In the field of lowering blood lipids and preventing cardiovascular diseases, statins are a drug that many friends have been taking for a long time. This type of drug can effectively reduce blood lipids and can also play a role in reducing the risk of cardiovascular disease. It is still the first choice drug and basic drug for clinical cardiovascular disease risk control and hyperlipid control.
The more widely used drugs are, the greater the chance of various medication errors. In real life, it is not uncommon for the use of wrong statins not only to prevent the disease from being effectively controlled, but even bringing physical health hazards. Today's popular science article will take you to get close to 4 examples of wrong medication use and introduce you to the misunderstandings of drug use and the relevant knowledge on rational medication use.
Example 1: Shouldn't take medicine for random use
Patient Xiao Wang is a big fat man. His physical examination found that his blood pressure was high and his blood lipids were also high. Among the various blood lipid indicators, the main increase was triglycerides, and the measured value reached 4.6mmol/L, but other blood lipid indicators, bottom density lipoprotein and cholesterol, etc. were within the normal range. Xiao Wang, who did not receive the doctor's guidance and thought he had "hyperlipidemia", bought 20mg of atorvastatin and took it. After taking it for one month, he checked his blood lipids. The total cholesterol and low-density lipoprotein cholesterol decreased a lot, but the triglyceride level was still at 4.2mmol/L, which was still much higher than the normal value below 1.8.
This situation is a behavior of random use of drugs. The main mechanism of action of statins is to compete to inhibit the activity of liver cholesterol synthetase, thereby inhibiting liver cholesterol synthesis and reducing blood lipids. For various blood lipid indicators, it mainly reduces the levels of total cholesterol and bottom density lipoprotein cholesterol, while the regulation effect of triglycerides is usually relatively weak. Therefore, after taking a large dose of atorvastatin for one month, the triglycerides did not drop, and in fact they did not get the treatment benefits they deserved.
Another thing to point out is that when many friends find abnormalities in certain physical indicators, they always think about what medicine to take to lower it, but never think about what else can I do besides taking medicine? In Xiao Wang's situation, he is young and has a medium- and low risk of cardiovascular disease. The blood lipid index is only moderately increased triglycerides. If you can pay more attention in your daily life, control fat and sugar, strengthen exercise, actively control weight, limit alcohol, and maintain a good work and mentality, triglycerides can be reduced through life conditioning, and there is no need to take medicine at all.
Example 2: Persist in taking medicine without rechecking blood lipids
Lao Zhao is a patient with cardiovascular disease. He had a sudden myocardial infarction a few years ago. After emergency treatment, the blood circulation has recovered after stent intervention. However, due to the high blood lipids, long-term use of statins is needed to control blood lipid levels. Therefore, he has insisted on taking statins every day for several years, but never checked his blood lipid level and asked him how he was controlling his blood lipids? Of course, I don’t know anything about it. Suddenly one day I had chest pain again and was admitted to the hospital again. I realized that this time I had stenosis in another part of the cardiovascular system. After checking the blood lipids, it was found that although he was taking statins, Lao Zhao's low-density lipoprotein cholesterol was still around 3.5 mmol/L, which was still far from the target value of 1.8 that patients with cardiovascular disease needed to control. Examples like
are really regrettable. If you can check blood lipids in the early stage of taking statins and find that the blood lipid control does not meet the standards, you can adjust the medication plan in time and strictly control the blood lipid level to meet the standards. Although it is not certain that this restenosis will not occur, strictly controlling blood lipids will indeed greatly reduce the risk of secondary occurrence of cardiovascular events.
Example 3: Choose a high dose to eat liver damage
Lao Qin is also a patient with hyperlipidemia. Combined with his cardiovascular risk assessment (which is a high-risk risk), the doctor suggested that he take statins to strengthen the control of blood lipids and try to ensure that the low-density lipoprotein cholesterol of blood lipids is controlled below 2.6mmol/L.Lao Qin took atorvastatin, and the doctor suggested that he take 10mg a day, but Lao Qin heard that the 40mg dose has a stronger lipid-lowering effect. Based on the idea of "the more you get better", Lao Qin insisted on taking this dose. After taking it for a few months, he developed symptoms such as loss of appetite, sallow complexion, and fatigue. He went to the hospital for examination and found that the aminotransferase was increased by more than ten times more than the normal value, and there were irreversible drug-induced liver damage.
The risk of adverse reactions of drugs is proportional to the intensity of action of the drug dosage. statins themselves have a certain risk of adverse reactions leading to increased aminotransferase, and the 40mg dose of atorvastatin is already the largest dose allowed in China. The risk of increased aminotransferase will of course be greatly increased.
statins have a 6% principle, that is, within the effective drug dosage range, the dosage of the drug will only increase by about 6% when the drug is reduced. However, the problem of increasing the risk of adverse reactions brought about by this is worthy of special attention. Especially for us Chinese, we are usually sensitive to statins and have good lipid-lowering effects, but the incidence of adverse reactions is relatively high. Therefore, on the basis of controlling blood lipid standards, it is a more reasonable and safer choice to choose low-dose statins as much as possible. For example, in Lao Qin's case, 10mg dose of atorvastatin is very good. Regular review of blood lipids, liver function, etc., plus life conditioning intervention, control blood lipids within the standard range.
Example 4: Discontinue the medication if the blood lipids meet the standards
patient Mr. Zhang is 55 years old this year. He has a family history of cardiovascular disease, 4.5mmol/L of low-density lipoprotein cholesterol, comprehensive blood pressure and other cardiovascular disease risk factors. Although no cardiovascular disease has occurred at present, it is also a high-risk situation. In this case, it is necessary to control the low-density lipoprotein cholesterol to at least 2.6. The doctor also prescribed rosuvastatin for him, asking him to take 5 mg every day. After taking it for a month, Mr. Zhang went for a follow-up examination of his blood lipids, and his blood lipid level dropped to 2.1 mmol/L. He believed that the hyperlipidemia had been "cured", so he stopped taking the medication by himself. Just about half a year after the drug was stopped, Mr. Zhang suddenly had symptoms such as crooked mouth and eyes, headache and vomiting. He was rushed to the hospital and found that he had an infarction stroke. Although he gradually recovered after rescue, it is believed that it will take a lot of time to completely recover the body's actions.
Hyperlipid problems, in fact, like hypertension, diabetes and other problems, are a chronic metabolic disease problem. The occurrence of dyslipidemia is caused by problems with the body's blood lipid metabolism. Judging from the current medical level, such chronic diseases cannot be "cured". On the one hand, we can strengthen blood lipid control through strict self-discipline and a healthy lifestyle. On the other hand, if life conditioning cannot effectively control blood lipids, lipid-lowering drugs should still be taken for a long time. In a situation like Mr. Zhang, if he insisted on taking statins, this sudden cerebrovascular event might not have happened.
The four real examples in real life mentioned above are all some of the wrong medications used by many friends. I hope that such examples can sound the alarm for everyone and help everyone to use statins reasonably and safely. Everyone is also welcome to actively forward and share so that more people can see such popular health knowledge.
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