Statins are the most widely used lipid-lowering drugs in clinical practice, effectively lowering cholesterol and LDL, stabilizing atherosclerotic plaques, and significantly reducing cardiovascular disease events.

Commonly used drugs include lovastatin, simvastatin, atorvastatin, and resuvastatin. "every medicine has its side effect", prolonged heavy use may have the following adverse effects that require our vigilance:

1. Muscle Syndrome:Muscle disorders are the most serious and relatively rare adverse effects of all statins and are characterized by myalgia, muscle tenderness, muscle weakness, and in severe cases, rhabdomyolysis. They usually appear early, typically 4-6 weeks after statin therapy. Myositis is diagnosed when muscular symptoms occur and creatine kinase is 10 times higher than normal on line. Myopathic symptoms that are not recognized in time and continued use of the drug are likely to lead to rhabdomyolysis and acute renal failure. Rhabdomyolysis rarely occurs when statins are taken alone, and the risk is higher when used in conjunction with fibrates, macrolide antibiotics, niacin, and epoxycycline. Avoid grapefruit juice when taking statins.

2. abnormally high blood sugar level: Statins, especially in large quantities, can cause abnormalities in the patient's blood glucose, as evidenced by increased fasting blood glucose levels, increased glycosylated hemoglobin levels, new onset of diabetes, and worsening of glycemic control in diabetes. Studies have shown that atorvastatin increases the incidence of diabetes by about 22%, Rosuvastatin by about 18%, simvastatin by about 10%, and lovastatin and fluvastatin have no effect.
   
   

3. hepatotoxicity: Hepatotoxicity of statins is dose-related and is contraindicated in patients with various forms of acute and chronic hepatitis with moderate to severe hepatic impairment. Transaminases should be monitored when statins are used, and should be discontinued immediately if they increase more than threefold during treatment.

4. cognitive function: Statins interfere with the synthesis of cholesterol, which is essential for its formation in the brain and its functioning, and lowering concentrations may trigger psychiatric and neurological symptoms, severe irritability, aggressive behavior, cognitive deficits, memory loss erectile dysfunction, and more.

Statin lipid-lowering drugs can lower blood lipids and stabilize plaque, is one of the standard core drugs for coronary heart disease and other cardiovascular diseases, but many people are worried that there will be some adverse reactions after long-term use, what are the adverse reactions of long-term application of statin lipid-lowering drugs? Is it a big problem?

1, liver damage problem. This is the most common long-term application of statin lipid-lowering drugs and the most worrying problem for many people. After long-term use of statin lipid-lowering drugs, some patients will appear transaminase elevation, the incidence of about 0.5% to 3.0%, was dose-dependent. In fact, statin lipid-lowering drugs on the liver damage is mild, even after the occurrence of even stopping the drug most can be basically normalized. In the newly published "European Atherosclerosis Society Consensus Group Statement", it is pointed out that: in patients taking any statin, there are 0.5%~2.0% transaminase mildly elevated, but clinically relevant transaminase elevation is only 1 in 100,000, and it is not even recommended that asymptomatic patients check liver enzymes. The U.S. Food and Drug Administration (FDA) Adverse Event Reporting System database has not found an increase in fatal or serious liver injury with statin use. Simply put, as long as there is no cirrhosis or active hepatitis, liver damage from taking statin lipid-lowering drugs is very mild and mostly reversible, so there is no need to worry too much.

2. The problem of related muscle adverse reactions. Long-term use of statins appear related muscle adverse reactions including myalgia, myositis and rhabdomyolysis, etc., but foreign randomized studies found that the muscle symptoms of statin is only 0.1~0.2%. Statin-related muscle symptoms include muscle pain, weakness and tenderness, usually symmetrical, affecting thigh, buttock, calf and back muscles. Many of the muscle-related adverse effects in patients with statins are subjective adverse effects.

3. Induce diabetic problems. Long-term use of statin has increased the risk of new diabetes, the incidence of about 10% to 12%. However, taking statin can make an additional 1 case of diabetes per 1,000 patients, but at the same time prevented 5 cardiovascular events, the benefit is still greater than the adverse effects, so both high-risk groups of diabetes and diabetic patients with indications for statin therapy should adhere to the use of such drugs.

