Blood lipids have returned to normal. Should the dosage of statins be reduced? The dosage should be reduced in the following situations

In recent days, several friends asked Huazi the same question: After taking statins, the low-density lipoprotein cholesterol (LDL-C) dropped to 1.8mmol/L. Should I reduce the dosage?

Huazi said that it is not recommended to reduce the dosage, because most people's dyslipidemia cannot be cured, and continuous medication is needed to control cholesterol to keep it within a safe range. If the dosage is reduced without authorization, it is likely to cause cholesterol to rise again, especially for people with atherosclerosis. The effect of statins is not as simple as lowering blood lipids.

1. The harm of elevated LDL-C

Among the blood lipids in the human body, low-density lipoprotein cholesterol (LDL-C) is a very important indicator, and its level can indicate the risk of cardiovascular and cerebrovascular diseases. Because LDL-C is the "raw material" of atherosclerosis, when the level rises, it will promote the formation and progression of hardened plaques, which is the pathological basis of coronary heart disease, cerebral infarction, myocardial infarction and other diseases.

Therefore, controlling LDL-C levels can reduce the risk of cardiovascular and cerebrovascular diseases. For healthy people, LDL-C needs to be controlled below 3.4mmol/L; for people with chronic diseases, LDL-C needs to be controlled below 2.6mmol/L; for people who have already suffered cerebral infarction, myocardial infarction, and coronary heart disease, LDL-C needs to be controlled below 1.8mmol/L to prevent recurrence of the disease.

2. LDL-C that needs to be controlled with medication

Many people think that LDL-C is the fat in the blood, so eating less or no fat, and being a vegetarian every day can lower LDL-C. This idea is not wrong, but only 30% of the LDL-C in the human body comes from the diet, and the other 70% is synthesized by the body itself, which is related to the human genes and has little to do with body fatness. Therefore, many people who are completely vegetarian and thin will also have excessive LDL-C.

When strict dietary control is implemented, the LDL-C produced by the human body will also increase, so most people with dyslipidemia cannot reduce it through simple dietary control and must use medication.

3. Statins can not only lower blood lipids

Statins are commonly used to lower cholesterol. They can directly inhibit the synthesis of cholesterol and reduce the LDL-C level in the blood. Most people have primary hyperlipidemia, and there is no specific cause or cure. The only way to control LDL-C levels is through continuous medication.

But what many people don’t know is that statins can not only lower blood lipids, but also have anti-inflammatory, antioxidant, and arterial intima metabolism-improving effects. Long-term use of statins by people with atherosclerosis can reduce the possibility of plaque rupture, reduce thrombosis, and even reverse plaques, avoiding cerebral infarction and myocardial infarction.

In order for statins to be effective in reversing plaques, two things need to be done.

The first point is to control LDL-C to the target. If the target cannot be achieved when using statins alone, it is necessary to use them in combination with drugs such as cholesterol absorption inhibitors and PCSK9 inhibitors.

Second, it is important to ensure that the medication is taken for a certain period of time. Most people need to take the medication for 2 to 4 years before they can see the reversal of plaques. According to current research results, the longer you take the medication, the better the protective effect on your cardiovascular system.

Therefore, precisely because statins have the function of protecting the cardiovascular and cerebrovascular systems, some people who have low blood lipids but are at risk of cardiovascular and cerebrovascular diseases will be required by doctors to take statins.

When should the dose of statins be reduced?

The reduction of blood lipids to normal is not an indication for reducing the dosage of statins, but it is necessary to continue to take the medicine regularly to keep LDL-C within a safe range. Only when the LDL-C level is lower than 1.4mmol/L, should the dosage of statins be reduced.

If severe adverse reactions occur during medication, the dosage needs to be reduced or the medication needs to be discontinued. If transaminase (ASL, ALT) exceeds 3 times the upper limit of normal; or creatine kinase (CK) exceeds 5 times the upper limit of normal, the medication needs to be discontinued.

It should be noted that statins may cause elevated blood sugar, but discontinuation of the medication is not recommended, because the benefits of statins in protecting the cardiovascular system far outweigh the risks of affecting blood sugar. Those with elevated blood sugar can add hypoglycemic drugs, or choose statins that have little effect on blood sugar, such as pitavastatin and pravastatin.

To sum up, when taking statins, it is not recommended to reduce the dosage after the blood lipids reach the standard, but to continue taking it. Only when LDL-C is low or serious adverse reactions occur, it is necessary to reduce the dosage or stop taking the medicine. The medicine must be used under the guidance of a doctor. If you have any questions about the use of the medicine, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.