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ANALYZING THE THERAPEUTIC EFFICACY OF ROSUVASTATIN IN
MANAGING HYPERCHOLESTEROLEMIA AND DYSLIPIDEMIA
Dildora Saidjanovna Narzullaeva
PhD, Senior Lecturer of the Department of Internal Diseases and Family Medicine, Bukhara
State Medical Institute, Bukhara, Uzbekistan.
https://orcid.org/0009-0005-5001-6910
E-mail:
Abstract:
This research aimed to assess both the clinical effectiveness and safety of
rosuvastatin therapy in patients diagnosed with hypercholesterolemia and dyslipidemia. The
study involved 60 participants treated at the therapeutic unit of Bukhara City Clinical
Hospital between 2024 and 2025. Subjects were randomly assigned to two groups: the first
group (n=30) received daily doses of rosuvastatin (10–20 mg), while the second group
(n=30) underwent lifestyle and dietary interventions without medication. The key
parameters analyzed included changes in lipid profiles — specifically total cholesterol,
LDL-C, and HDL-C — along with liver enzyme levels to ensure drug safety.
At baseline, lipid indicators were similar between both groups. After 12 weeks, those
treated with rosuvastatin demonstrated marked improvements: total cholesterol levels
dropped by 28%, LDL-C was reduced by 44%, and HDL-C rose by 27%, all with
statistically significant differences (p < 0.05). The lifestyle-only group did not show
meaningful changes in these metrics. The medication was well tolerated overall, with only
mild adverse reactions observed in two individuals, none of which required stopping the
therapy.
These results reinforce the established lipid-lowering potential of rosuvastatin and affirm
its safety in everyday clinical settings. The study highlights that rosuvastatin therapy yields
significantly better improvements in lipid profiles than non-pharmacological measures alone.
Therefore, it should be regarded as a key element in the prevention of atherosclerosis and
cardiovascular complications, especially for patients at heightened risk. Further extensive,
long-term trials are recommended to validate the durability of these benefits and track long-
term safety outcomes.
Keywords
: rosuvastatin, hypercholesterolemia, dyslipidemia, atherosclerosis, lipid profile,
prevention.
Introduction.
Atherosclerosis and its associated cardiovascular diseases (CVD) remain
among the primary causes of illness and premature death worldwide, contributing
significantly to disability and early mortality. The development of atherosclerosis is driven
by a complex set of factors, including lipid metabolism disorders, endothelial dysfunction,
chronic inflammation, and genetic predisposition. Among the modifiable risk factors,
dyslipidemia plays a central role. It is typically characterized by elevated levels of total
cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides, along with
reduced levels of high-density lipoprotein cholesterol (HDL-C). This lipid imbalance
contributes to the formation and progression of atherosclerotic plaques in the arteries,
leading to vascular narrowing and ischemic events such as myocardial infarction and stroke.
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Pharmacological management of dyslipidemia has become a cornerstone of cardiovascular
disease prevention. Statins, or HMG-CoA reductase inhibitors, are the first-line agents due
to their proven ability to reduce LDL-C, stabilize atherosclerotic plaques, and exert
additional effects such as anti-inflammatory action and improved endothelial function.
Among these, rosuvastatin stands out for its high potency, favorable pharmacokinetic
properties, and strong lipid-lowering efficacy even at low doses. It works by inhibiting the
rate-limiting step in cholesterol biosynthesis, resulting in marked reductions in LDL-C and
total cholesterol, as well as beneficial effects on HDL-C and triglyceride levels.
Although the effectiveness and safety of rosuvastatin have been confirmed in large-scale
clinical trials, continued evaluation in various clinical contexts and patient populations
remains important. Factors such as genetic variability, comorbid conditions, and concurrent
medications can influence treatment response and tolerability. Therefore, this study is
dedicated to assessing the clinical and laboratory efficacy and safety of rosuvastatin in
patients with dyslipidemia undergoing treatment in a city clinical hospital. The results are
intended to support the optimization of lipid management strategies tailored to the specific
needs of the local patient population.
Materials and Methods
This prospective, controlled study was conducted at the Therapeutic Department of Bukhara
City Clinical Hospital during the period from 2024 to 2025. A total of 60 patients diagnosed
with primary dyslipidemia or hypercholesterolemia were enrolled based on the diagnostic
criteria established by the European Society of Cardiology (ESC) and the European
Atherosclerosis Society (EAS) in 2016. The inclusion and exclusion criteria were rigorously
applied to ensure a homogeneous study population and minimize confounding factors.
Inclusion criteria
were as follows: patients aged between 35 and 70 years; total cholesterol
levels exceeding 5.2 mmol/L; LDL cholesterol levels above 3.0 mmol/L; and no prior
history of statin therapy, allowing for an unbiased assessment of rosuvastatin’s efficacy and
safety as an initial treatment.