4. Cognitive function problems. Statin therapy may cause transient cognitive abnormalities with a low probability of occurrence. The European Atherosclerosis Society Consensus Group Statement concluded that statin therapy does not adversely affect cognitive function.

5. Other. Headaches, insomnia, indigestion and other symptoms may occur and are mostly tolerated.

In conclusion, statin lipid-lowering drugs are still relatively safe, and for every 1 mmol/L reduction in LDL-C after statin therapy in populations with different cardiovascular risk stratification, there is a 20% reduction in the relative risk of major cardiovascular events and a 10% reduction in all-cause mortality, so if there are no contraindications, you should still be taking statin lipid-lowering drugs.

There is too much talk about these kinds of side effects of medications! What are medicines used for? Prevention and treatment of disease. All medications have advantages: therapeutic effects, 㢢, toxic side effects. Just like pros and cons work together to make a real person, it's just a matter of which side has more points. Drugs with more drawbacks either fail in development as a stillborn, or are fortunate enough to come to market and be taken out of the market.

Overseas for drug instructions in the chemical name, trade name, dosage, serving method, pharmacokinetics, metabolism, toxicology, that is, the possible toxic side effects should be strictly written in the instructions, otherwise even the approval of the Drug and Food Administration can not pass. This manual is the contract between the drug company and the doctor, one is to let the doctor know the use of drugs, dosage, possible output side effects, precautions should be taken to protect the patient. The second is a contract to avoid liability, where the contract is to protect the interests of the first party, including hospitals and patients' families must sign the informed consent before surgery. In foreign countries patients can not see the drug instructions, you can get from the pharmacy to do is bottled medicine, bottles labeled with the patient's name, drug dosage and method of taking, half of even the name of the drug is not written. The instructions are for the prescription, the doctor to see, the responsibility of medication is taken by the doctor, because he should be a qualified professional, make money and clinic treatment should be responsible for the responsibility of the medical practitioner.

China's cardiovascular disease prevalence and mortality rate is still in a rising stage. The projected number of current cardiovascular disease patients is 290 million, of which 13 million have stroke, 11 million have coronary heart disease, and 270 million have hypertension alone.In 2015, the proportion of cardiovascular disease deaths among all causes of death for rural and urban residents was 45.01% and 42.61%, respectively. Two out of every five deaths were due to cardiovascular disease. The prevalence of hypercholesterolemia was 9.0% and that of critical hypercholesterolemia was 22.5%. Knowledge of hyperlipidemia was 8.8% and 7.5% in men and women, treatment rates were 3.5% and 3.4%, and attainment rates were 1.9% and 1.5%. Is it appropriate to talk about the payoffs of statins with such low treatment and compliance rates?

Statins have been around for more than 30 years and have had an epoch-making effect on the incidence of cardiovascular disease and mortality. Many people still do not quite understand the infarction is not in the blood vessels of the "trash" obstruction caused by the blood there is trash people can not live, just some of the bad components of the formation of atherosclerotic plaques on the blood vessels, LDL cholesterol is the formation of plaques "饀饀", and its high and low Decided to fill the growth of fast and slow and size, the prerequisite that high blood pressure, high blood sugar, high blood fat, smoking caused by arterial intima damage, so that it is organic to the leftover seepage to the intima to become atherosclerotic plaque "filling". Therefore, statin is the most effective drug to reduce the synthesis of LDL cholesterol, but also inhibit the formation of plaque, expansion, rupture of the drug. As for the very low incidence of muscle and liver damage, it is important to advise patients to pay attention to the precautions to be taken when prescribing statins for the first time. There is a need to repeatedly fatigue bombing like over and over again to emphasize the side effects of statins, some people take statin every day, conscious and subconscious muscle damage, liver muscle like a "motto" in the mind, because often into the hospital on time to dispense the drugs of the patients attach special importance to their own health, and implied that the psychology of the heavier especially love to read the instructions in the side effects, word for word to the patients should be concerned about the first prescription of statins. Side effects, word for word.

