Comparison of Low Dose Versus High Dose Statin Therapy in Improving Dyslipidemia
DOI:
https://doi.org/10.70749/ijbr.v2i02.136Keywords:
Statin Therapy, Dyslipidemia, Coronary Artery Disease (CAD), Chronic Obstructive Pulmonary Disease (COPD)Abstract
Dyslipidemia, a significant contributor to atherosclerosis and its associated conditions like coronary artery disease, cerebrovascular disease, and peripheral vascular disease, requires effective management through lifestyle changes and pharmacological treatment. Statins are commonly used to reduce low-density lipoprotein (LDL) cholesterol levels, thus lowering the risks of myocardial infarctions and strokes. However, higher doses of statins, while more effective in reducing cardiovascular events, are associated with an increased risk of adverse effects such as myopathy and elevated liver enzymes. This study aimed to compare the efficacy of low-dose (10 mg) versus high-dose (40 mg) atorvastatin therapy in improving lipid profiles in patients with acute coronary syndrome (ACS).
A randomized trial was conducted with 90 ACS patients recruited from the Bolan Medical Complex, Quetta. They were randomly assigned to either receive 10 mg or 40 mg atorvastatin daily for four months. Lipid profiles, including HDL-C, LDL-C, triglycerides, and total cholesterol, were measured before and after the intervention. Both dosage groups showed significant improvements in their lipid profiles after the treatment period. However, there was no statistically significant difference between the two groups in the overall improvement of dyslipidemia. These findings suggest that both low and high doses of atorvastatin are effective in improving lipid profiles, but higher doses may not offer additional benefits in this patient population.
References
Barker, D. (2000). In utero programming of cardiovascular disease. Theriogenology, 53(2), 555-574. https://doi.org/10.1016/s0093-691x(99)00258-7
Berenson, G. S., Srinivasan, S. R., Bao, W., Newman, W. P., 3rd, Tracy, R. E., & Wattigney, W. A. (1998). Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. The New England Journal of Medicine, 338(23), 1650–1656. https://doi.org/10.1056/NEJM199806043382302
Bergmann, M. L. de A., Bergmann, G. G., Halpern, R., Rech, R. R., Constanzi, C. B., & Alli, L. R. (2011). Associated factors to total cholesterol: school based study in southern Brazil. Arquivos Brasileiros de Cardiologia, 97(1), 17–25. https://doi.org/10.1590/s0066-782x2011005000065
Brazilian Society of Cardiology (BSC). I guidelines for prevention of atherosclerosis in childhood and adolescence. (2005). Arq Bras Cardiol, 85, 3–36.
Carvalho, D. F. de, Paiva, A. de A., Melo, A. S. de O., Ramos, A. T., Medeiros, J. dos S., Medeiros, C. C. M. de, & Cardoso, M. A. A. (2007). Perfil lipídico e estado nutricional de adolescentes. Revista Brasileira de Epidemiologia [Brazilian Journal of Epidemiology], 10(4), 491–498. https://doi.org/10.1590/s1415-790x2007000400007
Cavali, M. de L. R., Escrivão, M. A. M. S., Brasileiro, R. S., & Taddei, J. A. de A. C. (2010). Metabolic syndrome: comparison of diagnosis criteria. Jornal de Pediatria, 86(4), 325–330. https://doi.org/10.2223/JPED.2006
Chang, C., Lee, J., Lin, J., Hung, Y., Liu, R., Shau, W., & Sheu, W. H. (2013). The lipid-lowering effect of atorvastatin in Taiwanese diabetic patients with hyperlipidemia. Tzu Chi Medical Journal, 25(3), 168-174. https://doi.org/10.1016/j.tcmj.2013.06.001
Costa, R. F., Santos, N. S., Goldraich, N. P., Barski, T. F., Andrade, K. S. de, & Kruel, L. F. M. (2012). Metabolic syndrome in obese adolescents: a comparison of three different diagnostic criteria. Jornal de Pediatria, 88(4), 303–309. https://doi.org/10.2223/JPED.2200
Dobler, C. C., Wong, K. K., & Marks, G. B. (2009). Associations between statins and COPD: a systematic review. BMC Pulmonary Medicine, 9(1), 32. https://doi.org/10.1186/1471-2466-9-32
Faria, E. C., Dalpino, F. B., & Takata, R. (2008). Lípides E lipoproteínas séricos Em crianças E adolescentes ambulatoriais de um hospital universitário publico. Revista Paulista de Pediatria, 26(1), 54-58. https://doi.org/10.1590/s0103-05822008000100009
Felitti, V. (2006). Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 11th edition. The Permanente Journal, 10(3). https://doi.org/10.7812/tpp/06-008
Harvey, R. A., Clark, M., Finkel, R., Rey, J., & Whalen, K. (2012). Lippincott’s illustrated reviews. Pharmacology.
