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High doses of simvastatin are also contraindicated with the widely used antihypertensive amlodipine. [18] A lower dose is also recommended in people taking the calcium channel blockers, verapamil and diltiazem, as well as those taking amiodarone. [19] [20]
They recommended selective use of low-to-moderate doses statins in the same adults who have a calculated 10-year cardiovascular disease event risk of 7.5–10% or greater. [22] In people over the age of 70, statins decrease the risk of cardiovascular disease but only in those with a history of heavy cholesterol blockage in their arteries. [24]
Moreover, statins are not recommended in pregnancy as they may cause foetal harm because of their mechanism of action. [19] Metabolised by the Cytochrome P450 (CYP450) enzyme, a major metabolic enzyme, simvastatin and lovastatin may accumulate in blood when administered with CYP450 inhibitors.
Data collection also did not note the dosage of statin medications, medication adherence, or changes in HDL cholesterol levels. Furthermore, the researchers did not stratify atherosclerotic ...
In other words, as many as 4 million people in the U.S. who currently take statins for primary prevention — meaning they have not had a cardiovascular event such as a stroke or heart attack ...
With median follow-up of 6 years, simvastatin+ezetimibe was found to reduce the primary outcome of CV mortality, major CV event, or nonfatal stroke (34.7% vs. 32.7%; P=0.016; NNT 50 per 7 years or NNT 350 per 1 year ). There was no reduction in all-cause or CV mortality with simvastatin+ezetimibe, though there was a reduction in MI and stroke. [6]