After reading most of the editors almost all mentioned rhabdomyolysis, which is the most serious and very low incidence complication of statins, searched 55 reports of statin-induced rhabdomyolysis in PubMed, CNKI, and VIP databases from 2008-2013, and there were only 59 cases of the disease, with 45 fully recovered, 11 improved, and 3 deaths after treatment. Of these, 60% were caused by simvastatin and all were over 70 years old. Do you think there is any reason to worry? Besides, myopathy: myalgia, muscle weakness incidence is less than 0.5-1%, after stopping or changing drugs can disappear. 普通人身上各处东痛痛、西痛痛决不是少数，经你文章进一步强化了说明书副反应的暗示作用，有几个“肌痛“的人肌酶真的升高？ As for liver damage if the original alcoholism, hepatitis B, hepatitis C history, fatty liver, liver enzymes close to the upper limit of the normal range or high and low in fluctuation, after taking statin really more than three times the maximum value of the normal range of less than 1% -3%.

Weighing the pros and cons of statins first of all to figure out what you are after you must take statin, some people do not have three high as long as the carotid artery is found to have plaque, regardless of whether there is no stenosis and the degree of stenosis, and so the statin and aspirin together on the brocade and then add a few proprietary Chinese medicines, this is a naked over-treatment. There are three high, addicted to smoking, no matter how much LDL, must be stratified according to the risk factors of cardiovascular disease to reach the standard, with different doses of statin to reach the standard on the line, never the lower the better, in 2003 the ACC published the LDL down to 2.6 mmoI / L on the plaque reversal, the General Assembly of all the doctors stood up to give a round of applause, and now what? If at the same time suffering from a variety of other diseases taking a number of drugs as far as possible not to choose atorvastatin, simvastatin, lovastatin, to prevent these are going to liver enzymes the most congested 3A4 channel, resulting in excessive blood concentration caused by toxic side effects. As for long-term use of statin for fear of inducing diabetes can choose pitavastatin or pravastatin. As for the triggering of Alzheimer's disease is really nonsense, the incidence of Alzheimer's disease 80-90 years old accounted for 30%, more than 90 years old up to 50% age is the most important factor in the development of. Cardiovascular disease people do not rely on statin can live to 90 years old is also considered a miracle!

2019.7.26

So far, statins are still the first choice and cornerstone drugs used in the clinic to regulate blood lipids. In addition to effectively lowering LDL cholesterol, statins also have a certain regulatory effect on triglycerides in the body, and at the same time have a certain degree of improvement in the case of low HDL cholesterol, and in addition to lowering blood lipids for long-term use of statins in high-risk and very high-risk groups of cardiovascular disease, there is also a role in the stabilization of plaques and the prevention of the risk of cardiovascular disease. .

Any medication taken for a long period of time carries certain risks, so it is necessary to understand the possible adverse reactions caused by statins and to be aware of the possible risks caused by taking statins while taking them, and today we are going to introduce you to this aspect of the problem.

Possible adverse effects of long-term statin use

Generally before statins are started, it is recommended that patients have their liver function and creatine kinase values checked, which is a base value sometimes used to confirm whether statins are causing side effects.

1. Long-term use of statin drugs may cause liver function abnormalities and elevated aminotransferases. Therefore, during the period of taking statin drugs, the aminotransferases should be checked regularly (e.g., once every six months), and the drugs should be discontinued if the aminotransferases are elevated by more than three times. Usually fat-soluble statins, such as simvastatin, atorvastatin, lovastatin, etc., which cause liver function abnormalities, can be switched to water-soluble statins such as Rosuvastatin, pravastatin, etc. to try, and can often improve.

2. Long-term use of statin drugs may cause muscle pain. If muscle pain occurs while taking statin drugs, do not delay and consult a doctor to check the creatine kinase value. If the value of creatine kinase is elevated by more than 10 times (compared to the time before the drug was taken), the drug should be stopped. If the muscle pain is delayed, resulting in excessive elevation of creatine kinase, it may not only cause rhabdomyolysis, but also affect kidney function in severe cases.

