Statins are a class of cholesterol-lowering drugs that work by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the liver’s synthesis of cholesterol. Randomized clinical trials (RCT) show that statins are most effective when given to patients who already suffer from cardiovascular disease (CVD). They are, however, also widely used without CVD but who suffer from elevated cholesterol levels and/or other risk factors like diabetes and hypertension. There are many different types of statins, some with a more potent LDL-lowering effect than others.
Statins inhibit the enzyme HGM-CoA reductase and its ability to produce mevalonate, which is an intermediate product in the multi-step synthesis of cholesterol. In what is often referred to as the mevalonate pathway, mevalonate would under normal circumstances undergo a number of biochemical transformations, eventually causing it to branch into several different compounds, including cholesterol and ubiquinone. Statins effectively block this process.
Figure 1: Statins (HMG-CoA reductase inhibitors) inhibit the synthesis of both cholesterol and coenzyme Q10
Statins are synthetically manufactured drugs intended for lowering cholesterol, but there are also naturally occurring statins. For instance, the oyster mushroom naturally contains lovastatin. Lovastatin is also found naturally in red yeast rice. Randomized clinical trials have found natural statins to be both effective and well tolerated - also in most individuals who do not tolerate synthetic cholesterol lowering drugs.