The Pharmacology of Statins

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Cardiovascular Diseases (CVD) are the currently the leading cause of death globally for both men and women accounting for 21.9 per cent of total deaths and is projected to increase to 26.3 per cent by 2030 . Statins are the treatment of choice for the primary and secondary prevention of cardiovascular disease and in the management of hypercholesterolaemia because of their proven efficacy and safety profile. Evidences are showing their effectiveness in reduction of cholesterol synthesis and number of pleiotropic effects, which may be cholesterol dependent and cholesterol independent. The present review focus on the origin, properties and effects of statins on endothelial function ( non lipid action of statins) through the increase of endogenous production of NO in different pathways.

Key words: Coronary artery Disease (CAD), Statins, Endothelium, Caveolin.

Coronary artery disease (CAD) is the most common type of multifactorial chronic heart disease. It is a consequence of plaque buildup in coronary arteries. The arterial blood vessels, which begin out smooth and elastic become narrow and rigid, curtailing blood flow resulting in deprived of oxygen and nutrients to the heart [1].
CAD is a leading cause of morbidity and mortality throughout the worldwide. The prevalence of biological and metabolic risk factors were also found to be high in development of coronary artery disease. Patients with hypercholesterolemia are at increased risk to experience cardiovascular events and to die from vascular disease [2]. .Statins, among the most commonly prescribed drugs worldwide, are cholesterol let downing agents used to manage cardiovascular and coronary heart diseases and to treat hypercholesterolemia. Statin’s therapy ...

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...on and forms an inhibitory complex with caveolin-1 leads to decrease in activity of enzyme in the cells. Transcription of Cav-1 gene is regulated by cholesterol responsive elements. Exposure of fibroblast and endothelial cells to free cholesterol and LDL Cholesterol was found to up regulate Cav-1 expression. Ca+2 mobilizing agents cause disinhibiton of e NOS by promoting Ca+2/Calmodulin triggered dissociation of Cav-1.
Statin downregulates Cav-1 in endothelial cells by blocking the cholesterol synthesis, a favorable effect on vascular function may partly mediated by interruption of the e NOS/Cav-1 complex [24].
Conclusion
In summary, accumulating evidence from various research and clinical trials indicates that Statin have pleiotropic effects, and improves the endothelial function through the increase of endogenous production of NO in different pathways.

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