Drugs that reduce cholesterol in the blood
Drugs that reduce cholesterol in the blood, are widely used in complex therapy and prevention of diseases of the cardiovascular system (CVS). They prevent the formation of atherosclerotic plaques. Cholesterol lowering drugs reduce mortality from cardiovascular accidents (heart attacks and strokes).
What is cholesterol?
Cholesterol is an organic compound belonging to the nature of lipophilic fatty alcohols. It is synthesized in the liver and enter the bloodstream, being absorbed from foods in the digestive tract. The value of this substance in the body:
- necessary for formation of hormones of a steroid structure;
- is a core component of the production of bile acids;
- necessary for the production of vitamins (D);
- protects blood cells (erythrocytes) by the action of specific (hemolytic) poisons;
- stabilizes cell membranes, regulating their fluidity;
- included in regulating membrane permeability of the system.
Cholesterol can’t dissolve in water. To move through the body the blood flow it is included in the composition of lipoprotein complexes. These compounds have different density. There are 2 forms of cholesterol. The fraction with low density (LDL), prone to precipitation in areas of damage to the blood vessel wall. This leads to formation of cholesterol conglomerate – plaque. Such education on the vascular wall reduces the diameter of the artery. Blood flow in this area may slow, decline or stop. This leads to a decrease in tissue nutrition receiving nutrients and oxygen from this vessel. Cholesterol, included in connection with high density, does not possess such properties. He is involved in the biological processes in the body.
What level of cholesterol is considered normal?
For analysis of lipid metabolism conducted the study of the General (total) index and specific fractions. To assess the risk of vascular accidents the most important is the integrated monitoring of triglycerides. Normal values vary with age, gender and received treatment.
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The violation of the total number and the ratio of lipid metabolism leads to the formation of atherosclerotic plaques and formation of thrombosis. Is important that normal levels of total cholesterol and LDL cholesterol in men up to 50 years – higher than in women. After that age it begins to decline. Such dynamics is due to the intensity of the synthesis of sex hormones.
What means are used to reduce cholesterol?
For the normalization of lipid metabolism is used, several groups of lipid-lowering drugs.
- Statins. This group of drugs reduces cholesterol synthesis in the liver. Chemicals of this type affect the enzyme involved in the chain of cholesterol formation. Treatment with drugs from the group of statins has the effect after 10 – 12 days. These drugs reduce LDL.
- Fibrates are derivatives fibroevoy acid. They do not inhibit the synthesis of LDL. Their mechanism of action is based on activation of the enzyme that breaks down the already existing complexes of low density lipoprotein. Cholesterol levels in patients receiving fibrates may be reduced from 20% to 50%. The positive aspect is the decrease in concentration of uric acid and reduction of postprandial glycemia.
- Drugs, leading to increased excretion of bile acids (Cholestyramine). Not actively used as lipid-lowering drugs.
- Derivatives of Niacin. Nicotinic acid affects the concentration of HDL, has antiatherogenic effect.
- Other. This group considered means of Dextrothyroxine to Policosanol. They have a different chemical structure and mechanism of the lipid-lowering effects. The Omacor has an effect on the heart, embedding the ion channels in the heart muscle, affects the level of thromboxane A2 and blood clotting, reduces the synthesis of LDL in the liver.
When cholesterol used drugs that reduce. This is achieved by blocking a liver enzyme that is involved in its synthesis (HGM-CoA HGM-CoA). Such a mechanism of action statins have. These medicines can get rid of high cholesterol by 25 to 55%. The effectiveness of the method «for cleaning vessels» depends on the structure of the drug. Differencebut statins 4 generations:
- Lovastatin was the first drug to reduce LDL cholesterol levels. An independent lipid-lowering effect, this drug is not. After transformation it is metabolized in the free b-acid, which reduces cholesterol synthesis. Lovastatin has revolutionized the field of treatment and prevention of diseases of the SSS. At high cholesterol the effectiveness of the use of drugs of lovastatin was observed at 25%. It is part of Vasilip, Simhala, Cardiostatin etc.
- Fluvastatin headed generation drugs second generation, becoming the first hypolipidemic agent, which alone reduces LDL levels, it reduces high cholesterol by 26 – 29%. Fluvastatin is part Lexol.
- The third generation will include the funds on the basis of atorvastatin. In its application the total cholesterol lowered by 30 to 45% and LDL cholesterol up to 61%. Part of the drugs Torvacard, Atomax, Tulip, Liprimar.
- Drugs of the last (fourth) generation are derivatives of rosuvastatin and pitavastatin. Their hypolipidemic effect is due to the increase in the number of cell receptors in the liver to LDL. Therefore, the complex of low density lipoprotein actively eliminated from the bloodstream and destroyed. The fall in LDL when taking these drugs is observed in 50 – 55%.
Who needs statins?
Statins achieve maximum efficiency in the treatment of ischemic heart disease chronic. Their therapeutic effect is used for the treatment and prevention of diseases of the SSS. The indications of statins are:
- giperholesterinemia resistant to diet for 3 months or more;
- homozygous variant manifestations of family giperholesterinemia;
- high level of coronary risk in combination with transient giperholesterinemia; statins are recommended in acute coronary syndrome, myocardial infarction during early in-hospital period, and hypertension with additional risk factors in patients of middle age group;
- stable angina post-infarction cardiosclerosis, stroke, diabetes and peripheral vascular atherosclerosis.
How to choose the best medication with lipid-lowering effect?
If there are several groups of drugs that reduce cholesterol, raises the question of which tablet is better to choose? To select for the treatment or prevention of diseases of the SSS will be able doctor. He will choose treatment in accordance with gender, age, stage of disease and accompanying pathology. Assigned their own «purge vessels» can lead to complications and worsening of existing diseases.
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