Abstract
The so-called 3-hydroxy-3-methyl-glutaryl-CoA (HMGCoA) reductase inhibitors, or the statins, represent a class of drugs that has been developed successfully over almost 30 years and are now widely used all over the world for cardiovascular prevention. The popularity of these drugs is based on the fact that not only they are clinically effective, but also some leading brands are now cheap when generics have been introduced. The statins can be classified into the drugs which are more effective per mg, such as rosuvastatin and atorvastatin, and the more common statins such as simvastatin, pravastatin, and fluvastatin. The first one, lovastatin, is not in use anymore. Newer drugs are being developed such as pivastatin, but one drug, cerivastatin, was withdrawn due to hepatotoxicity. All the statins use the same kind of metabolic mechanisms even if they differ in potency and pharmacological properties.
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References
Taylor F, Ward K, Moore TH, Burke M, Davey Smith G, Casas JP, Ebrahim S (2011) Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev (1):CD004816
Tonelli M, Lloyd A, Clement F, Conly J, Husereau D, Hemmelgarn B et al (2011) Alberta Kidney Disease Network. Efficacy of statins for primary prevention in people at low cardiovascular risk: a meta-analysis. Can Med Assoc J 183:E1189–E1202
Yusuf S, Islam S, Chow CK, Rangarajan S, Dagenais G, Diaz R et al (2011) Prospective Urban Rural Epidemiology (PURE) Study Investigators. Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey. Lancet 378:1231–1243
Spector R, Snapinn SM (2011) Statins for secondary prevention of cardiovascular disease: the right dose. Pharmacology 87:63–69
Kostis WJ, Cheng JQ, Dobrzynski JM, Cabrera J, Kostis JB (2012) Meta-analysis of statin effects in women versus men. J Am Coll Cardiol 59:572–582
Chen YH, Feng B, Chen ZW (2012) Statins for primary prevention of cardiovascular and cerebrovascular events in diabetic patients without established cardiovascular diseases: a meta-analysis. Exp Clin Endocrinol Diabetes 120:116–120
Yamashita S, Tsubakio-Yamamoto K, Ohama T, Nakagawa-Toyama Y, Nishida M (2010) Molecular mechanisms of HDL-cholesterol elevation by statins and its effects on HDL functions. J Atheroscler Thromb 17:436–451
Cholesterol Treatment Trialists’ (CTT) Collaboration, Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, Bhala N (2010) Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 376:1670–1681
Paciaroni M, Bogousslavsky J (2009) Statins and stroke prevention. Expert Rev Cardiovasc Ther 7:1231–1243
Callahan A, Amarenco P, Goldstein LB, Sillesen H, Messig M, Samsa GP et al (2011) SPARCL Investigators. Risk of stroke and cardiovascular events after ischemic stroke or transient ischemic attack in patients with type 2 diabetes or metabolic syndrome: secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Arch Neurol 68(10):1245–1251
Lundbye JB, Thompson PD (2005) Statin use in the metabolic syndrome. Curr Atheroscler Rep 7:17–21
Ooi EM, Watts GF, Chan DC, Chen MM, Nestel PJ, Sviridov D, Barrett PH (2008) Dose-dependent effect of rosuvastatin on VLDL-apolipoprotein C-III kinetics in the metabolic syndrome. Diabetes Care 31:1656–1661
Rosenson RS, Otvos JD, Hsia J (2009) Effects of rosuvastatin and atorvastatin on LDL and HDL particle concentrations in patients with metabolic syndrome: a randomized, double-blind, controlled study. Diabetes Care 32:1087–1091
Athyros VG, Ganotakis E, Kolovou GD, Nicolaou V, Achimastos A, Bilianou E et al (2011) Assessing the treatment effect in metabolic syndrome without perceptible diabetes (ATTEMPT) collaborative. Assessing the treatment effect in metabolic syndrome without perceptible diabetes (ATTEMPT): a prospective-randomized study in middle aged men and women. Curr Vasc Pharmacol 9:647–657
Robinson JG, Ballantyne CM, Hsueh W, Rosen J, Lin J, Shah A, Lowe RS et al (2011) Achievement of specified low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol apolipoprotein B, and high-sensitivity C-reactive protein levels with ezetimibe/simvastatin or atorvastatin in metabolic syndrome patients with and without atherosclerotic vascular disease (from the VYMET study). J Clin Lipidol 5:474–482
