statiner

Statiner, or statins in English, is a class of lipid-lowering medications that inhibit HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol synthesis. This reduces hepatic cholesterol content, which upregulates low-density lipoprotein receptors and increases clearance of LDL cholesterol from the blood. Statins also modestly lower triglycerides and can modestly raise HDL cholesterol.

Statins are used to reduce cardiovascular risk in people with high cholesterol, and in those with known atherosclerotic cardiovascular disease. They are first-line therapy for hyperlipidemia and are recommended for primary and secondary prevention based on individual risk. Common agents include atorvastatin, rosuvastatin, simvastatin, pravastatin, fluvastatin and pitavastatin, with dosing chosen to achieve targeted LDL-C reduction.

Safety and monitoring: Most patients tolerate statins well. Side effects include myopathy and rare rhabdomyolysis, particularly at high doses or with drug interactions; liver enzyme elevations can occur, so baseline and periodic monitoring of transaminases is advised. Interactions with CYP3A4 inhibitors (for example certain antifungals, macrolide antibiotics) can raise statin levels and adverse risk. Statins are contraindicated in pregnancy and are used with caution in liver disease. If intolerance occurs, dose adjustment or switching to a different statin may help.

History and impact: Introduced in the late 1980s, statins have become a central tool in cardiovascular risk reduction, supported by extensive clinical trial evidence.