aggregation and increase plasma fibrinolytic activity. All of these effects contribute to anti-atherosclerosis.

Clinical evidence shows that statins lower cholesterol, especially LDL cholesterol, which is the main culprit of cardiovascular and cerebrovascular diseases, and have an important and indelible role in stabilizing and narrowing atherosclerotic plaques and preventing and treating atherosclerotic cardiovascular diseases. Whether hypertension is accompanied by dyslipidemia or diabetes is accompanied by dyslipidemia, statins can reduce the risk of cardiovascular events in both hypertensive and diabetic patients.

The available data suggest that the benefit ratio of statins in reducing the risk of cardiovascular events is nine times greater than that of increasing the risk of new-onset diabetes, which shows that the cardiovascular protective effect of statins is much greater than the risk of new-onset diabetes. Moreover, the use of moderate-intensity statins is not only effective in reducing cardiovascular events, but is also safe and well tolerated. Moderate-intensity statins can lower LDL by an average of 30%-50%, including daily simvastatin 20mg or 40mg, atorvastatin 10mg or 20mg, resuvastatin 5mg or 10mg, lovastatin 40mg, pitavastatin 2mg or 4mg, and pravastatin 40mg or 80mg.

3、When taking atorvastatin for a long time, the blood lipid is normal while the blood sugar is high, do I need to stop taking it?

The standard for normal blood lipids is different for different people. For example, a LDL cholesterol of less than 3.4 is considered normal for the general population, but for people with hypertension combined with one risk factor, a blood lipid level of less than 3.4 is considered normal. However, for people with hypertension combined with two or more risk factors, or hypertension combined with diabetes, the LDL cholesterol needs to be reduced to less than 2.6 to meet the standard. Risk factors include being older than 45 for men or 55 for women, smoking, and low HDL cholesterol. For people with combined atherosclerotic cardiovascular disease, they need to get down to less than 1.8 to meet the standard. For this group of people, it is not recommended to stop the drug, and the benefits of combating cardiovascular disease far outweigh the risks.

By the same token, for diabetic patients who do not have atherosclerotic cardiovascular disease and are not comorbid with other risk factors for cardiovascular disease, but who have an LDL cholesterol greater than or equal to 2.6, they should also be taking a moderate-intensity statin on top of their lifestyle interventions. And if the diabetic patient is at high risk for atherosclerotic cardiovascular disease, the LDL cholesterol should be less than 2.6 to meet the standard. If a diabetic is comorbid with dyslipidemia and has more than one risk factor for cardiovascular disease, or if he or she is already comorbid with atherosclerotic cardiovascular disease, it will need to be reduced to less than 1.8 to meet the standard. Risk factors include: age (>40 years for men or postmenopausal women), smoking, hypertension, chronic kidney disease or microalbuminuria, HDL cholesterol <1. 04 mmol / L, body mass index >≥28 kg / m2, and a family history of early-onset ischemic cardiovascular disease. Discontinuation is also not recommended for this group, and the benefits of combating cardiovascular disease far outweigh the risks.

The available data suggest that in cases of abnormal blood glucose with statins, the response is usually small and can be attenuated by a glycemic control program. In the case of those who are diabetic themselves, the side effect of elevated blood glucose from statins can be eliminated without stopping the medication by increasing exercise, losing weight, controlling diet, and appropriately increasing the dose of glucose-lowering medication. And if it is other people who are not taking glucose-lowering drugs themselves, when they reach the target of lowering glucose, they can take glucose-lowering drugs appropriately, and generally speaking, through increasing exercise, regulating diet and other measures, they can effectively eliminate this side effect of high blood glucose, rather than stopping the drug for this reason, losing the other side of the coin, losing the big one because of the small one, so keep in mind!

Statins, mainly represented by atorvastatin, are one of the oral lipid-lowering prescription drugs widely used in clinical practice today.

Its significant lipid-lowering effect has long been demonstrated in large-scale randomized controlled clinical trials:It is by competitively inhibiting the activity of the rate-limiting enzyme (hydroxymethylglutaryl coenzyme A reductase) in the synthesis of cholesterol in our liver, thereby achieving a major reduction in serum total cholesterol, LDL, and a mild elevation of HDL levels.

But again, shortly after the market launch there did exist clinical reports that statins have some effect on our body's glucose metabolism and can cause blood sugar fluctuations!

