Topic overview

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Statins competitively inhibit HMG-CoA reductase, reducing cholesterol synthesis in the liver and increasing hepatic LDL receptor expression. Their main lipid effect is lowering LDL-C; they also modestly lower triglycerides and mildly raise HDL-C. The lesson distinguishes statins by intensity, duration of action, activation, and metabolic pathways, including how these differences inform dosing and interaction considerations. It also introduces dose-related muscle effects, liver enzyme changes, factors that increase myopathy risk, contraindications, and appropriate monitoring. Beyond lipid changes, statins have described effects on vascular function and inflammation, with evidence of improved cardiovascular outcomes in both primary and secondary prevention. These concepts provide a framework for understanding their place in ASCVD prevention and care.