3. Long-term use of statins may affect the metabolism of blood sugar, and some patients may even develop new-onset diabetes. Long-term use of statins, blood glucose should also be checked regularly, if there is an abnormal glucose tolerance or elevated blood glucose problems should be noted, but the chances of this happening are not great, even if such a situation occurs, if the physical condition requires the use of statins, do not stop taking statins because of the abnormalities of blood glucose.

4. Other side effects: statins may also cause side effects such as gastrointestinal discomfort, headache and dizziness, etc. Generally, for these minor side effects, the body can tolerate them through a period of time.

How to minimize and prevent possible side effects from statins

To prevent the possible side effects of statins, the following tips are given for your reference:

1. Starting with a small dose, starting with a small dose is the basic principle of taking statins. The method of starting with a small dose and gradually increasing the dosage can effectively avoid gastrointestinal side effects and other side effects that may occur, and improve the body's tolerance.

2. Try to choose a low dose of statin to take, if you can achieve the goal of lipid lowering, you should try to choose a small dose to take, the incidence of side effects of this type of drug, and the dose of the positive correlation, so try to choose a small dose to regulate the blood lipids, is the best way to reduce the incidence of side effects.

3. Regular monitoring of relevant indicators, such as aminotransferases, elevated blood glucose, usually the body generally does not have obvious symptoms to indicate, so during the period of taking statin, especially the initial period, regular monitoring of liver function and blood glucose is very important and necessary.

4. If you are not sure that the problems are caused by statins, you can try to stop taking the drug for a period of time. If the side effects occur when you stop taking the drug, and even the test indicators return to normal, and then you take the drug again, and then the problems occur again, then you can basically be sure that it is the side effects caused by statins.

5. If the body is intolerant, the dose should be reduced or the medication should be adjusted, and it is possible to take it every other day, but at the same time, it is also necessary to ensure that the effect of lipid regulation, and if the effect of lipid regulation is not good, it is possible to add ezetimibe to try.

6. Moderate supplementation of coenzyme Q10, of course, this is not yet a definite way of combining, but moderate supplementation of coenzyme Q10, in terms of the mechanism of action, can reduce the incidence of liver and myalgia side effects that may be caused by statin drugs. People can choose whether to take it or not, depending on their conditions and circumstances.

Statin is the most widely used lipid regulating disease in the world, with 3 main effects: one is to reduce LDL level; the second is to reduce triglyceride; and the third is to prevent and treat cardiovascular and cerebrovascular diseases. Most cardiovascular and cerebrovascular patients need oral statin treatment, but statin also has the following 4 kinds of side effects that should not be ignored.

1. Elevated transaminases

Statins reduce cholesterol synthesis in the liver and many people experience elevated transaminases within 3 months of statin use. Many scholars believe that this does not necessarily mean liver damage but may be a result of organ adaptation to statins and cholesterol reduction. Therefore, transient mild elevations can be observed only. If the elevation is greater than three times the upper limit of normal, i.e., greater than 120 U/L, it is recommended that the drug be discontinued or adjusted.

2. Myopathy

That is, muscle damage, a person may experience fever, generalized weakness, muscle aches and pains, and in severe cases, even kidney failure. If creatine kinase is more than 5 times the upper limit of normal it is necessary to stop or adjust the medication.

Some studies have suggested that statins damage muscle because they damage coenzyme Q10, which protects muscle cell integrity, so patients who develop muscle soreness from taking statins may try using coenzyme Q10 to ease the discomfort.

3. Diabetes

Many studies have shown that oral statins can cause an increase in blood glucose in patients, especially when used in higher doses. This is because statins prevent the liver from using glucose to synthesize cholesterol, so there is less glucose in the bloodstream to "go to," which can increase the amount of glucose in the bloodstream and cause hyperglycemia.

However, it is still necessary to use the medication when it is necessary, and should not be choked off, but we remind you to be careful to monitor the blood glucose level while using it.

4. Impact on cognition

Nerve cells require large amounts of cholesterol to grow and maintain normal brain function, and statin lowers cholesterol levels, which also includes brain cholesterol. And a lack of cholesterol in the brain produces significant neurological deficits that may lead to a number of mental and neurological symptoms, such as cognitive dysfunction and poor memory.

However, many patients can regain their original function after stopping the drug. Water-soluble statins that work only in the liver are also available.

