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Statin Therapy and Cognitive Impairment: Benefit or Harm?

https://doi.org/10.20996/1819-6446-2018-14-4-529-536

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Abstract

Statins are now widely used drugs for the treatment of dyslipidemia, effective drugs for lowering the level of low-density lipoprotein cholesterol, and also for reducing the risk of cardiovascular and cerebrovascular events. It is believed that statins are well tolerated. However, the potential relationship between statins and cognitive impairment in some people is assumed. This review paper was written in the light of the search for information on a specific problem of the potential adverse effects of statins on the cognitive function. The purpose of the article is to seek advice for health professionals on monitoring and reducing the risk of potential cognitive impairment during statin therapy. Rosuvastatin may be safer amongst statins in terms of influencing cognitive function. Evaluation of cognitive dysfunction in patients before starting therapy with statins is not necessary. Therapy with statins is not accompanied by a risk of developing cognitive dysfunction according to cohort and randomized studies. The presence of cognitive dysfunction and the exclusion of other possible causes of it, as well as the evaluation of the benefit/risk ratio for the abolition of statin therapy, are necessary in detecting cognitive dysfunction during statin therapy. A decrease in the dose of statin or the cessation of its use to assess the reversibility of symptoms is possible on the basis of the individual characteristics of the patient. Alternative replacement for another inhibitor of HMG-CoA reductase should occur if the statin is discontinued. A drug that less penetrates the blood-brain barrier, for example rosuvastatin, is more preferable.

About the Authors

O. D. Ostroumova
I.M. Sechenov First Moscow State Medical University (Sechenov University); A.I. Evdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Olga D. Ostroumova – MD, PhD, Professor, Chair of Clinical Pharmacology and Propaedeutics of Internal Medicine, Sechenov University; Professor, Chair of Faculty Therapy and Occupational Diseases, A.I. Evdokimov Moscow State University of Medicine and Dentistry

Delegatskaya ul. 20-1, Moscow, 127473



E. V. Chikh
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Evgenia V. Chikh – MD, PhD, Professor, Head of Chair of Clinical Pharmacology and Propaedeutics of Internal Medicine, Director of the Institute of Professional Education 

Trubetskaya ul. 8-2, Moscow, 119991



E. V. Rebrova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Ekaterina V. Rebrova – MD, PhD, Associate Professor, Chair of Clinical Pharmacology and Propaedeutics of Internal Medicine


A. Yu. Ryazanova
Volgograd State Medical University
Russian Federation

Anastasia Yu. Ryazanova – MD, PhD, Associate Professor, Chair of Clinical Pharmacology and Intensive Care

pl. Pavshikh Bortsov 1, Volgograd, 400008 



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For citation:


Ostroumova O.D., Chikh E.V., Rebrova E.V., Ryazanova A.Y. Statin Therapy and Cognitive Impairment: Benefit or Harm? Rational Pharmacotherapy in Cardiology. 2018;14(4):529-536. (In Russ.) https://doi.org/10.20996/1819-6446-2018-14-4-529-536

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)