Statin Intolerance and Adverse Effects in Lipid-Lowering Therapy – Pathomechanisms, Management Strategies, and Alternative Treatment Approaches
Statins are essential in preventing cardiovascular diseases by lowering LDL cholesterol levels. Landmark trials like 4S and HPS demonstrated significant reductions in cardiovascular events and mortality with statin use. Statins inhibit hepatic cholesterol synthesis and upregulate LDL receptors, impr...
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| Format: | Article |
| Language: | English |
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Nicolaus Copernicus University in Toruń
2025-06-01
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| Series: | Quality in Sport |
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| Online Access: | https://apcz.umk.pl/QS/article/view/61202 |
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| author | Natalia Śliwa Bartosz Dądela Eliza Kawalska Emilia Majewska Szymon Gnitecki Maciej Borowski Szymon Janczura Kacper Zielonka Marcin Markowski Joanna Jasińska |
| author_facet | Natalia Śliwa Bartosz Dądela Eliza Kawalska Emilia Majewska Szymon Gnitecki Maciej Borowski Szymon Janczura Kacper Zielonka Marcin Markowski Joanna Jasińska |
| author_sort | Natalia Śliwa |
| collection | DOAJ |
| description | Statins are essential in preventing cardiovascular diseases by lowering LDL cholesterol levels. Landmark trials like 4S and HPS demonstrated significant reductions in cardiovascular events and mortality with statin use. Statins inhibit hepatic cholesterol synthesis and upregulate LDL receptors, improving endothelial function and exerting anti-inflammatory effects. However, adverse effects can lead to discontinuation. Musculoskeletal symptoms, including myalgia and rhabdomyolysis, affect 5-20% of patients, often linked to mitochondrial dysfunction and coenzyme Q10 depletion. Hepatotoxicity, although less frequent, presents as elevated transaminases, particularly with lipophilic statins. Statins may also increase new-onset diabetes risk by 9-12%, potentially due to impaired insulin signaling and mitochondrial dysfunction. Cognitive effects remain controversial, with some reports of memory impairment, especially with lipophilic statins. Managing statin intolerance involves dose reduction, switching to hydrophilic statins, or coenzyme Q10 supplementation. Alternative therapies for statin-intolerant patients include ezetimibe, PCSK9 inhibitors, and bempedoic acid. Lifestyle interventions like a Mediterranean diet and regular exercise further support cardiovascular health while minimizing adverse effects.
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| format | Article |
| id | doaj-art-6456c68bdcff46e89e90cadac1291957 |
| institution | Kabale University |
| issn | 2450-3118 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Nicolaus Copernicus University in Toruń |
| record_format | Article |
| series | Quality in Sport |
| spelling | doaj-art-6456c68bdcff46e89e90cadac12919572025-08-20T03:32:51ZengNicolaus Copernicus University in ToruńQuality in Sport2450-31182025-06-014210.12775/QS.2025.42.61202Statin Intolerance and Adverse Effects in Lipid-Lowering Therapy – Pathomechanisms, Management Strategies, and Alternative Treatment ApproachesNatalia Śliwahttps://orcid.org/0009-0000-9829-1915Bartosz Dądela0https://orcid.org/0009-0003-2408-9812Eliza Kawalska1https://orcid.org/0009-0004-8244-6459Emilia Majewska2https://orcid.org/0009-0009-3043-1104Szymon Gnitecki3https://orcid.org/0009-0007-6839-6207Maciej Borowski4https://orcid.org/0009-0001-0789-804XSzymon Janczura5https://orcid.org/0009-0009-4214-4014Kacper Zielonka6https://orcid.org/0009-0009-5149-7786Marcin Markowski7https://orcid.org/0009-0006-5497-1138Joanna Jasińska8https://orcid.org/0009-0008-2496-1355Maria