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With the advent of aging, more and more people need to take statins to prevent cardiovascular diseases. Statins are also the drug of choice for the treatment of dyslipidemia, which is mainly caused by elevated cholesterol. What are the adverse effects of statins?

What are all the possible adverse reactions induced by statins?

1. Statin-associated myopathyRefers to pain or weakness of muscle tissue that occurs after statin use, including myopathy (without increased creatine kinase), myositis (with increased creatine kinase), and rhabdomyolysis (significant increase in creatine kinase up to 10 times above the upper limit of normal values, usually with darkened urine and myoglobinuria).

2. hepatotoxicityThe main metabolic site of statins is the liver, and their hepatic damaging effects mainly lead to the elevation of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and the clinical manifestations include acute liver failure, hepatitis, bile depletion, or asymptomatic aminotransferase elevation. Asymptomatic aminotransferase elevations are relatively common, and most of the hepatotoxicity occurs within 3 weeks to 6 months after drug administration.

3. allergic reactionAfter the application of fluvastatin, a patient had facial swelling in the next morning, and then generalized edema occurred, involving the face, trunk, lower limbs and other parts of the body, which was considered to be a drug-induced allergic reaction. After taking simvastatin, some patients developed congestive rash on the face, hands and feet, which appeared as small rice grain-sized papules that did not fuse with each other and macules with pain and itching, and then fused with each other to form a piece.

4. extraocular muscle paralysisA case of unilateral ptosis on atorvastatin was considered to be due to levator palpebral myositis. Ptosis was observed with pravastatin, followed by a gradual sensation of heaviness in both eyes, double vision about 2 weeks later, and inability to abduct the left eye when the eyeball was turned to the left by force, which was considered to be a paralysis of the left extraocular muscle.

5. sexual dysfunctionErectile dysfunction in men taking statins, with some patients experiencing decreased libido after 2 weeks of simvastatin, and erectile dysfunction after 6 weeks of continued use at the same dose.

6. polyuriaOf the statins, only simvastatin has the adverse effect of polyuria, which is particularly pronounced in nocturia.

7. Adverse reactions of the digestive systemStatins may also cause adverse reactions in the digestive system, such as abdominal pain. Diarrhea, acute gastric colic, nausea, poor appetite, bloating, constipation, and dyspepsia.

8. joint painSlight pain in the middle joint of the middle finger of the left hand after taking simvastatin, the pain worsened after continuing to take the medicine, and there was obvious swelling, with difficulty in moving the middle finger joint.

9. restlessness syndrome of the lower limbs (medicine)Simvastatin causes indescribable soreness and numbness in the lower limbs, mainly in the ankles and calves, with constant movement of the lower limbs to alleviate the symptoms, worsening of the discomfort at night, and mild elevation of creatine kinase isoenzymes and hydroxyJ-acid dehydrogenase.

How do you combat the adverse effects of statins?

1. Adjustment of drug dosesTreatment should be started with a small dose according to the recommended therapeutic dosage, and only when it is confirmed that there is no adverse reaction after a period of time can the dose be increased appropriately, so that the patient will be able to obtain the best therapeutic effect with minimal risk.

2. Consider the patient's particular pathology and physiologyIn order to prevent statin-associated myopathy, patients taking statins should be followed up and closely monitored for symptoms of muscle weakness or myalgia. Liver function should be checked regularly during the period of using statins, usually after two months of using statins, and compared with that before using statins. If the aminotransferase level is higher than the normal range or more than twice as high as that before taking the drug, the drug should be stopped immediately, and in the course of using the drug, closely observe whether there is discomfort in the upper right abdomen, jaundice, fatigue and other symptoms.

3. combination of drugsThe combination of fibrates and statins is associated with increased risk and effectiveness. The combination of the two drugs should be used in the presence of atherogenic dyslipidemia, especially in patients with diabetes mellitus and metabolic syndrome. Avoid combining statins with macrolide antibiotics, antifungals, thiazodone, amiodarone, cyclosporine and other drugs.

Summary: In order to avoid the adverse effects of statins, should strictly grasp the indications and contraindications of statins, should not easily change the dose of the drug, the use of drugs in the process of close monitoring of patients with or without adverse effects.

