Why do you need to take statins after suffering from coronary heart disease? Can it reverse the disease?

A patient with coronary heart disease asked Huazi that after he was diagnosed with coronary heart disease, the doctor asked him to take statins. He didn't quite understand, isn't this a lipid-lowering drug? His blood lipids were not high originally, he just had a little high blood pressure, why did he still need to take statins?

Huazi told him that statins are crucial for patients with coronary heart disease. They can not only protect the cardiovascular system and prevent myocardial infarction, but may also reverse the disease to a certain extent.

1. Why do people get coronary heart disease? The full name of coronary heart disease is coronary atherosclerotic heart disease. The function of the coronary artery is to supply blood to the heart. When atherosclerosis occurs, the lumen of the artery will narrow and the blood flow will decrease. When the heart does not get enough blood and oxygen supply, symptoms of angina pectoris will appear.

The main reason for atherosclerosis is that the intima of the artery is damaged, which allows cholesterol in the blood to enter the intima and form atherosclerotic plaques. Common factors that can cause damage to the intima of the artery are high blood pressure, high blood lipids, high blood sugar and smoking.

2. Risk factors for coronary heart disease Atherosclerotic plaques grow very slowly, usually taking more than a decade to cause significant stenosis of the arteries. When the stenosis of the coronary arteries exceeds 50%, the patient's activity tolerance will be significantly reduced. After continuous activity, the myocardium will experience pain due to insufficient oxygen supply, which can only be relieved after the patient is forced to rest, but it will not affect daily mild activities.

However, the real risk factor for coronary heart disease is not the degree of vascular stenosis, but the rupture of plaques. It takes more than ten years, or even decades, for plaques to grow from 50% stenosis to complete blockage of blood vessels. But what is more dangerous is that many atherosclerotic plaques are not stable. Under factors such as blood flow flushing, blood pressure changes, and arterial spasms, the surface of the plaques will rupture, which will activate the body's coagulation mechanism, form blood clots in the blood vessels, and block the blood vessels.

3. The key role of statins The main pharmacological role of statins is to inhibit the enzyme that synthesizes cholesterol in the human body, thereby reducing cholesterol levels, so they are classified as blood lipid regulating drugs. However, in addition to regulating blood lipids, statins also have a "key role" in atherosclerotic plaques that cannot be replaced by other drugs.

Statins can also improve the metabolism of the arterial lining; they can resist cholesterol oxidation and inflammatory stimulation; they can shrink the lipid core of the plaque, increase the density of the plaque, reduce the volume of the plaque, and transform unstable plaques into stable plaques. When taken for a long time (more than 2 to 4 years), they can partially reverse atherosclerotic plaques.

In other words, the "key role" of statins for patients with coronary heart disease is to stabilize plaques and prevent them from rupturing and forming blood clots. The target of medication is to reduce low-density lipoprotein cholesterol (LDL-C) to below 2.6mmol/L at least; if you have had a heart attack or have undergone heart stents, bypass surgery, etc., you need to reduce LDL-C to below 1.8mmol/L.

People with atherosclerosis are recommended to take statins for long-term treatment even if their blood lipids are normal. Relevant clinical trials have shown that the longer statins are taken, the lower the chance of cardiovascular accidents. For people with excessive blood lipids, other types of lipid-lowering drugs may be needed in combination to control LDL-C to the standard.

In summary, statins can stabilize atherosclerotic plaques in the coronary arteries, prevent plaque rupture, and prevent the occurrence of myocardial infarction. When taken for a long time, they can also shrink plaques and have a reversal effect. When taking the medicine, it is necessary to take it under the guidance of a doctor to reduce adverse reactions and avoid contraindications. If you find any problems during the medication process, please consult a doctor or pharmacist in time. I am pharmacist Huazi, welcome to follow me and let me be the pharmacist by your side.