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Mechanism of
HMG-CoA reductase is the path that is blocked with statins prevents the rate-limiting enzyme HMG-CoA reductase.
Main article: Cholesterol homeostasis
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Statins act by competitively inhibiting HMG-CoA reductase, the first committed enzyme HMG-CoA reductase way. Because statins similar to HMG-CoA on a molecular level, they take the place of HMG-CoA enzyme and reduce the rate by which it is able to produce mevalonate, the next molecule in the cascade that ultimately produces cholesterol, as well as a number of other compounds. This ultimately lowers cholesterol through several mechanisms.
[edit] inhibitor of cholesterol synthesis

By inhibiting HMG-CoA reductase, statins block the way for the synthesis of cholesterol in the liver. This is important because most of the circulating cholesterol comes from domestic production and not on a diet. If the liver can not produce more cholesterol, blood cholesterol levels fall. The synthesis of cholesterol seem to occur mainly at night, [3], so statins with short half-life, usually taken at night, to maximum effect. Studies have shown greater reduction of LDL and total cholesterol in a short period of simvastatin, made at night, but not in the morning, [4] [5], but show no difference in long-acting atorvastatin. [6]
[edit] Increasing LDL uptake

Liver cells of the sense of lowering cholesterol in the liver and seek to compensate by synthesis of LDL cholesterol receptors to draw from the circulation. [7] This is achieved using protease enzymes that cleave proteins called "membrane-bound sterol regulatory element binding protein, which migrates to the nucleus and leads to increased production of various other proteins and enzymes, including the LDL receptor. LDL receptor and then moved to the cell membranes of the liver and is associated with the adoption of LDL and VLDL particles ( "bad cholesterol" associated with the disease). LDL and VLDL are taken out of circulation in the liver and digestive system.
[edit] Other effects

Statins exhibition action after lipid-lowering activity in the prevention of atherosclerosis. ASTEROID Trial showed direct evidence of ultrasonic atheroma regression during statin therapy. [8], researchers hypothesize that statins prevent cardiovascular disease with the help of four proposed mechanisms (all subjects of a large amount of biomedical research): [9]

1. Improvement of endothelial function
2. Modulate inflammatory responses
3. Maintaining stability board
4. Preventing the formation of blood clots

Statins can benefit even those without high cholesterol. In 2008, the study found, fewer JUPITER, stroke, myocardial infarction, operations and even for patients who had no history of high cholesterol and cardiovascular disease, but elevated C-reactive protein. There were also 20% fewer deaths (mainly from the reduction of cancer deaths), although mortality from cardiovascular causes were not reduced. [10]

Statins were associated with a marked reduction of prostate cancer, benign prostatic hyperplasia, incontinence and impotence in older men. [11]
[edit] Indications and uses

Statins, the most powerful cholesterol-lowering agents available, lower LDL cholesterol (the so-called "bad cholesterol") to 1.8 mmol / l. This results in 60% reduction in the number of cardiac events (heart attack, sudden death), and 17% reduces the risk of stroke. [12] They have a smaller effect than the fibrates or niacin in reducing triglycerides and raising HDL-cholesterol ( "good cholesterol"). Professional guidelines generally require that the patient tried to cholesterol-lowering diet before considering the use of statins, statins or other pharmacologic agents may be recommended for patients who do not meet their lipid-lowering goals through diet and lifestyle approaches.

Indications of statins broadened in recent years. Initial studies, such as the Scandinavian Simvastatin Survival Study (4S), supported the use of statins in secondary prevention of cardiovascular disease or as primary prevention only when the risk of cardiovascular disease was significantly raised (as indicated in the risk assessment Framingham). [13] The testimony was substantially expanded by research, such as the Heart Protection Study (HPS), which showed the preventive effect of statin use in specific risk groups, such as diabetes. Trial of the asteroid, published in 2006, using only statins in high doses were lower than usual target calculated LDL values and showed disease regression in the coronary arteries using intravascular ultrasound. [8]

Based on clinical trials, the National Cholesterol Education Program guidelines and greater emphasis on aggressive reduction of LDL-cholesterol, statins continue to play an important role in both primary and secondary prevention of coronary heart disease, myocardial infarction, stroke and peripheral arterial disease.

Research continues in other areas where statins also have beneficial effects: colon cancer [14], inflammation, dementia, [15] lung cancer [16] nuclear cataracts, [17] and hypertension [18].