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Statins are the most widely used lipid-regulating drugs in clinical practice, but with the increase in the number of people with the disease and the increase in the scope of use of the drug, statins have been exposed to a gradual increase in the number of adverse reactions, and the time of occurrence of the adverse effects covers the period of time that occurs from immediately after the use of the drug to 25 months after the use of the drug, so in order to more safely apply statins, it is necessary to generalize and summarize their adverse reactions:

1. Muscle toxicity: This adverse effect may be related to the disruption of mitochondrial structure by oxidative stress in the body, which in turn affects calcium homeostasis, and thus patients with defects in energy metabolism are susceptible to muscle toxicity. In addition, muscular toxicity may not resolve with discontinuation of the drug, and immunosuppressive therapy is required.

2. Central Nervous System Damage: Central Nervous System Damage is mainly manifested in three aspects: (1) cognitive impairment; (2) fatigue, headache, dizziness; (3) intracranial hemorrhage.

3. Cataracts: A Canadian study reported that patients taking statins to lower cholesterol may be at increased risk of developing cataracts, and that the risk is age-related.

4. Diabetes: The U.S. Food and Drug Administration has issued a statement that statins may be increasing the risk of new-onset diabetes, so patients with multiple risk factors for diabetes should be screened regularly for diabetes.

5. Tumor: A recent study reported that patients with prostate cancer eradication who had been taking statins for more than 2 years had higher rates of pathological stage and recurrence than patients who had not taken statins.

6. Liver damage: statins do not have a significant impact on the prognosis of patients with hepatitis-induced aminotransferase elevation, and have the effect of lowering elevated aminotransferase in patients with hyperlipidemia and steatohepatitis, but statins are contraindicated in patients with acute liver failure and decompensated cirrhosis.

The authoritative interpretation of Pharmaceutical Affairs, unauthorized reproduction, plagiarism will be punished.

Mainly gastrointestinal adverse effects; hepatic impairment (elevated aminotransferases); rhabdomyolysis, mainly rhabdomyolysis, which in severe cases (small probability) leads to acute elevation of creatinine and progression to acute renal failure; headache; and immune system disorders with some types of statin drugs.

As a cardiovascular physician one must be as familiar with statins as one is with chopsticks for eating.

Let's start with a brief description of what statin does.

1, lipid regulation: lower cholesterol, low-density lipoprotein, triglycerides, raise high-density lipoprotein.

2, anti-inflammatory, stabilize plaque, prevention and treatment of cardiovascular and cerebrovascular diseases.

For most patients with high cholesterol and coronary heart disease, cerebral infarction, angina pectoris, myocardial infarction, post-stenting, post-bypass, etc., they basically have to be on a lifelong statin.

It is natural to be concerned about adverse effects of statin when it is taken for such a long period of time.

Most common adverse reaction for all statins/...

1. Liver function damage

Almost all statins have side effects that cause liver damage, and there is a quantitative relationship with statin drugs, meaning that the more you take, the more side effects you have.

However, liver function almost always returns to normal after stopping the drug if it is detected in time. And it most often happens in the first three months of taking it. So we need to review liver function before taking statin and in the first month, and every year thereafter.

2、Myotoxicity

That is, statins have the potential risk of damaging muscle, causing elevated muscle enzymes and leading to rhabdomyolysis, with serious consequences. Theoretically, a tenfold increase in muscle enzymes requires discontinuation of the drug, but clinically, for safety reasons, we need to discontinue the drug as soon as we find elevated muscle enzymes suspected to be related to the statin.

Therefore, muscle enzymes need to be monitored while taking statin and they need to be rechecked as soon as possible if muscle pain, generalized weakness, etc. develops.

3. New onset diabetes

Statin induces new diabetes, but the benefits of statin to patients far outweigh the harm caused by statin itself causing diabetes.

If statin induces new diabetes, it is treated as new diabetes and does not need to be stopped.

So, we also need to monitor our blood sugar and not to worry if we find it elevated, as the statin itself will give us more benefits.

