Statins are by far the most common class of cholesterol lowering medications.

Some classic examples here, Simvastatin, brand name Zocorvastatin, brand name Lipitor,

Rosuvastatin, brand name Krestor, and Pravastatin, brand name Pravacal.

So remember certainly that statin ending.

Now, the mechanism of action here is statins inhibit HMG-CoA reductase.

And what that enzyme does is it is a critical enzyme in the formation of cholesterol.

It's actually what they call the rate limiting step in the formation of cholesterol.

So in particular, what we do with statins is by inhibiting this enzyme,

we ultimately reduce the production of LDL, which is classically called the bad cholesterol. The benefit of lowering cholesterol is we can reduce the risk

of heart attack, reduce the risk of stroke, and also reduce the risk of atherosclerosis.

So these are kind of those fatty type deposits within the arteries, the vessels, that can lead to constriction

and lack of blood flow and potentially, obviously, events like I mentioned, with heart attack

and stroke.

Now, I did want to talk about dosing and timing of taking the dose of statin medications.

Cholesterol is primarily produced at night, and so this is often why you will see these medications

dosed at night.

Now, how particular is this? How important is this?

I would much rather have a patient take the medication because we know with statins and cholesterol therapy that adherence is not very good sometimes. So I would definitely make sure the

patient can be adherence, whatever time of day they take the medication. That's number one.

And secondly, some of these shorter half-life statins, such as symbastatin,

it's maybe a little more appropriate to dose at night

or maybe a little more important than, let's say,

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