Statin drugs are a type of medicine taken by millions to lower cholesterol. They are especially designed to lower LDL (low-density lipoprotein) cholesterol, also known as "bad cholesterol." In addition to lowering LDL, statin drugs can raise HDL (high-density lipoprotein) cholesterol. HDL is often referred to as "good cholestero" because it is primarily a protein that can clear LDL before it builds up in the body.
Statins are effective in reducing deaths from heart attacks and strokes in high risk patients. There is an on-going debate about whether statins should be given to lower risk patients.
High LDL cholesterol levels are believed to be a significant contributor to coronary artery disease (CAD). CAD is caused by the hardening of arteries over time, and it is believed that the slow build-up of LDL cholesterol inside the arteries is what causes this hardening. By lowering bad cholesterol levels, statins also help reduce the risk of heart disease, and may be prescribed to reduce the risk of heart attack and stroke-related death in people with high risk for or known CAD.
The Centers for Disease Control States that a 10% decrease in serum cholesterol levels may reduce CAD incidence by 30%.
Introduced in the 1980s, statins became enormous sellers in the 1990s and 2000s when they became the first widely used preventative medicines. There has been controversy about whether statins should be used for prevention, but studies have shown their benefit. A lipid profile is a standard part of blood work ordered in a standard physical.
Cardiovascular disease causes over 30% of deaths in the US and is a secondary cause in another 20%. According to one recent estimate, most men and many women over 40 could benefit from regular statin usage. These aren't necessarily people with "high" cholesterol. No matter what your cholesterol is, it could probably be lower if you took statins. Coronary events are highly correlated with the level of LDL cholesterol. The Centers for Disease Control report that 16% of American adults have high cholesterol (defined as over 240 mg/dL). More on this.
An estimated 21 million Americans are prescribed statin drugs. Both academic studies and anecdotal evidence from doctors indicate that a larger percentage of patients who start on statins stop within 6 months. The reasons for this may be the high cost of the drugs or the fact the benefits of treatment are not immediately obvious (people don't see any different when they take the medicine, so conclude it does nothing.)
Statins have been the top-selling drug in the United States during the 21st Century — not in terms of number of pills, but in terms of dollars at the retail level. The largest pharmaceutical company in the world is Pfizer, and its single best-selling product in recent years has been Lipitor. Merck is another giant in the drug field, and their biggest drug was Zocor a couple years ago. (Merck's patent on Zocor expired in 2006; the Lipitor patent expired in late 2011.) With the widespread availability of generic statin medications and the success of the drugs in lowering cardiovascular disease incidence, statin usage is likely to increase. It is argued that statins are one of the most important inventions of recent times.
Statins are effective for both men and women, and lower cholesterol in all groups, including those who have previous cardiovasculat problems and those who do not. Indeed, recent analysis has found that early reports of the benefits of statins were understaded and they are even better than previously believed. Whether statins should be used for primary prevention and be distributed widely to those without other risk factors, is a matter of much discussion and debate.
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