Hypercholesterolemia and Use of Statins

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Hypercholesterolemia is one of the most common conditions that is
encountered by the medical professionals. It is stated that the it is
marked as an important modifiable risk factors for the onset of the
cardiovascular disease among the patients. According to the study
of de la Sierra et al. (2015), it is a global health problems and is
associated with the onset of atherosclerotic cardiovascular disease.
This article is mainly designed to enhance knowledge among the
family members of the patients who are suffering from obesity and
overweight.
Physiology of the Disease
Hypercholesterolemia is a major risk factors for formation of
atherosclerosis, cerebrovascular disease, coronary heart
disease, peripheral arterial disease. Risk factors for developing
hypercholesterolemia is poor physical condition, bad food
practice among the patients . Complications related to the
hypercholesterolemia and atherosclerosis include ischemic
cardiomyopathy, myocardial infarction, erectile dysfunction,
ischemic stroke, claudication, sudden cardiac death and acute
limb ischemia. In this regard, it can be stated that consumption
of the saturated fats , cholesterol and trans-fatty acids can cause
hypercholesterolemia. Moreover, it is also reported that low HDL-
C levels are associated with abdominal obesity and smoking
behaviours. A primary contributor of the atherosclerotic lesion
formation in the blood vessels is the high level of low density
lipoprotein or LDL. On the contrary it is observed that the high
level of HDL in the blood is associated with the lower level of
risks of cardiovascular disease. Furthermore, the main focus in
hypercholesterolemia is to reduce the amount of LDL in the
blood (Huff & Jialal, 2019).
Mechanism of Action of Lovastatin
Lovastatin is also known as the brand name product Mevacor and
it is a lipid lowering drug under the statin group. The use of this drug
is mainly associated with the reduction of LDL levels and along with
this the risks of developing cardiovascular disease are also reduced.
According to the study of Anderson et al.(2016), use of statin is very
effective in blood LDL levels. The chemical formula of Lovastatin is
C24H36O5.. Lovastatin also lowers the pace of atherosclerosis
formation along with lowering the blood LDL levels.
Lovastatin is adjacent to diet to lower the level of LDL-C ,
total-C, and apolipoprotein B levels. While focussing on the
pharmacodynamics of the drug, it can be stated that it is a
oral antilepemic that reversibly inhibits HMG-CoA reductase
(Drugbank, 2020). At a therapeutic dose of this drug, it does
not block the action of HMG-CoA reductase, rather allows its
functionality to some extent so that required amounts of
mevalonate can be available. The action of this drug
stimulates the uptake of LDL and it also prevents the
production of very low density lipoprotein (VLDL). Gradually
the level of plasma LDL and VLDL is reduced. However, it
should be mentioned that the consumption of lovastatin can
cause muscle pain, tenderness or weakness and liver
dysfunction (Drugbank, 2020).
Hypercholesterolemia and Use of Statins
Anderson, T. J., Grégoire, J., Pearson, G. J., Barry, A. R., Couture,
P., Dawes, M., ... & Hegele, R. A. (2016). 2016 Canadian
Cardiovascular Society guidelines for the management of
dyslipidemia for the prevention of cardiovascular disease in the
adult. Canadian Journal of Cardiology, 32(11), 1263-1282.
de la Sierra, A., Pintó, X., Guijarro, C., Miranda, J. L., Callejo, D.,
Cuervo, J., ... & Rubio, M. (2015). Prevalence, treatment, and
control of hypercholesterolemia in high cardiovascular risk patients:
evidences from a systematic literature review in Spain. Advances
in therapy, 32(10), 944-961.
Drugbank (2020). Lovastatin. Drugbank. Retrieved from-
https://www.drugbank.ca/drugs/DB00227 [Accessed on 31st March
2020]
Huff, T., & Jialal, I. (2019). Physiology, cholesterol. Creighton
University School of Medicine.
Ibrahim, M. A., & Jialal, I. (2019). Hypercholesterolemia.
In StatPearls [Internet]. StatPearls Publishing.
The activity of the scavenger receptors modifies accumulated LDL and
leads to formation of the foam cells. Therefore, more accumulation of
lipids in the blood vessel wall will cause migration of smooth muscle
cells into the lesion. Finally the smooth muscle cells condense in the
newly produced plaque forming the fibrous plaque. This acts as the
protector of the lesions and prevents the exposure of lipid cores to the
lumen of the blood vessels. Atherosclerotic plaques can cause
obstruction of the vessel and thereby decreases blood flow distally and
leads to ischemia. Furthermore, usually due to the presence of
macrophages (vulnerable plaque) rupture, abundant lipid and the
formation of a thrombus causes complete blockage of the blood flow.