As seen in the picture:Not only atorvastatin, taking other statin drugs also have a certain effect on the patient's blood sugar, mainly in the form of increased levels of fasting blood glucose, glycated hemoglobin and so on.

However, it is still unclear how statins affect a patient's blood glucose. The main view is that statins affect a patient's insulin secretion, causing insulin resistance and elevated glycated hemoglobin, while others believe that statins activate a specific immune response that prevents insulin from functioning properly!

So, the subject's suggestion that people who have been taking atorvastatin for several years have normal lipids and high blood sugar is indeed likely to be caused by taking statins.

This point also prompts us:Patients who need to take statins in the future or doctors who are recommending patients to take statins must be asked about the patient's past medical history, especially any history of blood glucose abnormality, before taking the medication, so that they can be observed and appropriate treatment plans can be taken.

So, is it true that as soon as a statin, represented by atorvastatin, shows an increase in blood glucose, it must be stopped? What is the rationale?

The answer is very clear:Not necessarily, while stopping statins is not recommended in most cases!

There are three main bases:

Article I:Statins may indeed carry a risk of causing elevated blood sugar andOur State Food and Drug Administration has also revised statin drug inserts to include a reference to adverse reactions affecting blood glucose！

But the incidence of adverse effects such as elevated blood sugar is particularly low, and in 2010 a study showed that over a four-year period, only 1 in 255 people taking statins developed diabetes, while the number of heart attacks and deaths from heart-related diseases could be reduced by 5.4.Thus, while taking statins may raise the risk of diabetes, their therapeutic and preventive cardiovascular benefits are even better, and it is important not to divorce the risks from such important benefits and discard them!

article 2, currently clinically, taking statins is not off-limits to diabetic patients, but is insteadA key recommended class of lipid-lowering drugs to take!

(Picture: Atorvastatin's indication clearly states that it can be taken if you have diabetes.)

And in recent years, more and more studies have concluded that patients with type 2 diabetes should take statins regardless of their cholesterol levels, not only because diabetes is also one of the high-risk factors for cardiovascular disease, but also, and mainly, because the application of statin therapy significantly reduces total cholesterol and low-density lipoprotein, of whichThe American Diabetes Association made it clear in 2004 that lowering LDL is the primary goal for reducing the risk of cardiovascular disease in type 2 diabetes, and that treatment with statins can reduce LDL levels by at least 30% in people with diabetes!

(As shown: clinical outcomes of 140 patients with type 2 diabetes admitted to a hospital from 2014-2017 who were treated with long-term statin therapy)

Article IIIIn fact.Everyone's risk of developing diabetes is inherently unequal.For example, older people are definitely more likely to develop diabetes than younger people, so you can't simply put the blame for developing diabetes on statins just because there is a risk of someone taking statins to raise their blood glucose, because people with cardiovascular disease are inherently more likely to develop diabetes than normal people, and even some important cardiovascular medications such as thiazide diuretics and niacin are associated with an increased risk of diabetes.It's a medicine that's poisonous, so you have to consider the long term and weigh the pros and cons！

What can I do if I have been taking statin for a couple years and my blood sugar is abnormal? This is a good question. Many of you may want to ask if it was the statin that caused your blood sugar to become abnormal. This is something that no one can give a definite answer to. We can only say that statin has the potential to increase the risk of diabetes, but in terms of individual cases, no one can say whether the patient's diabetes was caused by the individual or by taking statin for a long period of time.

As for this kind of statin for several years, and then the occurrence of diabetes, Dr. Zhang's advice is: if the patient is a clear diagnosis of cardiovascular and cerebrovascular disease, or cardiovascular and cerebrovascular disease high-risk groups, then oral statin may not be able to stop, can only be through the formal treatment of diabetes, such as taking medication or insulin and so on, to improve blood glucose, the treatment of diabetes. Because statin itself for many diabetic patients also has a protective effect, reduce the incidence of cardiovascular and cerebrovascular disease in diabetic patients.

Situations such as the above do exist in the real world, and the solution for the vast majority of patients is as I've described, but they definitely still need to be analyzed on a case-by-case basis, so don't choke on them.

