Statins: the drugs for the 21st century?

This review summarizes the current evidence on beneficial effect of statins on the atherogenesis and the preventive potential of coenzyme Q 10 to avoid statin-induced myopathy. Statins, originally discovered in molds are the most effective medication to decrease the low-density cholesterol (LDL-C) which is the key participant in atherogenesis. Statins accomplish this by inhibiting the hydroxymethyl glutaryl coenzyme A reductase, an enzyme that is rate limiting for cholesterol biosynthesis. Inhibition of HMG CoA reductase stimulates in the liver the LDL receptors. The result is an increased clearance of LDL particles from the bloodstream and by this mechanism statins have proved to be highly effective in reducing the cardiovascular risk, as amply documented in clinical studies confirming inhibition of atherosclerosis. Additional beneficial effect of statins occurs by modulation of endothelial functions and by diminishing vessel wall inflammation. Statins reduce the level of the C-reactive protein, a strong predictor of adverse cardiovascular events. Beneficial effects of statins on endothelial dysfunction and synthesis of nitric oxide NO were described. Different statin preparation might differ in their antioxidant effects (Fig. 2, Ref. 46). Full Text (Free, PDF) www.bmj.sk.