Statins: pros and cons

Med Clin (Barc). 2018 May 23;150(10):398-402. doi: 10.1016/j.medcli.2017.11.030. Epub 2017 Dec 29.
[Article in English, Spanish]

Abstract

Statins inhibit the critical step of cholesterol synthesis in which 3-hydroxy-3-methylglutaryl coenzyme A (HMGC) is transformed to mevalonate by the enzyme HMGC reductase. By doing so, they have a potent lipid-lowering effect that reduces cardiovascular risk and decreases mortality. Since the mevalonate pathway also influences endothelial function, the inflammatory response, and coagulation, the effects of statins reach well beyond their cholesterol lowering properties. As with all drugs, statins may have adverse effects; these include musculoskeletal symptoms, increased risk of diabetes, and higher rates of hemorrhagic stroke. However, the frequency of adverse effects is extremely low and, in selected patient populations, the benefits of statins considerably outweigh the potential risks.

Keywords: Accidente; Adverse effects; Diabetes; Efectos adversos; Estatinas; Miositis; Myositis; Statins; Stroke.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / pharmacology
  • Anti-Inflammatory Agents / therapeutic use
  • Anticholesteremic Agents / adverse effects
  • Anticholesteremic Agents / pharmacology
  • Anticholesteremic Agents / therapeutic use*
  • Atherosclerosis / drug therapy
  • Atherosclerosis / prevention & control
  • Blood Coagulation / drug effects
  • Cardiovascular Diseases / prevention & control
  • Cerebral Hemorrhage / chemically induced
  • Cholesterol / biosynthesis
  • Diabetes Mellitus, Type 2 / chemically induced
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / metabolism
  • Fibrinolytic Agents / adverse effects
  • Fibrinolytic Agents / pharmacology
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Immunologic Factors / adverse effects
  • Immunologic Factors / pharmacology
  • Immunologic Factors / therapeutic use
  • Inflammation / drug therapy
  • Inflammation / prevention & control
  • Mevalonic Acid / metabolism
  • Musculoskeletal Diseases / chemically induced

Substances

  • Anti-Inflammatory Agents
  • Anticholesteremic Agents
  • Fibrinolytic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Immunologic Factors
  • Cholesterol
  • Mevalonic Acid