Hurst, J. R., Hagan, G., & Wedzicha, J. A. (2007). Mechanism of statin-associated mortality reduction in COPD. Chest, 132(4), 1409; author reply 1409-10. https://doi.org/10.1378/chest.07-1435
Janda, S., Park, K., FitzGerald, J. M., Etminan, M., & Swiston, J. (2009). Statins in COPD: a systematic review. Chest, 136(3), 734–743. https://doi.org/10.1378/chest.09-0194
Jolliffe, C. J., & Janssen, I. (2006). Distribution of lipoproteins by age and gender in adolescents. Circulation, 114(10), 1056–1062. https://doi.org/10.1161/CIRCULATIONAHA.106.620864
Josan, K., & McAlister, F. A. (2007). Cholesterol lowering for secondary prevention: what statin dose should we use? Vascular Health and Risk Management, 3(5), 615–627.
Longmore, J. M., Longmore, M., Davidson, E., Foulkes, A., & Mafi, A. (2010). Oxford handbook of clinical medicine. Oxford University Press.
Mansour, H., Obaid, A., & Bursh, H. (n.d.). Comparison between 20 mg versus 40 mg dose of atorvastatin among dyslipidemic patients associated with diabetes or coronary artery disease: a randomized clinical trial. Medicine, 2017(6). https://doi.org/10.5455/medscience.2016.05.8571
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). (2002). Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation, 106(25), 3143–3421. https://doi.org/10.1161/circ.106.25.3143
Nishikido, T., Oyama, J., Keida, T., Ohira, H., & Node, K. (2016). High-dose statin therapy with rosuvastatin reduces small dense LDL and MDA-LDL: The standard versus high-dose therapy with Rosuvastatin for lipid lowering (SARD) trial. Journal of Cardiology, 67(4), 340-346. https://doi.org/10.1016/j.jjcc.2015.05.017
Preiss, D., & Sattar, N. (2011). Statins and the risk of new-onset diabetes: a review of recent evidence: A review of recent evidence. Current Opinion in Lipidology, 22(6), 460–466. https://doi.org/10.1097/MOL.0b013e32834b4994
Romaldini, C. C., Issler, H., Cardoso, A. L., Diament, J., & Forti, N. (2004). Risk factors for atherosclerosis in children and adolescents with family history of premature coronary artery disease. Jornal de pediatria, 80(2), 135–140. https://doi.org/10.2223/jped.1153
Santos, R. D. (2001). III Diretrizes Brasileiras Sobre Dislipidemias E Diretriz de Prevenção Da Aterosclerose do Departamento de Aterosclerose Da Sociedade Brasileira de Cardiologia. Arquivos Brasileiros de Cardiologia, 77, 1-48. https://doi.org/10.1590/s0066-782x2001001500001
Stone, N. J., Robinson, J. G., Lichtenstein, A. H., Bairey Merz, C. N., Blum, C. B., Eckel, R. H., Goldberg, A. C., Gordon, D., Levy, D., Lloyd-Jones, D. M., McBride, P., Schwartz, J. S., Shero, S. T., Smith, S. C., Watson, K., & Wilson, P. W. (2014). 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Circulation, 129(25_suppl_2). https://doi.org/10.1161/01.cir.0000437738.63853.7a
Waters, D. D., Ho, J. E., DeMicco, D. A., Breazna, A., Arsenault, B. J., Wun, C., Kastelein, J. J., Colhoun, H., & Barter, P. (2011). Predictors of new-onset diabetes in patients treated with Atorvastatin. Journal of the American College of Cardiology, 57(14), 1535-1545. https://doi.org/10.1016/j.jacc.2010.10.047
Young, R. P., & Hopkins, R. J. (2010). Possible role of statins in COPD-related pulmonary hypertension. Chest, 137(5), 1250–1251; author reply 1251. https://doi.org/10.1378/chest.09-2778
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