Rankings / Cardiovascular & Lipids
Rosuvastatin / atorvastatin (statins)
CV/Lipid · HMG-CoA reductase inhibitor
Tier A+
What this is
SAMSON 2020 definitively demonstrated that most 'statin myalgia' is nocebo (same symptoms on placebo). Rosuvastatin gives the most LDL reduction per mg and has the longest half-life. High-intensity dosing (rosuvastatin 20-40 or atorvastatin 40-80) is the secondary prevention standard. Biohacker hostility to statins vastly outstrips evidence.
Mechanism
Competitive inhibition of HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis; upregulates hepatic LDL receptors → reduced circulating LDL-C; also anti-inflammatory (CRP reduction), plaque stabilization, endothelial effects
Dose & route
Rosuvastatin 5-40 mg/day; atorvastatin 10-80 mg/day PO
Citations
- https://pubmed.ncbi.nlm.nih.gov/33186535/
- https://pubmed.ncbi.nlm.nih.gov/20167359/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6908093/
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This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.