**Alpha Statin Dose Changes in Elderly Patients with Coronary Heart Disease: Lipid-Lowering Efficacy and Safety Study**
Before pumping, 12 hours of fasting blood glucose levels were measured for lipid levels, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), blood urea nitrogen (BUN), creatinine (Cr), alanine aminotransferase (GPT), and creatine kinase. A group of 29 cases continued taking atorvastatin daily at 20 mg (Group B had 26 cases, taking atorvastatin daily at 10 mg; Group C had 23 cases, discontinuing alpha statin therapy). All patients received dietary therapy and conventional treatment such as blood pressure control, vasodilators, antiplatelet agents, and hypoglycemic drugs before and during treatment. Three months and 12 months later, these targets were detected to observe changes in lipid levels and liver and kidney function. Adverse reactions such as rash, nausea, vomiting, muscle pain, and monthly records of heart failure and angina episodes were also recorded.
**1.3 Statistical Analysis:** SPSS software was used for statistical analysis using the chi-square test. A P-value 0.05). In Group B, observed for 3 and 12 months, TC, TG, and LDL-C also decreased but not as significantly (P < 0.05). In Group C, the values did not show an obvious decline, and the difference was not significant. However, the number of cases of heart failure and angina pectoris increased significantly compared to the first two groups. Liver and kidney function in all patients showed no significant change, and there were no complications.
**3 Discussion:** Atorvastatin is one of the main statins used for treating hyperlipidemia, particularly for increasing cholesterol-lowering effects. It is a HMG-CoA reductase inhibitor, the rate-limiting enzyme in cholesterol synthesis. Its primary role is to inhibit cholesterol synthesis in liver cells, increase the number of LDL receptors on the liver cell membrane, and promote the clearance of LDL and VLDL by the liver, thereby reducing plasma total cholesterol, LDL, and VLDL levels. Additionally, it lowers triglycerides [21].
In this study, patients were divided into three groups based on the dose of atorvastatin. Among them, the group that continued to receive 20 mg of atorvastatin daily showed significant reductions in TC, TG, and LDL-C after three months (P = 0.001). TC decreased by 8.21%, TG decreased by 11.02%, and LDL-C decreased by 10.56%. After 12 months of treatment, TC, TG, and LDL-C continued to show significant decreases. In Group B, observed for 3 and 12 months, TC, TG, and LDL-C significantly decreased (P < 0.05), but the degree was less than in Group A. In Group C, the indicators changed little. The number of cases of heart failure and angina pectoris increased compared to the treatment groups, especially after 12 months of treatment.
The above study indicates that atorvastatin has lipid-lowering efficacy and also exhibits cardioprotective effects, reducing incidents [31]. The reasons for elevated blood lipids are believed to be the discontinuation of lipid-lowering drugs, leading to unrestricted cholesterol synthesis and plaque instability. BUN, Cr, and GPT levels remained normal before and after treatment, indicating no adverse effects of the drug on liver and kidney function. There was no occurrence of muscle pain or increased CK levels. Group B patients maintained lower lipid levels better than Group A, but with reduced dosage, thus decreasing the economic and medication burden on patients. Long-term maintenance of this dosage could potentially replace high-dose lipid-lowering drugs, becoming our next research topic.