However, before deciding whether statins can be taken in half, we have to do the following three things.
First of all, know your blood lipid target value.
Everyone's specific situation is different, such as: the basic level of blood lipid is different; Different cardiovascular risk factors; The combined cardiovascular diseases are different, so the target value of blood lipid is different. Therefore, it is very important for everyone to know what their blood lipid target value is.
Second, know your current blood lipid level.
After taking statins, you should regularly monitor the blood lipid level and know your own blood lipid control. Generally speaking, after taking lipid-lowering drugs for the first time, it is necessary to check the blood lipid level, liver transaminase and creatine kinase at the same time, monitor the side effects, and then decide whether to adjust the treatment plan according to the results.
Third, compare your blood lipid level with the target value.
If your blood lipid level is slightly lower than the target value, it is not appropriate to reduce lipid-lowering drugs at this time. Then if the blood lipid level is significantly lower than the target value, we can reduce the lipid-lowering drugs to half at this time. Note that after taking half a dose of statins, you need to test your blood lipid level again about one month to see if half a dose of statins can keep your blood lipid level within the target value.
So, how do you know your blood lipid target value?
This is a professional problem. When you see a doctor, you can ask a doctor to know your blood lipid target value. Today, Dr. Xu will talk to you for your reference.
The increase of blood lipid level, especially the increase of low density lipoprotein cholesterol (LDL-C), is closely related to atherosclerosis. Therefore, the guideline suggests that the risk of atherosclerotic cardiovascular disease (ASCVD) in the future 10 year should be divided into low risk, medium risk, high risk, extremely high risk and ultra-high risk, and the target value of LDL-C should be determined according to the degree of risk.
The following people belong to low/medium risk population, and the target value of LDL-C is less than 3.4 mmol/L.
1. Patients with simple hypertension.
2. 0~3 people with the following risk factors. (1) Age (male ≥45 or female ≥ 55); (2) Smoking includes secondhand smoke; (3)HDL-C is low (the level of high-density lipoprotein cholesterol is reduced); (4) Obese body mass index ≥28 or abdominal obesity (male waist circumference ≥90CM, female ≥ 85 cm); (5) Family history of early ischemic cardiovascular disease (onset age of first-degree relatives < 50 years old).
The following people belong to high-risk groups, and the target value of LDL-C is less than 2.6 mmol/L.
1. Diabetic patients.
Hypertension is accompanied by two or more other risk factors, and low density lipoprotein cholesterol ≥ 2.6 mmol/L. ..
3. The glomerular filtration rate (EGFR) of patients with chronic kidney disease is 65438 0.5 ~ 59 ml/min.
4.LDL-C≥4.9 mmol/L 。
The following people belong to extremely high-risk groups, and the target value of LDL-C is < 1.8 mmol/L or the decrease of LDL-C is ≥50%.
1. Diabetes patients with hypertension.
2. Diabetes mellitus complicated with another risk factor, and LDL-C ≥ 3.4 mmol/L. ..
3.ASCVD patients, including coronary heart disease, angina pectoris, myocardial infarction, after cardiac stent implantation, after cardiac bypass surgery, ischemic cardiomyopathy, cerebral infarction, transient ischemic attack, carotid artery or lower extremity atherosclerotic plaque with stenosis, account for more than 50%.
The following people belong to ultra-high risk groups, and the target value of LDL-C is < 1.4 mmol/L or the decrease of LDL-C is ≥50%.
For ASCVD patients, if one of the following conditions exists at the same time, they belong to the ultra-high risk group.
1. Recurrent ASCVD events.
2. Multiple coronary artery lesions.
3. Recent acute coronary syndrome, including unstable angina pectoris and acute myocardial infarction.
4. Atherosclerotic vascular diseases in the heart, brain or peripheral vascular beds. Such as patients with coronary heart disease complicated with cerebral infarction.
5.LDL-C≥4.9 mmol/L 。
6. Diabetes.
Generally speaking, early detection and prevention of dyslipidemia can effectively reduce the occurrence of ASCVD such as myocardial infarction and ischemic stroke. Therefore, everyone should know their blood lipid target value and monitor their blood lipid level regularly. For patients whose LDL-C value is still not up to standard after active treatment and lifestyle changes (adhering to healthy diet, regular exercise, staying away from tobacco, limiting alcohol and maintaining ideal weight), statin therapy can be considered.
The side effects of statins are dose-related. In order to reduce the side effects of statins, the minimum effective dose can be considered. But there is a premise, which must be based on the standard of blood lipids. If the current blood lipid level is far below the target value, the dose can be reduced to half a tablet, but if it is only slightly below the target value, it is not recommended to reduce the dose.