Statins

Statin FAQs

How long has Atorvastatin been in use?

Are there any risks with taking statins?

What is a statin?

Statins (also known as HMG-CoA reductase inhibitors) are a group of medications prescribed for the prevention of cardiovascular disease (including myocardial infarction and stroke) and to lower the level of LDL cholesterol in the blood. Atorvastatin, commonly sold under the name Lipitor, is one of 7 currently approved statin medications. Others include rosuvastatin, simvastatin, fluvastatin, lovastatin, pravastatin and pitavastatin.

How long has Atorvastatin been in use?

Atorvastatin was first approved for use in 1996 and is now one of the most commonly prescribed medications in Australia.

How do statins work?

Statins lower circulating LDL cholesterol levels in the blood by blocking a key liver enzyme involved in cholesterol synthesis. Regular statin therapy results in approximately 18-55% reductions in circulating LDL cholesterol, as well as modest reductions in circulating triglycerides (7-30%) and increases in HDL cholesterol (5-15%)^1-3.

Do statins react with other drugs?

Some medications may interfere with how statins work, including nicotinic acid (vitamin B3), cytochrome P450 3A4 inhibitors and other lipid lowering medications. For more information on drug interactions please contact STAREE on 1800 770 664 or your local pharmacy.

Are there any risks with taking statins?

Some people experience adverse symptoms when using statins. These can range from mild to severe and may be temporary or longer lasting. The most common side effect is mild muscle pain (myalgia) which occurs in 1-10% of people taking a statin. Other side effects may include constipation, nausea, headache and lethargy. There is a very small increased risk of elevated liver enzymes and the development of type 2 diabetes while taking statin therapy.

The chance of developing side effects can vary greatly between people, though the likelihood of experiencing adverse effects from any drug may be increased in older people.

References

1. Stancu, C. & Sima, A. Statins: mechanism of action and effects. Journal of cellular and molecular medicine 5, 378-87 (2001).

2. Nicholls, S.J., et al. Statins, high-density lipoprotein cholesterol, and regression of coronary atherosclerosis. Journal of the American Association 297, 499-508 (2007).

3. Maron, D.J., Fazio, S. & Linton, M.F. Current perspectives on statins. Circulation 101, 207-13 (2000).

History of statins

1900s	German pathologist Virchow noticed the artery walls of patient contained a substance identified as cholesterol
1950s	Compactin, the first statin was discovered in Japan.
1970s	Framingham study showed links between cholesterol and heart disease.
1978	Merck Research Laboratories discovered Lovastatin (the first commercially available statin).
1984	NIH conclude that lowering elevated LDL cholesterol with diet and drugs would reduce risk of CHD.
1987	Lovastatin becomes available by prescription
1990–1994	4S trial shows unequivocally a reduction of mortality with simvastin (men and women aged 35-70 years).
1995–1998	5 clinical outcome trials show a reduction of coronary events with very few adverse effects
2000	Heart Protection study confirms safety of statins in five year trial of 20,000 patients (men and women aged 40-80 years; most participants aged under 70).
2013	US guidelines on statin use change to recommend statin use in those with a 7.5% or higher 10 year risk of cardiovascular disease in those aged 40-75 years. No guidance for those aged over 75.
2014	The UK National Institute for Health and Care Excellence (NICE) draft new guidelines on statin use, which recommends primary prevention statin therapy for those with an increased risk of coronary vascular disease, up to age 84.
2015	Launch of the first primary preventive trial of statins in those aged over 70 in Australia – the STAREE trial.