As a result acute myocardial infarctions, unstable angina can take
place (Ibrahim & Jialal, 2019).
Introduction
Pathophysiology of the Disease
Pathophysiology of the Disease
While discussing about the pathophysiology of the
hypercholesterolemia, it can be stated that formation of the
atherosclerosis or plaque formation. Formation of the plaque in
the blood vessels can cause various negative health related
consequences. The process through which the endothelial
plaques develops in the blood vessels of the body is the
endothelial damage. Damage in the endothelial tissues leads
to the malfunction of the endothelial cells and thereby causes
permeation of LDL particles through the vascular walls. As a
consequence of this accumulation of the lipoprotein specifically
LDL within the vessel wall stuck by the cellular matrix takes
place. (Huff & Jialal, 2019).
What is Hypercholesterolemia
The problem of hypercholesterolemia mainly refers to the
elevated levels of non-high-density lipoprotein cholesterol
(HDL-C) or low-density lipoprotein cholesterol (LDL-C) in the
blood of the individuals. Cholesterol is mainly a fatty
substance that is present naturally in the body of the
individual. The fat and cholesterol are absorbed in the
intestine and then it is transported to the liver. The liver
coverts the fats into cholesterol and then it is released in to
the blood stream. Among the cholesterol components, there
are mainly two categories - low-density lipoprotein (LDL)
cholesterol (the "bad" cholesterol) and high-density
lipoprotein (HDL) cholesterol. The low density
cholesterol is termed as bad cholesterol and the high-
density lipoprotein cholesterol is named as good
cholesterol. High level of LDL can lead to
hypercholesterolemia and may cause cardiovascular diseases
(Ibrahim & Jialal, 2019).
Pharmacology of the Medicines
In order to treat the condition of hypercholesterolemia, the use of
statin is very popular and the mechanism of statin is completely
dependent on the inhibition of cholesterol producing enzyme
named HMG-CoA reductase. This enzyme is one of the rate
limiting enzymes of cholesterol biosynthesis in liver. Stain binds to
the active site of the substrate of the HMG-CoA and as a
consequence of this the production of the mevalonate is reduced
and the overall synthesis process is altered. Therefore, lower
amount of cholesterol production in the liver eventually lowers the
amount of cholesterol from the blood (Drugbank, 2020).
Conclusion
Hence, it can be concluded that the problem of
hhypercholesterolemia has become a global problem in
recent time and it is associated with the risks of
developing cardiovascular diseases as well.
Hypercholesterolemia mainly refers to the elevated levels
of non-high-density lipoprotein cholesterol (HDL-C) or
low-density lipoprotein cholesterol (LDL-C) in the blood of
the individuals and eventually causes of atherosclerosis
formation due to the accumulation of lipids. As a result the
blood flow is disturbed and leads to angina or other
cardiovascular disease. For treating the condition statin,
an inhibitor of HMG-CoA inhibitor, can be used. Therefore,
Lavostatin is an effective medicines under this group that
works in a same mechanism.
Abstract
Introduction
The problem of hypercholesterolemia has become a global problem in recent time and it is associated with the risks of developing cardiovascular diseases as well. The main risk factor that
is associated with the problems of plaque formation in the blood vessels of the body. This article is designed for the peers of the orthopedic department of the hospital.
Discussion
Hypercholesterolemia mainly refers to the elevated levels of non-high-density lipoprotein cholesterol (HDL-C) or low-density lipoprotein cholesterol (LDL-C) in the blood of the individuals
and eventually causes of atherosclerosis formation due to the accumulation of lipids. Among the cholesterol components, there are mainly two categories - low-density lipoprotein (LDL)
cholesterol (the "bad" cholesterol) and high-density lipoprotein (HDL) cholesterol. The low density cholesterol is termed as bad cholesterol and the high-density lipoprotein cholesterol is
named as good cholesterol. As a result the blood flow is disturbed and leads to angina or other cardiovascular disease. For treating the condition statin, an inhibitor of HMG-CoA inhibitor,
can be used. Lovastatin is an effective medicine under this group that works in a same mechanism. Lovastatin also lowers the pace of atherosclerosis formation along with lowering the
blood LDL levels. Lovastatin is adjacent to diet to lower the level of LDL-C , total-C, and apolipoprotein B levels. While focussing on the pharmacodynamics of the drug, it can be stated that
it is an oral antilepemic that reversibly inhibits HMG-CoA reductase.
Conclusion
Therefore, it can be stated that the issue of hypercholesterolemia is nothing but the deposition of lipids in the blood vessels due to high plasma cholesterol level in the body. Use of
Lovastatin can reduce the plasma cholesterol level by reducing the production of mevalonate, a product of cholesterol biosynthesis in hepatic cells.