My understanding is that the statins with the greatest LDL reducing effect are Crestor, Lipitor, Zocor, and Pravachol, in that order. I don’t mention Leschol and Mevacor since they appear to be rarely used since recently due to the aforementioned being more powerful. Do we have any available solid data on the effects of the various individual statins other than LDL reduction? For example, do we know which ones raise HDL the most? What about effects on particle size or Lp(a), etc. I guess really the most important question would be – is any one of these statins more proven than the rest in regards to reducing cardiovascular events?
I think it's more of which one your body will tolerate the best. Different brands seem to show different side effects in many people. Lipitor in some women have produced breast pains or enlargement and even the manufacturers cannot explain that one. Still, I suppose it's cheaper than plastic surgery. Some statins cause abdominal pains in some people, or nausea or serious muscle cramps and even damage. So I don't think it's just picking the one which you feel has the best affects, it's which one suits your body the best. In most cases I've read about, statins have hardly affected HDL levels, in fact most people have trouble raising them. When statins lower LDL, this automatically makes the HDL a higher proportion than it was. Triglycerides can also be a problem in some people, trying to lower them.
There are all kinds of statins out there, as ed said, you have to find out which one you tolerate. I have been on them for many years as I was unable to lower my LDL with diet and exercise alone. They have worked well and I have had no side effects, but everyone is different. Most of these can be replaced by the generic Simvastatin. It's cheap and is the basis of many of the meds out there. For instance, it's the generic for Zocor plus Vytorin is Simvastatin with Zetia, a Fenofibrate for lowering tri's.
Statins improve blood cholesterol levels primarily by inhibiting a liver enzyme called HMG Co-A reductase, thus reducing the liver's ability to make cholesterol. Statins cause a significant reduction in LDL cholesterol levels, a moderate reduction in triglyceride levels, and a small increase in levels of HDL cholesterol.
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