Content Sources:
1. Jiang Linshuang, Chen Maowei. Clinical features of atorvastatin drug-induced liver injury[J]. Chinese Journal of General Practice,2024,27(30):3772-3775,3783.
2. Guo Qiao. Effect of atorvastatin combined with trimetazidine in the treatment of coronary heart disease in the elderly and its effect on the incidence of cardiovascular events[J]. Clinical Rational Drug Use,2024,17(2):34-37.
3. Feng Guixian. Efficacy and safety of atorvastatin calcium in the treatment of acute cerebral infarction[J]. Chinese Journal of Modern Drug Application,2024,18(15):67-69.
In 2017, Zeng Hongli, a 55-year-old vegetable grower living in Kunming, now has hundreds of acres of land and employs dozens of employees after more than ten years of hard work. Now Zeng Hongli is over half a hundred years old, but she is still idle, from the management of the plantation to the weeding of the field, she will personally deal with it, and she keeps spinning like a spinning top every day, and she is also tired of it.
Zeng Hongli's family was poor when she was a child and she didn't have much education, so her education level was not high, but this did not prevent her from being a reasonable and good boss. She knows that it is not easy for everyone to make money, and at the same time provides food and accommodation for employees while offering a good salary. Because she considered that she was a manual laborer, Zeng Hongli asked the canteen to cook more dishes with oil and water, such as: stir-fried animal offal, pork belly, braised pork, etc., and she would eat it with her employees every day, and her weight also increased unconsciously.
In September 2017, Zeng Hongli was bending over to check how the crops were growing, and when she got up, she didn't know if her posture was wrong and twisted to her waist, and suddenly there was a sharp pain in her waist, as if a muscle had been broken, and her waist movement was also restricted, accompanied by pain in her right lower limb. Zeng Hongli could only hold her waist after returning home, dragging her painful lower limbs to the pharmacy to buy activating oil and plasters. After using the medication, she felt that the pain was much better, so she didn't pay attention to it.
On September 20, it rained heavily in the sky and the temperature plummeted, Zeng Hongli felt a familiar pain in her waist again, the pain was mild and bearable. But when she went to bed at night, the pain in her lower back intensified, as if she had been pricked by dozens of needles, and the pain made her toss and turn in bed and couldn't sleep. She went to the hospital early the next morning, but the results surprised her. The cause of pain is lumbar muscle strain, which is easy to cause muscle damage as we age, poor body repair ability, and long-term physical activity.
But doctors say there is also a bigger ticking time bomb hidden in his body. Blood lipid test showed that Zeng Hongli's total cholesterol was as high as 11.5mmol/L, triglycerides were 6.3mmo/L, and low-density lipoprotein cholesterol was 5.78mmol/L, far beyond the normal range. Diagnosis of hyperlipidemia. If the intervention is not detected in time, lipid deposition in the blood, the formation of plaque, narrowing of the blood vessel wall, and the hardening of the arteries, which may cause cardiovascular and cerebrovascular accidents. Zeng Hongli was very surprised, except for low back pain, she didn't feel any discomfort in her body, and she was usually doing physical strength, how could the indicators be so abnormal?
The doctor explained that hyperlipidemia is not like diabetes, which has "three more and one less" (more food, more drinking, more urination, and weight loss), nor is it like high blood pressure that causes dizziness and headaches. Hyperlipidemia itself has almost no symptoms and is difficult to detect in the early stage, but if the blood lipids are high for a long time, it can lead to a series of intercurrent diseases, including atherosclerosis, coronary heart disease, stroke, etc.
Later, the doctor asked Zeng Hongli about her eating habits, and said that although she was doing physical activity, which was good for her blood lipids, it was futile to only exercise without dietary control. Zeng Hongli often eats greasy food or animal offal such as pork liver and fat intestines, which are the main culprits of high blood lipids after eating.
The doctor prescribed atorvastatin as a lipid-lowering drug for Zeng Hongli, and asked her to check her blood lipids regularly in the future, Zeng Hongli could only go home depressed, began to take the medicine on time, and prayed that the next blood lipid would return to normal. Time passed in a flash, and soon it was time for a reexamination, but the results still disappointed Zeng Hongli, with total cholesterol as high as 9.5mmol/L, triglycerides 5.3mmo/L, and low-density lipoprotein cholesterol 4.78mmol/L.
At first, Zeng Hongli didn't pay much attention to this, but after learning about the seriousness of the complications of myocardial infarction, stroke, and coronary heart disease, she was completely honest, no longer casual, but took medicine on time, and at the same time began not to eat in the cafeteria, but tried to go home and cook some nutritious and light food by herself.
It's been five years since Zeng Hongli took atorvastatin, and taking medicine has become an essential part of her daily life. In the past five years, her mental state has been getting better and better day by day, and her body has not experienced any discomfort. Just when Zeng Hongli thought that her life was on the right track, an accident struck......
In October 2022, Zeng Hongli, after returning from a holiday trip, began to feel dizzy frequently, and sometimes even felt that the world was spinning, but fortunately, it didn't last long. Vision also began to deteriorate, blurred when seeing distant objects, squeezing your eyes to see clearly, waking up in the morning with wet eyes and feeling like you couldn't open them. Zeng Hongli also muttered that going out for a trip was more tiring than going to work, and she was so tired that she was uncomfortable.