(Contributed by: Gao Lili, Clinical Pharmacy Department, Plain Hospital, Qianfoshan Hospital, Shandong Province)

At present, statins mainly include lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, resuvastatin and pitavastatin, which are mainly used to lower TC and LDL-C, and can be used for hyperlipidemia and atherosclerotic cardiovascular disease. So, if someone who has been taking atorvastatin for a few years develops normal lipids and high blood glucose, do they need to stop taking the statin? What is the basis for this?

First, look at the results of statin's effect on blood sugar:

Long-term use of statins is associated with a risk of dysglycemia and increased risk of new-onset diabetes mellitus, which is strongly associated with high-dose statin use, age, gender, elevated fasting glucose, elevated triglycerides, obesity such as a body mass index (BMI) of >30 kg/m2, and comorbidities with hypertension.

Second, in terms of the possible mechanisms of statin's effect on blood glucose:

Statin causes mitochondrial dysfunction in pancreatic β-cells, myocytes, and adipocytes, resulting in decreased insulin secretion and increased peripheral insulin resistance; down-regulation of the expression of insulin-sensitive glucose transporter-4 in adipocytes, which increases peripheral insulin resistance; induces muscle fatigue and lowers muscular energy, which reduces exercise potential and activity, resulting in decreased energy expenditure; and permanent oligomyosarcoma (skeletal muscle atrophy) and increased insulin resistance.

Again, in terms of the overall benefit of statin on cardiovascular disease compared to the risk of new-onset diabetes:

The ratio of the overall cardiovascular benefit of statins to the risk of new-onset diabetes is 9:1, and the cardiovascular protection provided by statins far outweighs the risk of new diabetes, i.e., the risk of new diabetes from statins is much lower than their cardiovascular benefit.

From the above, it is clear that high doses of statin or advanced age, for example, can put statin at greater risk of new-onset diabetes by mechanisms related to decreased insulin secretion and increased insulin resistance. Therefore, if the adverse effect of statin on blood glucose is relatively small (an average increase of 0.3% or less), the treatment program of statin can be adjusted; if diabetes is diagnosed during the course of statin therapy medication, weight loss, reasonable diet, and glucose-lowering medication should be taken if necessary.

References:

1 Expert consensus on safety evaluation of statins[J]. Chinese Journal of Cardiovascular Disease,2014,42(11):891-892

2 Chinese expert consensus on the use of statins in older adults with dyslipidemia[J]. Chinese Journal of Internal Medicine,2015,54(5):469-473

Do patients who have been taking atorvastatin for several years with normal lipids and high blood glucose need to stop taking the statin?

The answer is no. The basis is as follows.

1. People who take atorvastatin to lower blood lipids should be patients with atherosclerotic cardiovascular disease or high-risk groups, and the blood lipids drop to normal under the condition of taking the drug, which is the result of the drug's action. If the drug is discontinued, blood lipids will not be effectively controlled and increase, it will accelerate the progress of atherosclerosis, increase the instability of atherosclerotic plaques, easy to aggravate the condition, triggered by cardiovascular disease acute events.

2. Statins are known to cause elevated blood glucose and increase the risk of new-onset diabetes, but the probability of this happening is low. The result of the study was an increase of 1 case per 255 cases over 4 years. Compared to the benefits of statins against cardiovascular disease, the overall benefit to risk ratio is 9:1, with the benefits far outweighing the risks. Even diabetics are taking statins to lower cholesterol and are benefiting.

3. If the person taking the drug is already a patient with atherosclerotic cardiovascular disease or a high-risk group with abnormal lipid metabolism, then it is likely that there are also factors in his organism for the occurrence of abnormal glucose metabolism and diabetes mellitus (because they are all metabolic abnormalities with co-morbidities), and he himself is a high-risk group for diabetes. The development of diabetes can occur even without statin use. It is difficult to determine whether a patient's elevated blood glucose is the result of the onset of his or her own disease or the statin. In other words, statins can cause elevated blood glucose, but elevated blood glucose is not necessarily due to statins.

4. The adverse effects of statins that raise blood glucose and increase the risk of new-onset diabetes belong to the class effect of this type of drug and are not unique to atorvastatin, only that the degree of action of different statin drugs is not exactly the same. Atorvastatin belongs to the statin drugs in the cholesterol-lowering effect of the stronger drugs, patients taking atorvastatin lipid normal, then switch to other drugs, one may affect the effect of lipid-lowering, and secondly, not necessarily reduce the risk of elevated blood glucose.

