Statins in the practice of an internal medicine specialist: A review

Abstract

Statins have been used in clinical practice for more than 40 years to treat and prevent atherosclerosis and its complications. The results of observational studies indicate that, despite a large evidence base, statins in Russia are still prescribed in low doses, for a maximum of 6 months, leading to a low percentage of achieving the target levels of low-density lipoprotein cholesterol and, thus, to a high residual risk of cardiovascular complications. This paper presents a literature review and analysis of the basic principles of statin therapy in primary prevention, intensive lipid-lowering therapy in patients with very high cardiovascular risk, as well as key safety updates on cholesterol decrease for various organs and systems (liver, kidneys, muscles, nervous system), and carbohydrate metabolism. The article also provides a brief overview of new international guidelines to optimize the diagnosis and treatment of dyslipidemias, which can be useful in the day-to-day practice of an internal medicine specialist.

Keywords

• primary prevention
• dyslipidemia
• statins
• ezetimibe
• low-density lipoprotein cholesterol
• recommendations
• cardiovascular risk
• safety
• diabetes mellitus
• myopathies
• hyperenzymemia
• dementia
• chronic renal failure