What is a statin (HMG-CoA reductase inhibitor)?

From the Guidelines

Statin use is recommended for adults aged 40 to 75 years with one or more cardiovascular disease (CVD) risk factors and a calculated 10-year CVD event risk of 10% or greater, as it reduces the probability of CVD events and mortality by at least a moderate amount. According to the USPSTF recommendation statement 1, statins are a class of lipid-lowering medications that function by inhibiting the enzyme 3-hydroxy-3-methyl-glutaryl coenzyme A reductase, which is involved in the rate-limiting step in the production of cholesterol. The USPSTF found adequate evidence that use of low- to moderate-dose statins reduces the probability of CVD events (myocardial infarction or ischemic stroke) and mortality by at least a moderate amount in adults aged 40 to 75 years who have one or more CVD risk factors (dyslipidemia, diabetes, hypertension, or smoking) and a calculated 10-year CVD event risk of 10% or greater.

Some key points to consider when prescribing statins include:

• The likelihood that a patient will benefit from statin use depends on their absolute baseline risk of having a future CVD event, which can be estimated using the ACC/AHA Pooled Cohort Equations 1
• Clinicians should discuss with patients the potential risk of having a CVD event and the expected benefits and harms of statin use
• The USPSTF recommends using low- to moderate-dose statins, as the most directly applicable body of evidence for patients without a history of CVD demonstrates benefits with use of these doses
• Statins are most effective when combined with a heart-healthy diet, regular exercise, and other lifestyle modifications to manage cardiovascular risk

In terms of specific patient populations, the USPSTF recommends:

• Initiating use of low- to moderate-dose statins in adults aged 40 to 75 years with one or more CVD risk factors and a calculated 10-year CVD event risk of 10% or greater
• Discussing with patients and selectively offering use of low- to moderate-dose statins in adults aged 40 to 75 years with one or more CVD risk factors and a calculated 10-year CVD event risk of 7.5% to 10%
• No recommendation for initiating statin use in adults 76 years and older who are not already taking a statin, due to insufficient evidence to determine the balance of benefits and harms.

From the FDA Drug Label

Rosuvastatin is a 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA)-reductase inhibitor Atorvastatin calcium tablets are an HMG-CoA reductase inhibitor (statin) Simvastatin is a prodrug of 3-hydoroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor

Statin is a type of drug that acts as an HMG-CoA reductase inhibitor, which is used to lower cholesterol levels in the blood.

• It works by inhibiting the enzyme HMG-CoA reductase,
• Which is involved in the production of cholesterol in the liver. 2, 3, 4

From the Research

Definition of Statin

• A statin is a type of lipid-lowering medication that is commonly used to prevent cardiovascular disease 5.
• Statins work by reducing the levels of low-density lipoprotein cholesterol (LDL-C) in the blood, which can help to decrease the risk of heart attacks, strokes, and other cardiovascular events 6.

Types of Statins

• There are several different types of statins available, including atorvastatin, rosuvastatin, and simvastatin [(5,6)].
• Each type of statin has a slightly different effect on LDL-C levels and may have different side effects 5.

Mechanism of Action

• Statins inhibit the enzyme HMG-CoA reductase, which is involved in the production of cholesterol in the liver 7.
• By inhibiting this enzyme, statins reduce the amount of cholesterol produced in the liver and increase the uptake of LDL-C from the blood 7.

Benefits and Risks

• Statins have been shown to be effective in reducing the risk of cardiovascular events, including heart attacks and strokes [(5,6)].
• However, statins can also have side effects, such as myopathy, renal dysfunction, and hepatic dysfunction 5.
• The benefit-harm profile of statins can vary depending on the specific type of statin and the individual patient 5.