Skłodowska-Curie Provincial Specialist Hospital in Zgierz, Parzęczewska 35, 95-100 Zgierz, PolandHospital of Our Lady of Perpetual Help in Wołomin, Gdyńska 1/3, 05-200 Wołomin, PolandDr. Tytus Chałubiński Specialist Hospital in Radom, Adolfa Tochtermana 1, 26-610 Radom, PolandProvincial Multi-Specialist Center of Oncology and Traumatology M. Copernicus in Łódź, Pabianicka 62, 93-513 Łódź. Central Clinical Hospital of Medical University of Lodz, Pomorska 251, 92-213 Łódź, Poland Central Clinical Hospital of Medical University of Lodz, Pomorska 251, 92-213 Łódź, Poland Maria Skłodowska-Curie Provincial Specialist Hospital in Zgierz, Parzęczewska 35, 95-100 Zgierz, PolandMedical University of Łódź, Kościuszki 4, 90-419, Łódź, Poland Central Clinical Hospital of Medical University of Lodz, Pomorska 251, 92-213 Łódź, PolandStatins are essential in preventing cardiovascular diseases by lowering LDL cholesterol levels. Landmark trials like 4S and HPS demonstrated significant reductions in cardiovascular events and mortality with statin use. Statins inhibit hepatic cholesterol synthesis and upregulate LDL receptors, improving endothelial function and exerting anti-inflammatory effects. However, adverse effects can lead to discontinuation. Musculoskeletal symptoms, including myalgia and rhabdomyolysis, affect 5-20% of patients, often linked to mitochondrial dysfunction and coenzyme Q10 depletion. Hepatotoxicity, although less frequent, presents as elevated transaminases, particularly with lipophilic statins. Statins may also increase new-onset diabetes risk by 9-12%, potentially due to impaired insulin signaling and mitochondrial dysfunction. Cognitive effects remain controversial, with some reports of memory impairment, especially with lipophilic statins. Managing statin intolerance involves dose reduction, switching to hydrophilic statins, or coenzyme Q10 supplementation. Alternative therapies for statin-intolerant patients include ezetimibe, PCSK9 inhibitors, and bempedoic acid. Lifestyle interventions like a Mediterranean diet and regular exercise further support cardiovascular health while minimizing adverse effects. https://apcz.umk.pl/QS/article/view/61202statinsHMG-CoAMyopathyliver diseasecholesterolPCSK9 |
| spellingShingle | Natalia Śliwa Bartosz Dądela Eliza Kawalska Emilia Majewska Szymon Gnitecki Maciej Borowski Szymon Janczura Kacper Zielonka Marcin Markowski Joanna Jasińska Statin Intolerance and Adverse Effects in Lipid-Lowering Therapy – Pathomechanisms, Management Strategies, and Alternative Treatment Approaches Quality in Sport statins HMG-CoA Myopathy liver disease cholesterol PCSK9 |
| title | Statin Intolerance and Adverse Effects in Lipid-Lowering Therapy – Pathomechanisms, Management Strategies, and Alternative Treatment Approaches |
| title_full | Statin Intolerance and Adverse Effects in Lipid-Lowering Therapy – Pathomechanisms, Management Strategies, and Alternative Treatment Approaches |
| title_fullStr | Statin Intolerance and Adverse Effects in Lipid-Lowering Therapy – Pathomechanisms, Management Strategies, and Alternative Treatment Approaches |
| title_full_unstemmed | Statin Intolerance and Adverse Effects in Lipid-Lowering Therapy – Pathomechanisms, Management Strategies, and Alternative Treatment Approaches |
| title_short | Statin Intolerance and Adverse Effects in Lipid-Lowering Therapy – Pathomechanisms, Management Strategies, and Alternative Treatment Approaches |
| title_sort | statin intolerance and adverse effects in lipid lowering therapy pathomechanisms management strategies and alternative treatment approaches |
| topic | statins HMG-CoA Myopathy liver disease cholesterol PCSK9 |
| url | https://apcz.umk.pl/QS/article/view/61202 |
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