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LIPID OR CHOLESTEROL-LOWERING DRUGS TO TREAT AFTER CORONARY ARTERY BYPASS SURGERY
Reductase Inhibitors – Statins
Probably the most commonly used drugs to lower lipids (cholesterol) are the so-called reductase inhibitors (such as simvastatin or pravastatin). These drugs inhibit the synthesis of cholesterol and lead to significant lowering of total cholesterol and LDL cholesterol. They are always used in combination with a low-fat, low-cholesterol diet and they may be prescribed in combination with other drugs. Their adverse effects include occasional abdominal discomfort and (rarely) liver damage and muscle damage which may produce a variety of symptoms and may also be detected by blood tests.
There have now been a number of large studies which have demonstrated the great effectiveness of reductase inhibitors in lowering total cholesterol and LDL cholesterol, also in raising HDL cholesterol, reducing need for further interventions and further operations, reducing hospital admissions, reducing later heart attacks and improving life expectancy. It appears that these very considerable benefits can be achieved with a very small risk of adverse effects and hence with very considerable safety.
Bile Sequestrants
The other major group of lipid-lowering drugs, which are not absorbed into the body, are the so-called bile sequestrants (Cholestyramine, Colestipol and others). They absorb bile salts which are then passed in the motions. The deficiency of bile salts which they cause leads the liver to produce larger amounts of bile salt. These are produced by using up cholesterol. Thus, indirectly, cholesterol is excreted. The liver absorbs more cholesterol from the blood to achieve this end, thereby lowering the blood cholesterol level. The adverse effects of these drugs are very troublesome to some patients. They may cause abdominal distention, a sense of bloating and constipation. Other people, however, can take them without any problems.
Other Lipid-lowering Drugs
There are several other drugs which are used for particular lipid problems. Examples include treatment for both high LDL cholesterol and triglycerides or for both low HDL cholesterol and high triglyceride.
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