Your Cholesterol Medications Explained, Part 2 of 5 #medisolpharmacy #statins #cholesterol

Added: 2026-06-02

[00:00:00]Statins remain the first line treatment for most patients who need cholesterol lowering.

[00:00:05]These medications work by blocking an enzyme in the liver called HMG-CoA reductase, and the liver responds by increasing LDL receptors on its surface.

[00:00:15]And think of LDL receptors like tiny catamarans.

[00:00:20]The more catamarans the liver has, the more LDL it can pull out of circulation.

[00:00:25]And as LDL levels fall, cardiovascular risk falls as well. Now, here's where things get interesting. Statins don't all lower cholesterol equally. Some are stronger than others, and doctors often classify them into intensity groups.

[00:00:42]Lower intensity statins generally lower LDL by less than 30%. Moderate intensity statins lower LDL by roughly 30% to 49%, and high intensity statins lower LDL by 50% or more. For example, atorvastatin 40 to 80 mg and rosuvastatin 20 to 40 mg are considered high intensity statins.

[00:01:03]Rosuvastatin 10 mg surprises a lot of patients because it's actually considered a moderate intensity, not high intensity. And that shows just how potent rosuvastatin is compared to other statins.

[00:01:17]And some statins are also more commonly taken in the evening because your body produces much of its cholesterol overnight.

[00:01:26]But atorvastatin and rosuvastatin stay in the body long enough that they can be generally taken any time of day.

[00:01:33]And this is why two patients sitting next to each other in the waiting room may be taking completely different statin doses.

[00:01:42]One may need a modest reduction in LDL, while another may just need more aggressive lowering because of a prior heart attack, diabetes, or significantly elevated cholesterol levels.

[00:01:55]You'll also hear people talk about lipophilic and hydrophilic statins.

[00:02:00]Well, lipophilic statins include atorvastatin, simvastatin, and lovastatin, while hydrophilic statins include rosuvastatin and pravastatin.

[00:02:10]And the basic idea is that lipophilic statins enter a wider range of tissues, while hydrophilic statins tend to be more liver selective. So, one practical example is rosuvastatin because it has lower penetration into muscle tissues, some cardiologists prefer it to patients who previously experienced muscle symptoms on another statin. Well, that doesn't mean that it's guaranteed to prevent side effects, it just simply means that if one statin doesn't work for you, another statin may still be worth trying.