Heart Protection Study Collaborative Group, Bulbulia R, Bowman L, Wallendszus K, Parish S, Armitage J, Peto R et al (2011) Effects on 11-year mortality and morbidity of lowering LDL cholesterol with simvastatin for about 5 years in 20,536 high-risk individuals: a randomised controlled trial. Lancet 378:2013–2020
JUPITER Study Group, Ridker PM, MacFadyen JG, Fonseca FA, Genest J, Gotto AM, Kastelein JJ et al (2009) Number needed to treat with rosuvastatin to prevent first cardiovascular events and death among men and women with low low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein: justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin (JUPITER). Circ Cardiovasc Qual Outcomes 2:616–623
Koenig W, Ridker PM (2011) Rosuvastatin for primary prevention in patients with European systematic coronary risk evaluation risk ≥5 % or Framingham risk >20 %: post hoc analyses of the JUPITER trial requested by European health authorities. Eur Heart J 32:75–83
Lazich I, Sarafidis P, de Guzman E, Patel A, Oliva R, Bakris G (2012) Effects of combining simvastatin with rosiglitazone on inflammation, oxidant stress and ambulatory blood pressure in patients with the metabolic syndrome: the SIROCO study. Diabetes Obes Metab 14:181–186
LaRosa JC, Deedwania PC, Shepherd J, Wenger NK, Greten H, DeMicco DA et al (2010) TNT Investigators. Comparison of 80 versus 10 mg of atorvastatin on occurrence of cardiovascular events after the first event (from the Treating to New Targets [TNT] trial). Am J Cardiol 105:283–287
Preiss D, Seshasai SR, Welsh P, Murphy SA, Ho JE, Waters DD et al (2011) Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA 305:2556–2564
Koh KK, Sakuma I, Quon MJ (2011) Differential metabolic effects of distinct statins. Atherosclerosis 215:1–8
Strazzullo P, Kerry SM, Barbato A, Versiero M, D’Elia L, Cappuccio FP (2007) Do statins reduce blood pressure? - a meta-analysis of randomized, controlled trials. Hypertension 49:792–798
European Association for Cardiovascular Prevention & Rehabilitation, Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O et al (2011) ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 32:1769–1818
Krysiak R, Gdula-Dymek A, Bachowski R, Okopien B (2010) Pleiotropic effects of atorvastatin and fenofibrate in metabolic syndrome and different types of pre-diabetes. Diabetes Care 33:2266–2270
Ott C, Schmieder RE (2009) The role of statins in the treatment of the metabolic syndrome. Curr Hypertens Rep 11:143–149
Hermans MP (2010) Impact of fenofibrate on type 2 diabetes patients with features of the metabolic syndrome: subgroup analysis from FIELD. Curr Cardiol Rev 6:112–118
Cannon CP, Giugliano RP, Blazing MA, Harrington RA, Peterson JL, Sisk CM et al (2008) IMPROVE-IT investigators. Rationale and design of IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial): comparison of ezetimbe/simvastatin versus simvastatin monotherapy on cardiovascular outcomes in patients with acute coronary syndromes. Am Heart J 156:826–832
Dunkley AJ, Davies MJ, Stone MA, Taub NA, Troughton J, Yates T, Khunti K (2011) The Reversal Intervention for Metabolic Syndrome (TRIMS) study: rationale, design, and baseline data. Trials 12:107
Redon J, Cifkova R, Laurent S, Nilsson P, Narkiewicz K, Erdine S, Mancia G (2008) Scientific Council of the European Society of Hypertension. The metabolic syndrome in hypertension: European society of hypertension position statement. J Hypertens 26:1891–1900
CÃfková R, Nilsson PM (2009) Statins and hypertension. J Hypertens 27:662–665
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Nilsson, P.M. (2013). The Role of Statins in the Metabolic Syndrome. In: Beck-Nielsen, H. (eds) The Metabolic Syndrome. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1331-8_10
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DOI: https://doi.org/10.1007/978-3-7091-1331-8_10
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