Statins work by inhibiting an enzyme that participates in the synthesis of cholesterol; thereby lowering cholesterol is the main biochemical consequence.
Following large-scale studies, statins have been shown to represent the class of lipid-lowering drugs with the highest efficiency in primary and secondary cardiovascular prevention. This is due primarily to decreased LDL fraction (fraction of cholesterol that promotes atherogenesis) but probably other effects represented by LDL oxidation inhibition, antithrombotic and antioxidant action which contribute to stabilizing plaque buildup.
Cholesterol-lowering power of the representatives of this class is: rosuvastatin > atorvastatin > simvastatin > pravastatin > lovastatin > fluvastatin.
Statins are administered in a single dose at bedtime, because the cholesterol synthesis predominates at night.
Side effects can be myositis, altered liver tests, rhabdomyolysis, but are very rare.
The therapy target is lowering cholesterol below 175 mg% for those with high cardiovascular risk and 190 mg% for those with low cardiovascular risk.