Roughly half the cholesterol that circulates in the blood is generated by the liver, and the drugs employ a natural or synthetic form of a substance derived from a fungus to block an enzyme the liver needs to produce cholesterol. That slashes LDL, the major villain in the development of heart disease because it deposits fatty particles inside the walls of the coronary arteries. Depending on the choice and dose of statin, LDL levels can drop by about 15 percent to 40 percent. The drugs also lift HDL by smaller amounts, which reduces risk because HDL carries fatty particles out of the bloodstream and back to the liver for elimination. Lipitor, the newest statin, might seem to be the obvious choice because it's the best at reducing LDLs.
Many physicians obviously feel that way.
Lipitor has gobbled up nearly half of the statin market in only five years, according to IMS Health, a group that tracks drug sales. Mevacor, Pravachol, and Zocor meet that standard. And some doctors believe in aggressively driving down LDLs to the max. For him, that usually means Lipitor. Many health plans will pay for only certain statins, which puts the others out of the running unless the physician is willing to do battle.