Statins: How the drug prevents heart attacks and strokes
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Statins are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol collects on the inside of your artery walls, thereby raising your risk of heart disease. Taking statins can therefore amount to a life-saving intervention for many people at risk of cardiovascular problems.
Knowing precisely when to stake statins to optimise their impact on high cholesterol levels is less clear.
A study published in the British Medical Journal (BMJ) aimed to determine whether taking simvastatin in the morning had significantly different efficiency from taking it in the evening.
The researchers did this by measuring cholesterol concentrations in fasting patients’ serum.
Simvastatin is a common statin prescribed to lower cholesterol.
The researchers randomised adults stable on 10 or 20 mg of simvastatin at night for primary or secondary prevention of coronary heart disease, stroke, or peripheral vascular disease, to dosings in the morning or evening for a period of eight weeks.
They measured fasting blood lipid profiles at baseline and at eight weeks.
Lipid profile is a blood test that can measure the amount of cholesterol and other fatty deposits in your blood.
The researchers sampled blood between 8:30 and 9:30 am.
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The outcome that the researchers considered to be the most important was change in the total cholesterol concentration between the beginning and follow up of the study.
They also measured the concentration of LDL cholesterol and other fatty deposits in the blood.
The researchers found that switching taking simvastatin from in the evening to in the morning resulted in “statistically significant” increases in total and LDL cholesterol.
“Simvastatin is probably best taken at night because concentrations of total cholesterol and of low density lipoprotein are significantly greater when it is taken in the morning,” the researchers wrote.
They continued: “Simvastatin is the most widely prescribed statin in the United Kingdom, and this finding has implications for compliance in preventing coronary heart disease.
“The absence of a similar effect with atorvastatin may be explained by its longer elimination half life.”
Atorvastatin is another common statin prescribed to lower high cholesterol levels.
Statins side effects
Many people who take statins experience no or very few side effects.
“Others experience some troublesome, but usually minor, side effects, such as diarrhoea, a headache or feeling sick,” notes the NHS.
According to the health body, your doctor should discuss the risks and benefits of taking statins if they’re offered to you.
The risks of any side effects also have to be balanced against the benefits of preventing serious problems.
A review of scientific studies into the effectiveness of statins found around one in every 50 people who take the medicine for five years will avoid a serious event, such as a heart attack or stroke, as a result.
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