On October 19, when Zeng Hongli followed the staff to inspect the vegetables in the greenhouse, there were no uncomfortable symptoms at first, but as she walked, she suddenly felt a sharp pain in her head, like being hit by a heavy object, with a splitting headache, and the pain made her break out in a cold sweat and wanted to squat down and rest. Before she could do so, her eyes suddenly turned black and she fell straight to the ground. Seeing this, the employees immediately dialed 120 and notified the family, and while waiting for the ambulance, the employees found that the corners of Zeng Hongli's mouth were dripping with white foam, and the corners of her mouth began to be crooked.
Although after receiving the emergency call, ambulance personnel were immediately dispatched. However, due to the remoteness of the greenhouse planting base area, half an hour had passed when I arrived at the destination. After arriving at the hospital, the doctor immediately arranged for Zeng Hongli to take blood and head CT examination, and to maintain vital signs, but Zeng Hongli still had a heartbeat, pulse arrest, and no spontaneous breathing symptoms. The medical staff began to perform round after round of cardiopulmonary resuscitation, and no matter how hard the medical staff tried, Zeng Hongli's electrocardiogram still showed a straight line. Zeng Hongli's death was announced.
At this time, the head CT report came out. The results showed that a large area of slightly low-density shadow was seen in the temporal lobe of the right frontoprietal island, the adjacent gyrus was swollen, and the sulci and cisterns became shallow. Bilateral frontotemporal skull under the inner plate of the skull shows an arcuate fluid density shadow. Consider acute cerebral infarction of the temporal lobe of the right frontoprietal island.
Hearing the bad news, the husband instantly collapsed to the ground, and the husband could not accept the fact that his wife had left him forever, and sat on the ground alone and wept secretly. The same is true of Zeng Hongli's son, who had a big emotional breakdown and shouted loudly as if he lost his mind: "My mother has no other diseases except hyperlipidemia, and she has been taking medication and eating a light diet, and it is normal to have several reexaminations." How can a cerebral infarction suddenly occur? I need an explanation from the hospital! ”
The doctor is also difficult to ride, he has checked Zeng Hongli's past medical history, and indeed only hyperlipidemia, and the blood lipids are well controlled under the dual action of drugs and lifestyle. It stands to reason that the chance of developing a cerebral infarction is very low. However, it does report a cerebral infarction. What is the cause of this?
With doubts, the doctor asked the family in detail about Zeng Hongli's medication and lifestyle. After some exchanges, I finally found the clue. The doctor shook his head and sighed: "Cerebral infarction will not find her for no reason, but she did these two things wrong in the process of taking medicine, which gave her a chance to take advantage of it...... Clinically, many patients have taken the same medication as your mother, which will lead to an increasing incidence of cardiovascular and cerebrovascular diseases! This way of eating is not strange if you have a cerebral infarction! ”
First: Change the dosage at will
As the saying goes, once you are bitten by a snake for three years, you are afraid of the well rope, Zeng Hongli is such a person, although she took the medicine on time, but she did not take the medicine according to the amount. Because she was too worried about the occurrence of myocardial infarction and cerebral infarction, Zeng Hongli would increase the dose of one tablet without permission as soon as she had symptoms such as dizziness and fatigue or couldn't help eating slightly greasy food, and the next day she would resume the original recommended dose. Not only is this not beneficial, but it is also very dangerous, as it can interfere with the stable concentration of the drug in the body, leading to a decrease in the efficacy of the drug and increasing the risk of cardiovascular events.
Generally speaking, although the addition of drugs can indeed produce a powerful effect in the short term, reducing elevated blood lipids, but also will increase the side effects of drugs, and may also lead to the emergence of drug resistance, so that the body's sensitivity to drugs is reduced.
Second: Failure to pay attention to drug interactions
When drugs are used in combination, drug interactions may occur, and some synergistic effects can sometimes be antagonistic, and atorvastatin is no exception. For example, atorvastatin can interact with amiodarone, macrolide antibiotics, etc., increasing the risk of liver and kidney failure, and when combined with antacids such as aluminum magnesium hydroxide, it will have an antagonistic effect, resulting in a decrease in the blood concentration of the drug, affecting the stability and therapeutic effect of the drug.
Zeng Hongli had many symptoms of gastrointestinal discomfort during the period of taking atorvastatin, such as acid reflux, belching, etc., and purchased antacids for treatment by herself, because she was not a professional knowledge, so she did not know that taking antacids and atorvastatin would have antagonistic effects, affecting the lipid-lowering effect of atorvastatin, thus laying a hidden danger for cerebral infarction.
Therefore, while using atorvastatin, the potential risks and benefits should be discussed with your doctor if you want to use it in combination with other drugs, and you may need to adjust the dose or closely monitor the concentration of the drug in your blood. Remember not to use drugs blindly.
(Note: "In 17 years, a 55-year-old woman insisted on taking statins, and 5 years later had a heart attack, the reason was that she had a misunderstanding" The names are pseudonyms, and some pictures are network pictures; Reprinting and plagiarism are prohibited in the article)