Taking the above considerations into account, patients with normal lipids and high blood glucose after taking atorvastatin do not need to stop taking the statin, but only need to be further examined and diagnosed according to the degree of high blood glucose, and treated with medication if necessary.

(Image from the Internet)

Atorvastatin is a class of oral lipid-lowering drugs widely used in clinical practice, which is mainly used to lower the level of low-density lipoprotein (LDL) in the blood and reduce cholesterol for the purpose of prevention and treatment of cardiovascular diseases. However, in November 2012, the State Food and Drug Administration (SFDA) issued an Adverse Drug Reaction Bulletin (ADR Bulletin) reminding patients and medical personnel to be alert to the abnormal blood glucose adverse reactions to statins. The main manifestations are new-onset diabetes, elevated glycosylated hemoglobin levels, elevated fasting blood glucose levels, and deterioration of glycemic control in diabetes.

The State Food and Drug Administration suggests that patients who experience symptoms that may be related to dysglycemia or diabetes, such as excessive drinking, urination, fatigue, and excessive eating, should immediately consult a physician to clarify the cause of the disease and take appropriate management measures.

If a patient already suffers from cardiovascular disease or has high risk factors for cardiovascular disease, he or she must take statins for a long period of time to control lipid levels, and even if there is an adverse effect of elevated blood glucose, the pros and cons should be weighed and the statin should not be discontinued at will. The U.S. Food and Drug Administration (FDA) believes that the benefits of statins for cardiovascular disease are much greater than the risk of new-onset diabetes, and the relationship between the two is 9:1, which should not be given up for patients with cardiovascular disease because of the risk of new-onset diabetes.

References:

[1] State Food and Drug Administration warns against abnormal glycemic adverse reactions to statins and interactions with HIV protease inhibitors. China Pharmacy, 2013 (1) :29-29.

[2] Li P, Meidan. Effects of statins on blood glucose[J]. China Hospital Medication Evaluation and Analysis, 2014, 14(2):102-103.

[3] SUN Jing, CHEN Tielong, CHEN Qilan. Research progress on the effect of statins on diabetes mellitus[J]. China Modern Physician, 2016, 54(26):162-164.

Author：Li Chunyu Unit：Clinical Pharmacy Department, Fengtai Hospital, Beijing, China, Member of Pharmaceutical Affairs Network

Drugs.com authoritative interpretation, unauthorized reproduction, plagiarism will be prosecuted

I. Can statins increase the risk of diabetes?

The answer is yes, there is clear clinical evidence that confirms that statin drugs have an added risk of developing diabetes! So, by taking oral statin drugs, there is an increased likelihood of developing diabetes! But oral statins should not be rejected because of the risk of new onset diabetes! Just as one should not choke on a statin, one should not refuse to use a statin for this reason!

Second, should I stop taking statin if my blood sugar is elevated or diabetes occurs?

This is actually expressed in the guidelines, statin is to increase the risk of diabetes, but new diabetes is not necessarily all caused by statin, this is one! Two, diabetic patients, more than anything else, need statins to prevent cardiovascular disease, and there is no substitute for statins for either primary or secondary prevention! The benefit of statin drugs taken orally has nothing to do with diabetes! Even if diabetes occurs, the benefit of statin medication taken orally is greater than the added risk of diabetes! The layman's explanation is that even if you have diabetes, the benefits of taking the statin orally still outweigh discontinuing the statin, so at this point in time, it's better to keep taking it!

Third, can I stop using statin if my blood lipid is normal?

Normal lipid levels are not a criterion for discontinuing statin use, nor are they a reason for not continuing to take an oral statin! In the case of coronary heart disease, for example, the latest guidelines state that there is no need to be concerned about lipid levels when taking an oral statin! In other words, no matter what the lipid level is, as long as there are no contraindications, you need to continue to take oral statins. Therefore, no matter what your lipid level is, the benefits of statin medication need to be continued, and statins should not be discontinued just because the lipid level is normal! Even if you have normal lipids in comorbid diabetes, you need to continue taking oral statins!

