24/04/2026
📚🫀 How to Start Statins – Quick Clinical Guide
🧠 What are Statins?
Statins are lipid-lowering drugs that inhibit HMG-CoA reductase → reducing LDL cholesterol and preventing atherosclerotic cardiovascular disease (ASCVD).
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⚠️ When to Start Statins? (Common Indications)
1️⃣ Established ASCVD
• Previous MI, stroke, or peripheral arterial disease
→ Start high-intensity statin
2️⃣ LDL ≥ 190 mg/dL
• Suggests familial hypercholesterolemia
→ Start high-intensity statin
3️⃣ Diabetes Mellitus (Age 40–75)
• LDL ≥ 70 mg/dL
→ Start moderate-intensity statin
4️⃣ High 10-Year ASCVD Risk
• Age 40–75
• LDL ≥ 70 mg/dL
→ Start statin depending on risk level
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💊 Statin Intensity
🔴 High-Intensity (↓ LDL ≥50%)
• Atorvastatin 40–80 mg
• Rosuvastatin 20–40 mg
🟠 Moderate-Intensity (↓ LDL 30–49%)
• Atorvastatin 10–20 mg
• Rosuvastatin 5–10 mg
• Simvastatin 20–40 mg
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🧪 Baseline Tests Before Starting
• Lipid profile
• ALT (liver enzyme)
• Consider CK if risk of myopathy
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⚠️ Important Precautions
• Avoid in active liver disease
• Contraindicated in pregnancy
• Watch for myalgia or muscle weakness
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📊 Follow-Up
• Repeat lipid profile after 4–12 weeks
• Aim for ≥50% LDL reduction in high-risk patients
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✅ Clinical Tip
Statins are first-line therapy for dyslipidemia and significantly reduce the risk of heart attack and stroke.
