Guidance
Appendix A: Grouping of statins
Appendix A: Grouping of statins
For the purpose of this guideline, statins are grouped into 3 different intensity categories according to the percentage reduction in low‑density lipoprotein cholesterol (see table 1).This grouping was agreed by GDG consensus, informed by analyses in the literature. See the full guideline for a discussion of this grouping.
Table 1 Grouping of statins used in this guideline
|
Reduction in low‑density lipoprotein cholesterol |
|||||
|
Dose (mg/day) |
5 |
10 |
20 |
40 |
80 |
|
Fluvastatin |
– |
– |
21%1 |
27%1 |
33%2 |
|
Pravastatin |
– |
20%1 |
24%1 |
29%1 |
– |
|
Simvastatin |
– |
27%1 |
32%2 |
37%2 |
42%3,4 |
|
Atorvastatin |
– |
37%2 |
43%3 |
49%3 |
55%3 |
|
Rosuvastatin |
38%2 |
43%3 |
48%3 |
53%3 |
– |
|
1 20%–30%: low intensity. 2 31%–40%: medium intensity. 3 Above 40%: high intensity. 4 Advice from the MHRA: there is an increased risk of myopathy associated with high‑dose (80 mg) simvastatin. The 80 mg dose should be considered only in patients with severe hypercholesterolaemia and high risk of cardiovascular complications who have not achieved their treatment goals on lower doses, when the benefits are expected to outweigh the potential risks. |
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The information used to make the table is from Law MR, Wald NJ, Rudnicka AR (2003) Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta‑analysis. BMJ 326: 1423.