Of course statin, in addition to these three main side effects, taking statin may also cause renal impairment, may trigger neurological symptoms such as angioneurotic edema, headache and dizziness, abdominal pain, nausea, gastrointestinal and other side effects.

In short, we must find out if it is necessary for us to take a statin, and if so, we must also find out what adverse reactions and side effects are associated with taking a statin!

Nowadays, high blood lipid has become a common health problem for many people who have to work hard for a long time and have a lot of entertainment. High blood lipid will not cause big problems in the short term, but in the long term, it may lead to a variety of serious diseases, such as coronary heart disease and cerebrovascular accidents, which is the result of long-term increase in blood lipid and high blood viscosity, which clogs the blood vessels. Statins are routinely used in the clinic to lower total cholesterol and low-density lipoprotein (LDL), but also lower triglycerides to a certain extent, and raise high-density lipoprotein (HDL), which is why statins are considered to be a more comprehensive and potent lipid-regulating drug. In addition, statins also protect the vascular endothelium, reduce the inflammatory response, antioxidant, block neuroendocrine over-activation, anti-thrombotic, plaque stabilization, etc., which plays an important role in reducing cardiovascular events and improving the prognosis, and it is another important cornerstone for the prevention and treatment of cardiovascular diseases in addition to aspirin. The drug is effective, but as a long-term use, eaten every day like a meal, statins also have some side effects that have to pay attention to, here we look at it specifically.

There are many types of statins, including simvastatin, pravastatin, atorvastatin, resuvastatin, pitavastatin and others. Although they play an important role in clinical practice, they also have a number of side effects, the more common ones include.

1. Gastrointestinal reactions include nausea, constipation, diarrhea, flatulence, dyspepsia and abdominal pain. Most of them are mild, so there is no need to stop the drug for minor gastrointestinal discomfort. For patients with a history of chronic gastrointestinal disease, the dose can be gradually increased from a small dose. It is recommended to take it at bedtime, which improves the efficacy of the drug and also reduces the gastrointestinal reaction to some extent.

2. Liver function impairment Statins may cause transaminase elevation, mainly due to the effect on hepatic cytochrome metabolism, about 1 to 2% of people will have transaminase level increased more than 3 times the upper limit of normal value, usually after reducing or stopping the drug, transaminase can be reduced to normal. Elevated aminotransferases usually occur within 1 to 3 months of starting treatment, mainly in the form of alanine aminotransferase, which is mostly transient and will return to normal in most cases. Oral statins are not recommended for patients with cirrhosis and liver failure who have severe abnormal liver function. For patients with other causes of aminotransferase higher than 3 times, they need to wait for liver function to improve before taking statins.

3. Muscle damage The main manifestations are myopathy, myalgia, myositis, muscle weakness, arthralgia or rhabdomyolysis. Rhabdomyolysis is a serious adverse effect of statins, but the incidence is very low, about 0.02%. The incidence of serious muscle adverse events varied among statin drugs, with pravastatin and lovastatin muscle being the lowest, and resuvastatin significantly higher than atorvastatin and simvastatin.

4. Increased risk of new-onset diabetes Statins have been shown to increase the risk of diabetes, possibly due to impaired insulin signaling, decreased adipocyte differentiation, decreased insulin secretion; increased insulin resistance, and decreased insulin sensitivity. in 2012, the U.S. FDA issued a public notice warning that statins can increase the risk of new-onset diabetes and worsen blood glucose control. Despite this, the cardiovascular benefits of statin therapy far outweigh the risk of new-onset diabetes.

5. Renal Injury Benign proteinuria of unknown origin can occur during statin use, which may be related to its ability to inhibit tubular reabsorption of small molecular weight proteins. In rare cases of rhabdomyolysis, tubular obstruction can occur, leading to tubular injury and localized ischemia and necrosis.

Although statins have some side effects, they are generally very safe medications and serious adverse reactions are very rare. Liver and kidney functions are usually rechecked once every three months or so while taking the drug. For patients with slightly poorer liver reserve function, liver-protecting drugs can be added at the same time, and changes in liver function can be closely observed. When used in combination with beta-lipotropic drugs, liver function and muscle enzymes should be followed up and tested in a timely manner to prevent the occurrence of adverse events.