When should statins be taken? Different levels of risk have different control standards

Recently, an elderly friend told Huazi that he found that his cholesterol was high during a physical examination, with a low-density lipoprotein cholesterol (LDL-C) of 4.6mmol/L, and the doctor recommended that he take statins. He asked Huazi, how do doctors judge when he should take statins? Is there any standard to determine when to start taking statins?

Huazi told him that there are standards for when to start statin treatment and how to adjust the medication during treatment. The doctor will conduct a comprehensive assessment based on the patient's low-density lipoprotein cholesterol (LDL-C) level and other risk factors to determine the treatment time and goals.

1. Threats to health from elevated LDL-C

Cholesterol is a nutrient in the human body and is involved in various biosynthesis and metabolic processes. Cholesterol in the blood exists in the form of lipoproteins. The role of low-density lipoprotein (LDL) is to transport cholesterol to all parts of the body after combining with cholesterol to form LDL-C.

However, if the LDL-C level is too high and cannot be fully utilized, it will be deposited on the intima of the arteries and cause an inflammatory response . If other factors such as high blood pressure, high blood sugar, smoking, obesity, aging, and genetics cause damage to the intima of the arteries, LDL-C will also enter the intima of the arteries to form atherosclerotic plaques. Continued progression may cause diseases such as myocardial infarction and cerebral infarction .

2. What are the criteria for controlling LDL-C?

Before starting treatment, the risk factors for cardiovascular and cerebrovascular diseases should be identified, such as high blood pressure, diabetes, smoking, age (male>45 years old; female>55 years old), obesity, low high-density lipoprotein cholesterol (HDL-C) (lower than 1.04mmol/L), and genetics (a family history of cardiovascular and cerebrovascular diseases such as cerebral infarction, myocardial infarction, and coronary heart disease in direct relatives).

1. When to start drug treatment : For people who do not have hypertension, diabetes, and no more than three other risk factors, drug treatment is recommended when the LDL-C level exceeds 4.9mmol/L. The upper limit of the LDL-C reference value on most hospital test reports is 3.4mmol/L , which is usually also used as the control target for healthy people.

2. People with chronic diseases : If you have chronic diseases such as hypertension and diabetes, or if you do not have chronic diseases but have more than 3 other risk factors, it is recommended to start drug treatment. The LDL-C control target is below 2.6mmol/L .

3. People who have had related diseases : People who have had myocardial infarction, cerebral infarction, coronary heart disease, or carotid artery stenosis greater than 50% need to control LDL-C below 1.8mmol/L . If the condition is serious, it needs to be further reduced to below 1.4mmol/L .

3. Statins are the main drugs for controlling LDL-C

The most important thing to control LDL-C levels is statins . Not only can statins directly inhibit the synthesis of cholesterol, but more importantly, statins can stabilize atherosclerotic plaques and reduce the possibility of rupture.

The direct consequence of atherosclerosis is arterial stenosis, which prevents the heart, brain, kidneys and other organs from getting enough blood and oxygen, but this is not the most dangerous situation. The biggest danger of atherosclerosis is the instability of plaques, which may rupture, induce thrombosis, and cause serious diseases such as myocardial infarction and cerebral infarction.

Statins are the only drugs that can stabilize and reverse plaques, and no other drugs can completely replace them . Therefore, doctors may require long-term use of statins for people with low LDL-C levels but atherosclerosis.

In summary, in the treatment of cardiovascular and cerebrovascular diseases, low-density lipoprotein cholesterol (LDL-C) level is an important indicator. Different risk factors have different requirements for LDL-C levels. During specific treatment, the doctor will conduct a comprehensive assessment of the patient's condition and set individualized control goals.

Statins can not only lower LDL-C levels, but also stabilize and reverse plaques, which can reduce the risk of cardiovascular and cerebrovascular diseases. They should be kept in the treatment plan as much as possible . Once atherosclerosis is formed, it cannot be completely eliminated, so statin treatment usually needs to be maintained for a long time. The drug must be used under the guidance of a doctor. If you have any questions about the use of the drug, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.