Neurológia pre prax 1/2021

Statins and neuroprotective effects

Statins are used to treat primary hypercholesterolemia and dyslipidemia. They significantly reduce cardiovascular risk in primary and secondary prevention. In the Czech Republic, atorvastatin and rosuvastatin are the most used drugs, otherwise simvastatin and fluvastatin are less prescribed. For statin therapy, appropriate HDL cholesterol target values should be established, and special regimen with adjunctive therapy with ezetimibe in selected patients. Drug side effects may occur with statin therapy, such as nausea, fatigue, myalgia, rarely statin myopathy. A number of studies have shown that statins have neuroprotective effects on the brain tissue. They can cross the blood-brain barrier and reduce microglia activation followed by subsequent leaching of proinflammatory mediators. Under pathological conditions, statins induce vasodilation in the brain, inhibit the proliferation of smooth muscle cells in the vessel wall, improve endothelial cell function, and stabilize the atherosclerotic plaque. They have antiplatelet, antioxidant and anti-inflammatory effect.

Keywords: statins, neuroprotective effect, statin myopathy, brain tissue