After ordering a blood test for cholesterol, a physician prescribes the patient expensive cholesterol medications known as statins to prevent diseases of the cardiovascular system. Statins, however, like all medications, have side effects.
Statins are chemicals that reduce the production of enzymes, which are necessary for the synthesis of cholesterol. Usually the instructions that accompany these cholesterol-reducing drugs state 1. Statins lower cholesterol concentration in the plasma due to “inhibition of HMG-CoA reductase” and “reduce cholesterol synthesis in the liver” (Pichandi et al., 2011, p.51). 2. They reduce the concentration of cholesterol in patients with homozygous “familial hypercholesterolemia” (Pichandi et al., 2011, p.51), immedicable with lipid-lowering drugs. 3. Statins reduce total cholesterol by 30-45%, and "harmful" cholesterol by 40-60%. 5. Statins “reduce the risk of ischemic complication by 15%,” including “myocardial infarction and risk of angina pectoris with evidence of myocardial ischemia by 25%” (Pichandi et al., 2011, p.52).
Among the side effects of statins are insomnia, asthenia syndrome, headache, nausea, constipation, diarrhea, abdominal pain, flatulence, myalgia, amnesia, malaise, dizziness, hypoesthesia, paresthesia, and peripheral neuropathy (Pichandi et al., 2011, pp. 50-52).
In the autumn of 2013 the British Medical Journal 2014), represented by its editor Fiona Godley, published an article data of which specified the negative impact on the patients` health from the use of statins. The comments were made in reference to an observational study, which had reported that 20% of patients taking large doses of statins experienced adverse events (British Medical Journal, 2014).
Having analyzed the results of 14 clinical studies aimed at understanding the effect of statins in 34,000 patients, researchers concluded that statins did reduce the risk of strokes and heart attacks, but in view of the serious side effects, it was not recommended to prescribe statins to people with no history of heart disease or stroke. In those who regularly took statins, liver function abnormalities, cataracts, kidney failure, as well as depression, mood swings, short-term memory loss, and muscle myopathy were observed (Bruckerta & Ferrieres, 2014).
The combination of statins and grapefruit has a harmful impact on the body, which can cause various health problems. Grapefruit juice contains a chemical called bergamottin. This compound reacts with P-450 and P-glycoprotein, enzyme systems that are known to split certain chemicals and transport them from one part of the body to another. Operation of this enzyme changes when it reacts to grapefruit juice. The chemicals in the grapefruit prevent the splitting of statins which then accumulate in the blood. Elevated levels of statins, as mentioned, is very dangerous to the kidneys and liver. Grapefruit can reduce the activity of enzyme CYP3A4 by about one-half. Simply put, when statins are followed by a drink of grapefruit juice, the amount of statin in the blood doubles (Kiani & Imam, 2007).
Lastly, we would like to give general characteristics of taking statins by an average person. The physician should select the statin to be prescribed. It is recommended to start with one 10-20 mg dose of statins a day, preferably in the evening (since most of the synthesis of cholesterol takes place during sleep). A special diet for patients taking a statin treatment course is preferable. Such patient should restrict the amount of salt (sodium ions) in their diet and shall add foods rich in potassium. Grapes, wine and grape juice are not recommended. Grapefruit and grapefruit juice are not permitted when a person is taking statins. Grapefruit juice can interact with statins for up to three days. Even a few ounces of grapefruit juice can raise the levels of statins in the blood.
References
Godlee, F. (Ed.) (2014). British Medical Journa. Adverse effects of statins. Retrieved
Bruckerta, E. & Ferrieres, J. (2014). Evidence supporting primary prevention of cardiovascular
diseases with statins: Gaps between updated clinical results and actual practice.
Science Direct. Retrieved from http://www.sciencedirect.com/science/article/pii/S1875213614000278
Kiani, J. & Imam, S.Z. (2007). Medicinal importance of grapefruit juice and its interaction with
various drugs. US National Library of Medicine. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2147024/
Pichandi, S., Pasupathi, P., Raoc, Y., Farook, J., Ambika, A., Ponnusha, B., Subramaniyam, S., & Virumandye, R. (2011). The role of statin drugs in combating cardiovascular
diseases. International Journal of Current Scientific Research. Retrieved from http://cogprints.org/7309/1/The_role_of_statin_drugs_in_combating_cardiovascular_diseases_%E2%80%93A_review.pdf
