Statins need to take medicine for life, what situation can stop medication? The doctor will make it clear for you

The incidence rate of hyperlipidemia is high in the population. People are now using statins to control [1]. Statins have become the first-line drugs for secondary prevention of cardiovascular and cerebrovascular diseases. They have become the two cornerstones of prevention of cardiovascular and cerebrovascular diseases together with aspirin.

in recent years, the status of statins in the secondary prevention of cardiovascular and cerebrovascular diseases has been catching up with aspirin. As the first-line drug, statins have been applied to more and more people, and their side effects have attracted more and more attention [2]. What side effects do statins have?

the main side effects of statins are: may cause myalgia or rhabdomyolysis, blood sugar rise, liver function damage, etc., we will talk about it separately.

muscle toxicity: long term oral statins can cause muscle toxicity, which is generally manifested as myalgia or rhabdomyolysis. This kind of patients usually appear in patients with a large number of long-term oral statins, and the conventional dose generally does not cause symptoms. But doctors often worry about this side effect, so before using statins, they often repeatedly tell patients to come to the hospital for review once muscle soreness occurs. Hyperglycemia: long term oral statins may cause hyperglycemia. This is the most common side effect of statins, with a relatively high incidence. However, some scholars have statistics that most of the patients with hyperglycemia have other basic diseases, such as hypertension, hyperlipidemia or elevated serum uric acid. Scholars believe that: even if such patients do not take statins, they will have a high risk of diabetes in the future. It can be seen that statins cause hyperglycemia, but there are still some controversies.

hepatotoxicity: long term use of statins will cause the increase of transaminase, which is also seen in patients with long-term large amount of oral administration. If the level of transaminase rise is relatively light, not more than three times the normal high value, generally do not need special attention, can continue to take medicine. But transaminase more than three times the normal high value need to go to the hospital, under the guidance of the doctor to reduce the dosage or stop the drug. If patients with liver congestion or abnormal bilirubin, it is necessary to stop the drug in time. Other side effects: taking statins may also cause some symptoms of nervous system, digestive system and urinary system, usually manifested as headache, dizziness, abdominal pain, abdominal distension and mild proteinuria. These are reversible complications, which usually recover quickly after withdrawal.

with the wide application of statins, more and more people begin to care about the side effects of taking statins for a long time. Under what circumstances can statins be stopped? Let’s talk about this problem.

reducing blood lipid: statins mainly reduce low density lipoprotein cholesterol. Statins have the best and safest clinical efficacy in reducing cholesterol. If patients can not tolerate it, ezetimibe or PCSK9 inhibitors can be selected to reduce blood lipid, but the curative effect is not as good as statins. Stable atherosclerotic plaque: atherosclerotic plaque formed by arteriosclerosis, which is divided into stable hard plaque and unstable soft plaque. Soft plaque is easy to break and fall off, which is one of the main causes of cardiovascular and cerebrovascular diseases. After long-term oral administration of statins, unstable soft plaques can be transformed into stable hard plaques, thus reducing the incidence of cardiovascular and cerebrovascular diseases. Anti inflammatory effect: statins can inhibit the inflammatory reaction on the vascular wall, reduce the aggregation of platelets on the vascular wall, and reduce the occurrence of arteriosclerosis, thus reducing the incidence of cardiovascular and cerebrovascular diseases. Reverse plaque effect: in some patients, after long-term use of drugs, the plaque in blood vessels may decrease or even disappear.

everyone uses statins for different purposes. We can choose the withdrawal time according to the purpose of statins. The following three categories of people can choose to stop taking drugs.

there are side effects that need to be handled carefully: for example, myalgia or rhabdomyolysis; abnormal increase of transaminase, which is more than three times of the normal high value; combined with liver congestion and high bilirubin. In this case, statins need to be stopped. At the same time, other cholesterol lowering drugs are needed to control the level of LDL-C in plasma. The purpose of medication is to control the level of serum cholesterol: patients have no other underlying diseases, and have never had cardiovascular and cerebrovascular diseases. The purpose of taking statins is to control the level of low-density lipoprotein cholesterol in plasma. This kind of patient’s cholesterol if drops to the normal range, may choose to stop the medicine. However, blood lipid test must be reviewed in time. If cholesterol rises again, medication should be taken again. The purpose of medication is to stabilize and reverse atherosclerotic plaques: for patients who have never suffered from cardiovascular and cerebrovascular diseases for two years, if the blood tests are normal and the plaque in arteriosclerosis vessels has disappeared, statins can be stopped. However, it is also necessary to review relevant indicators regularly. If the condition worsens again, please Take the medicine again in time.

in a word, statins are the most effective and safe drugs in the secondary prevention of cardiovascular and cerebrovascular diseases compared with other similar drugs. Don’t stop your medicine because you are afraid of its side effects. The benefits of taking drugs far outweigh the risks we need to take.

the above are Dr. Zhang’s personal views on when to stop statins. If you agree with my opinion, please pay attention, leave a message or like it. It’s not easy to create. Thank you for your support. If you are interested in the knowledge of hyperlipidemia, please pay attention to me. I’m Doctor Zhang Wei. I’ll see you next time.

[1] Zou Shulian, Qiu Qinwei. Clinical analysis of adverse reactions induced by statins combined with other drugs [J]. Forum of primary medicine, 2019, 23:4695-4696.

[2] Zhu Feng, Liu Weiwei, Ming Xiaoxing. Observation on the efficacy of statins in the intensive treatment of young patients with acute cerebral infarction [J]. Journal of clinical rational drug use, 2019, 12:15-17. < A href=" " target="_ blank" rel="noopener">CUISINE&HEALTH