A Brief Note On Patients With Coronary Heart Disease : How Do Statins Work And Why Are They Considered

Coronary artery disease is a disorder affecting the blood vessels of the heart, generally in the form of atherosclerosis. Atherosclerosis literally means “fatty harden mush”. This is formed from the

“You're more likely to have high cholesterol that can lead to heart disease if you have any of these risk factors such as smoking, obesity, large waist circumference, poor diet, lack of exercise and diabetes.” (Mayo Clinic Staff)

A sufficient coronary artery blood flow is essential to supply oxygen for normal cardiac activities (Craft, 2014, p. 599). Atherosclerosis is a common form of CHD. It is an inflammation disease when plasma cholesterol is high. Risk factors such as hypertension, high cholesterol, smoking and diabetes increase the risk of endothelium injuries, contributing to the increase in oxidated lipid-lipoprotein (LDL). Foam cell is produced by the increase in the number of macrophages signalled by oxidated LDL. Next, the accumulation of foam cells will cause the formation of fatty streak lesions on arteries walls. Over time, fatty streak lesions migrate to the site and form fibrous plaque due to the increase in smooth muscles and collagen. The thickening and hardening initiated by an accumulation in calcified fibrous plaque caused the blood vessels to narrow. As a result, a decrease in tissue perfusion contributing to the development of myocardial ischemia (Craft, 2014, p. 599; McCance & Huether, 2014, pp. 1145-1147).

Atherosclerotic research has recently concentrated on inflammatory cytokines involved in vascular inflammation and how they stimulate the production of endothelial adhesion molecules, which could enter circulation in soluble form, and have the cytokines stimulate the production of messenger cytokine interleukin-6, which incites the liver production of acute-phase reactants such as C-reactive protein to increase. (Packard et al., 2007) In short, cytokines released into the bloodstream have a tendency to bring about an inflammatory response. Researchers have also found that that treatment with lipid-reducing agents is correlated with reduced morbidity and mortality from coronary heart disease and it seems to work near the atherosclerotic lesion, causing stabilization, slowed progression and, in some cases, regression of lesions. (Blankenhorn, 1989) In research it is well know that one human risk factor for atherosclerosis is hypercholesterolemia, which is when total cholesterol and low-density lipoprotein cholesterol are elevated. (Genis et al., 2000) There are more contributors and characteristics of hypercholesterolemia, which include inflammatory responses to oxidative stress,

I am concerned with coronary artery disease (CAD), as it is the leading cause of death in the United States and Florida. It is the most well-known kind of coronary illness. Over time CAD can debilitate the heart muscle and contribute to heart attacks. There are many modifiable risk factors, such as quit smoking, decrease alcohol intake, modifying the diet to reduce sodium and sugar intake, reducing obesity by losing weight, and increasing activity. Hypertension, diabetes also contributes to CAD.

Taking Statins to lower cholesterol is the top prescription drug, for adults over 60, issued to defeat CHD (Qiuping, Dillon and Burt 5). Although, the Statins prescribed are shown to lower the risk of a second heart attack in men; no significant reduction in risk is found with men who do not already have CHD, if the research is examined closer (Abramson). Once again, moderate exercise coupled with a sensible diet proves to be just as effective as an expensive drug, although once a person has CHD the Statins can help (Abramson). The drug companies have effectively penetrated every demographic in the US with “needed” prescriptions and in many instances the American people are asking for it.

Statins has multiple organ effects by affecting the liver, musculoskeletal system and the nervous system, controlled clinical trials with randomized blinded assignment of treatment groups to patients treated with statins and placebo was conducted, hence valid data about adverse effects of statins were obtained (doc1.pdf-[8] ). The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators conducted a study in which patients with history of transient ischemic attack or thrombotic stroke were allocated into two groups, one treated with statin and the other group with placebo, after conducting this study

Determine if the addition of ezetimibe to statin therapy will further decrease LDL and adverse cardiovascular events.

Fluvastatin is a highly regarded drug that is involved with treating hypercholesterolemia and preventing cardiovascular disease. The drug is used to lower both high cholesterol and triglycerides levels. The drug is able to perform this task by increasing good cholesterol levels (HDL) while, at the same time, reducing bad cholesterol levels (LDL). Fluvastatin decreases the production of bad cholesterol by blocking the action of the enzyme HMG- CoA reductase in the liver. This results in a decrease in the amount of cholesterol in liver cells and subsequently leads it

In conclusion, statins are the mainstay of lipid-lowering therapy, with multiple studies confirming that low-density lipoprotein reduction leads to improvements in cardiovascular morbidity and mortality. Adverse effects and interactions associated with their use are outweighed by their proven benefits in clinical event

Coronary heart disease is a result of coronary artery disease. The article "Coronary artery disease," states that one of the greatest risk factors for this disease is definitely: age, sex, family history, smoking, high blood pressure and cholesterol levels, etc. There are several treatments mentioned, however the most important type of treatment can given from the patient itself, by making a commitment to a new healthy lifestyle such as quitting: smoking and eating unhealthy. Although many feel there is no way to avoid coronary artery disease, it's false, because coronary artery disease is preventable. Eating a healthy diet, managing your weight, and staying in shape, can immensely help to prevent any type of heart disease.

The risk factors that could lead to Coronary Artery Disease are common factors that many individuals in the world can acquire. Factors include high blood pressure, smoking, diabetes, obesity, high cholesterol, depression, etc. Factors such as smoking is very common for people to do

It decreases the activity of \textit{3-hydroxy-3-methylglutaryl coenzyme A reductase}(HMGCR), an enzyme involved in one of the first steps in creating cholesterol\citep{pmid15803163}. It enters hepatocytes through the SLCO1B1 transporter, after which it is metabolized to its active form\citep{pmid22992668}. SLCOB1 transports many endogenous and xenobiotic substrates. Many statins (and other substrates) are too hydrophilic to enter the cell through passive membrane transport, thus need to be transported actively through SLCO family

Cardioprotective effect of statins is ascribed by lowering LDL-C and improving the lipid profile as reflected in plasma cholesterol levels.

Risk factors and behaviours that predispose someone to develop CHD can be divided into modifiable and non-modifiable