This article is from "Nankai Sun Pharmacist", which is used for medical science popularization for reference. Which lipid-lowering drugs lower uric acid?Which statin *** is the smallest?How long can statins last?
Atorvastatin is a statin lipid-regulating drug, which can inhibit cholesterol synthesis in liver cells, accelerate the clearance of lipids in the blood, significantly reduce blood cholesterol and low-density lipoprotein cholesterol levels, reduce serum triglyceride levels, slightly increase high-density lipoprotein cholesterol levels, and also has anti-inflammatory, antioxidant, improving vascular endothelial function, stabilizing atherosclerotic plaques and anti-thrombosis and other anti-atherosclerotic effects. In addition, atorvastatin also has a definite uric acid-lowering effect, reduces blood uric acid levels by promoting renal uric acid excretion, and is the preferred lipid-lowering drug for hyperuricemia complicated with hypercholesterolemia.
Fenofibrate belongs to the fibrate class of lipid-lowering drugs, which can significantly reduce triglycerides and very low-density lipoprotein cholesterol, slightly reduce total cholesterol and low-density lipoprotein cholesterol, and also have anticoagulant, antithrombotic and anti-inflammatory effects. In addition, fenofibrate also has a definite uric acid-lowering effect, by inhibiting URAT1 (a renal urate transporter), inhibiting the reabsorption of uric acid in the proximal tubule of the kidney, and promoting renal uric acid excretion, it is the preferred lipid-lowering drug for patients with hyperuricemia and hypertriglyceridemia.
Most statins need to be metabolized by the liver and are affected by liver enzymes, especially lovastatin, simvastatin and atorvastatin, which have extensive drug-drug interactions and are prone to induce adverse reactions, while pravastatin and pitavastatin are almost not metabolized by the liver, are little affected by liver enzymes, and have a low incidence of interactions.
Statistics have found that the incidence of muscle adverse reactions of rosuvastatin is significantly higher than that of simvastatin and atorvastatin, while the incidence of muscle adverse reactions of lovastatin, pravastatin and fluvastatin is lower.
All kinds of statins, with pravastatin is the safest, because it is a water-soluble statin, which is not easy to penetrate the blood-brain barrier, central adverse reactions are rare, plasma protein binding rate is low, it is not metabolized by the liver, drug-drug interactions rarely occur, metabolites are inactive, and the incidence of systemic adverse reactions is low.
The higher the LDL cholesterol, the higher the risk of cardiovascular and cerebrovascular events, and the lower the LDL cholesterol can significantly reduce the risk of cardiovascular disease and all-cause death.
Statin is currently the main clinical drug to lower LDL cholesterol, for stable coronary heart disease, ischemic cardiomyopathy, ischemic stroke, transient ischemic attack, peripheral atherosclerosis, and other high-risk patients, LDL cholesterol should be controlled below 26mmol l, preferably less than 18mmol L, other low- and medium-risk groups should control LDL cholesterol below 34mmol L, which can benefit more, so statins should be taken consistently for a long time.
Consistent use of medium-dose statins can reduce LDL cholesterol by an average of 25%-50%, and the use of high-intensity statins** is not recommended at this time to avoid adverse reactions, leading to drug discontinuation and affecting patients' medication compliance. The clinical benefit of statin use** comes from the lowering effect of LDL cholesterol, which should be continued long-term after the desired effect, discontinuation should be avoided if tolerated, discontinuation can increase the risk of cardiovascular events, and if adverse effects occur during statin use, dose reduction may be considered, If you take the drug every other day or switch to another statin or use a non-statin lipid-regulating drug, you should recheck your LDL cholesterol every 6-12 months during the medication process, and if you continue to meet the target several times, you can consider taking a statin every other day, but be sure to follow your doctor's advice.