Atorvastatin has been taken for several years, the blood lipids have been normalized, but the blood sugar is high, this time need to stop taking statin drugs? For this question, is really a lot of friends want to know a situation, but I can give the answer is, not necessarily. Why not necessarily, today we will explain in detail -

The first thing to recognize is the relationship between elevated blood glucose and long-term use of atorvastatin

A lot of information on the Internet has mentioned that long-term use of statins may lead to elevated blood glucose, but so far, there is no conclusive clinical evidence that proves that atorvastatin can cause elevated blood glucose, if the phenomenon of elevated blood glucose occurs during the long-term use of atorvastatin, you want to confirm that whether it is triggered by the use of medication, you can stop taking the medication for a period of time, and if after stopping the medication, the blood glucose can be If your blood sugar returns to normal after stopping the medication, and then rises again after taking the medication, you can be sure that it is caused by the medication.

Whether or not you need to stop taking your medication also depends on the situation

The first thing that can be confirmed is that even diabetics can take atorvastatin for a long period of time, and studies have shown that after a study of nearly 3,000 patients with type 2 diabetes over a period of many years of follow-up, it was found that per capita oral intake of 10mg of atorvastatin or a placebo, the incidence of adverse events in the treatment group, over a period of nearly 4 years of follow up, was not significantly different from that of the placebo group.

For people with low to medium risk of cardiovascular disease, after taking medication to control blood lipids up to the standard, they can consider stopping atorvastatin and controlling blood lipids through life control and conditioning, but they also need to check their blood lipid index regularly to prevent the reappearance of hyperlipidemia problem.

However, for the high-risk and very high-risk groups of cardiovascular disease, such as patients with coronary heart disease, or have a number of cardiovascular disease risk, such as smoking, obesity, chronic kidney disease, low HDL cholesterol and other conditions of high-risk patients, lipids are only up to the standard is not enough, in addition to controlling the blood lipids, and also stabilize the plaque, the prevention of coronary heart disease, so regardless of whether the blood glucose Therefore, regardless of whether blood glucose is elevated or not, regardless of whether the elevation of blood glucose is caused by taking medication or not, it is still necessary to insist on taking atorvastatin to prevent the risk of cardiovascular disease.

Finally, to summarize, the need to stop taking statins is not based on whether blood glucose is elevated or not, but rather on the body's health indicators and the need to prevent cardiovascular disease. For patients at high risk of very high risk of cardiovascular disease, the physical benefits of taking statins for a long period of time far outweighs the risk of abnormal glucose metabolism that may be caused by statins, and therefore, it is important to stick with them.

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As with Dr. Lee's previous remarks, the decision to take or not to continue a statin depends primarily on the risk-benefit ratio of taking the statin, not simply because of lipid or blood glucose levels, which of course are also important reference factors.

Diabetes is not a contraindication to statin use. On the contrary, diabetics tend to be at high risk for cardiovascular disease as well, and are often still one of the recommended populations for statin use.

There may be a relationship between statin and elevated blood glucose. The results of many studies suggest that after intensive or moderate-dose treatment with a statin, the odds of developing elevated blood glucose increased about 1.2-1.6 times in the group taking the statin compared with the placebo group. And among those with pre-existing type 2 diabetes, there was an average increase of 0.12% in glycosylated hemoglobin after taking statin.

The development of hyperglycemia after statin use is associated with age, body mass index (BMI), hypertension, and original fasting blood glucose and triglyceride levels.

And what about the effectiveness of statin in preventing cardiovascular disease? In the primary prevention of cardiovascular disease (no original cardiovascular disease), statin use in moderate-risk cardiovascular patients can reduce the risk of developing cardiovascular disease by 24%. For people who already have cardiovascular disease, for every 1 mmol/L drop in LDL cholesterol, mortality due to cardiovascular disease may drop by 15%.

As the subject said, he has been taking statin for many years and now his lipids are normalized but his blood sugar is elevated, should he stop taking statin? The choice depends largely on how high the subject's current risk of ischemic cardiovascular disease is. If the risk of ischemic cardiovascular disease is expected to be >10% in the next 10 years, it is best to continue to take statins despite normal blood lipids and elevated blood glucose, and you can talk to your doctor about adjusting the dosage of the medication to maintain it at a minimal amount.

If the subject does not have other cardiovascular and cerebrovascular disease risk, only have high blood lipid a risk factor, the current blood lipid is normal, assessed, the risk of cardiovascular and cerebrovascular disease within 10 years <10%, you can stop statin to see, if the blood lipid in the dietary control plus appropriate activity can be maintained at a normal level can be completely do not need to take statin.