Exclusion criteria
encompassed patients with active hepatic or renal pathology, including
elevated liver enzymes or impaired kidney function, as these conditions could influence drug
metabolism and safety profiles. Additionally, individuals with secondary causes of
hyperlipidemia, such as hypothyroidism, nephrotic syndrome, or other endocrine disorders,
were excluded to isolate the effect of primary dyslipidemia. Patients with documented
intolerance or contraindications to statin therapy were also excluded to ensure patient safety.
Following screening, participants were randomized in a 1:1 ratio into two groups. The
main
group
(n=30) received rosuvastatin therapy at doses ranging from 10 to 20 mg once daily,
adjusted according to clinical response and tolerability. The
control group
(n=30) was
managed with lifestyle modifications, including adherence to a low-cholesterol diet
emphasizing reduced intake of animal fats, alongside recommendations for regular physical
activity consistent with current clinical guidelines.
Clinical and laboratory evaluations were conducted at baseline and after 12 weeks of
intervention. Laboratory parameters measured included serum total cholesterol, LDL
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cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, and hepatic
transaminases (alanine aminotransferase [ALT], aspartate aminotransferase [AST]) to
monitor both efficacy and safety. Clinical data encompassing blood pressure, div mass
index, and symptomatology were recorded. Furthermore, patient-reported tolerability and
adverse events related to rosuvastatin were systematically documented throughout the study
period.
This methodological approach aimed to provide comprehensive insight into the lipid-
lowering efficacy, safety profile, and overall clinical impact of rosuvastatin in a real-world
hospital setting.
Results
After 12 weeks of rosuvastatin therapy, significant improvements in the lipid profile were
observed in the main group:
Parameter
Before Treatment
After Treatment
Change (%)
Total Cholesterol
6.8 ± 0.4 mmol/L
4.9 ± 0.3 mmol/L
−28%
LDL Cholesterol
4.5 ± 0.3 mmol/L
2.5 ± 0.2 mmol/L
−44%
HDL Cholesterol
1.0 ± 0.2 mmol/L
1.27 ± 0.2 mmol/L
+27%
Triglycerides
2.1 ± 0.3 mmol/L
1.6 ± 0.2 mmol/L
−24%
No statistically significant changes were observed in the control group (p>0.05). Regarding
safety, two patients in the main group reported mild adverse effects (headache, nausea),
which did not require discontinuation of therapy. Liver enzyme levels (ALT, AST) remained
within normal ranges.
Discussion
The results obtained in this study unequivocally confirm the high efficacy of rosuvastatin in
the correction of lipid metabolism disorders in patients with primary dyslipidemia.
Treatment with rosuvastatin led to a pronounced reduction in low-density lipoprotein
cholesterol (LDL-C) levels by more than 40%, accompanied by a notable increase in high-
density lipoprotein cholesterol (HDL-C) by approximately 27%. These changes are of
critical clinical importance, reflecting a substantial atheroprotective effect, which is well
recognized as a key factor in reducing the progression of atherosclerosis and consequent
cardiovascular events. Our findings are consistent with data reported in large-scale
international clinical trials, particularly the JUPITER study, which demonstrated that
rosuvastatin significantly reduces the incidence of major cardiovascular events in patients
presenting with elevated levels of C-reactive protein and moderately increased cholesterol,
despite otherwise low or average LDL-C concentrations. The JUPITER trial also highlighted
the pleiotropic effects of rosuvastatin, including anti-inflammatory properties and
endothelial function improvement, which may contribute to its cardiovascular benefits
beyond lipid lowering. In addition to efficacy, rosuvastatin exhibited a favorable safety and
tolerability profile in the studied cohort. No serious adverse events or significant elevations
in hepatic enzymes were observed, supporting the drug’s suitability for long-term use in
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clinical practice. This is particularly important given the concerns often raised regarding
statin-associated side effects, which can limit patient adherence and treatment success. The
comparison with the control group, which received only dietary and lifestyle
recommendations, underscores the limitations of non-pharmacological interventions alone in
achieving optimal lipid profile improvement among patients at high cardiovascular risk.
Although lifestyle modifications are fundamental and should be continuously encouraged,
they often fail to provide adequate reductions in LDL-C or significant increases in HDL-C in
a relatively short time frame. Thus, our data reinforce the necessity of early initiation of
statin therapy in appropriate patient populations to effectively mitigate cardiovascular risk.
Overall, the study supports the growing div of evidence advocating for rosuvastatin as a
first-line agent in the management of dyslipidemia, particularly in settings similar to our
clinical environment. Further longitudinal studies with larger sample sizes and extended
follow-up periods are warranted to confirm these benefits and assess long-term outcomes.
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