Abstract
This review article highlights recent developments in the clinical pharmacology of
statins. A thorough literature search was performed using PubMed Central, Scopus,
and Google Scholar, focusing on keywords related to statin kinetics, mechanisms, cardiovascular
protection, side effects, and variations in individual responses. Understanding the
pharmacokinetics of statins is essential for maximizing their therapeutic effects
while reducing side effects and potential drug interactions. Statins have varying
degrees of lipophilicity, resulting in different kinetic profiles that affect their
bioavailability, elimination, and interactions with other drugs.
The main mechanism by which statins lower cholesterol in blood is by inhibiting liver
3-hydroxy-3-methylglutaryl-CoA reductase, thereby increasing low-density lipoprotein
receptor expression on hepatocytes and decreasing its plasma levels. This will ultimately
reduce the risk of cardiovascular events. Statins also have antithrombotic and anti-inflammatory
effects by increasing the availability of nitric oxide, inhibiting procoagulant proteins,
and inhibiting platelet activation, all of which contribute to cardiovascular protection.
Several clinical evidences support the effectiveness of statins in preventing venous
thromboembolism and acute coronary syndrome. However, statins are associated with
an increased risk of new-onset diabetes, particularly with high-intensity statins,
necessitating careful monitoring in high-risk patients. Additionally, there is variability
in patient responses to statin therapy, influenced by genetic polymorphisms and biological
differences, highlighting the need for personalized treatment strategies. As clinical
guidelines continue to evolve, incorporating genetic and biological factors will be
vital for optimizing statin therapy and managing cardiovascular risks. In conclusion,
there is substantial evidence that statins still play a vital role in preventing cardiovascular
disease, necessitating a comprehensive approach that combines pharmacological interventions
with lifestyle modifications to enhance patient outcomes.
Keywords
cardiovascular protective effects - personalized treatment of statins - statin kinetics
- statin side effects - statins
