Cholesterol and saturated fats have killed more people around the world than all the battles and wars combined. In the United States alone, more than half a million people succumb to heart attack and stroke each year. This does not even include the morbidities and disabilities caused by the blockages of arteries in the abdomen and limbs due to cholesterol plaque build-up, leading to lack of blood supply to vital organs. Luckily for all of us today, there are the wonder drugs called statins.
The risk factors
Besides hypercholesterolemia (high blood serum cholesterol levels) from eating red meats, eggs, dairy products with high saturated fat contents, there are other contributing factors to the development of cardiovascular diseases, such as smoking, lack of exercise, excess body weight, unmanaged stress, untreated or poorly controlled high blood pressure, diabetes, and, to some degree, genetics.
Prevention
There is no question that prophylaxis by living a healthy lifestyle, minimizing those risk factors listed above, is the best way to slow down arteriosclerosis and reduce your risk for heart attack, stroke, cancer, possible Alzheimer’s and Multiple Sclerosis. It has been clinically shown that lifestyle changes alone (low fat, high-fiber diet of fish and vegetables, plus daily exercises and abstinence from tobacco) could reduce the Low Density Lipoprotein (LDL, the bad cholesterol) by 40 percent, whereas statins reduce the LDL between 25 percent-60 percent. Some people need a combination of lifestyle changes and statins.
Where statins come in
If the cholesterol and triglycerides are still uncontrolled in spite of positive behavioral lifestyle changes, the wonder drugs, statins, could be just what the doctor would prescribe. Some physicians are more aggressive than others but the trend appears to be towards early use of statins in dramatically lowering the total cholesterol down to (not 200 anymore but) 150 as the new healthy cut-off level, the LDL to below 100, increasing the HDL (good cholesterol High Density Lipoprotein) to above 60, and reducing the Triglycerides to below 150. While statins can tame the cholesterol risk factor, it can not thwart or negate the adverse effects of smoking, lack of exercise, uncontrolled high blood pressure and obesity.
Arteriosclerotic plaques
Twelve to fifteen million Americans of various ages and conditions depend on one statin or another to reduce or prevent the waxy goo formation (arteriosclerosis) on the walls of their arteries all over the body. The cheesy materials are fat deposits or plaques on the arterial intima (inner wall lining) which continuously build up, cause narrowing, and eventually block the arteries, cutting off the blood supply to the vital organs like the heart (heart attack), the brain (stroke), etc.
What are statins?
Statins are cholesterol-lowering pills, a top-selling class of drug in the United States, first introduced in 1987, accounting for about 15 billion dollars in 2003. They work by (1) blocking an enzyme that the body needs to produce cholesterol, which lowers the cholesterol, and by (2) boosting the liver’s efficiency in removing LDL (bad cholesterol) from the bloodstream, by increasing LDL-receptor production in the liver, which receptors eliminate the excess blood LDL and resulting in lower bad cholesterol.
How adverse is the couch-potato syndrome?
This sedentary and lazy behavior has caused a lot or mortality and morbidity. Couch-potato lifestyle is no joke. This has led to a dramatic increase of 61 percent of obesity in the 1990s and 49 percent increase in diabetes that same period. Statistics show that fewer than 50 percent of American do any form of daily exercises, and obesity is now in epidemic proportion. The “bigger, super-sized,” portions in fast junk food restaurants, which, by the way, are also loaded with saturated fats, is a big factor in transforming America and other westernized countries into unhealthier societies. Forty-two million Americans have total cholesterol of over 240, majority of them with couch-potato syndrome. McDonald’s has recently announced “down-sizing” their portions for obvious health reasons. Many food outlets and restaurants are expected to follow suit. A healthy move, indeed.
Which statin to take?
There are many statins in the market today. The choice of statin is based on the medical findings for each individual. Your physician will guide you accordingly and prescribe what is best for you. As we have reported in our previous column, a recent study revealed that getting cholesterol to super-low levels can stop the progression of arteriosclerotic heart disease. The anti-cholesterol drugs are today being used to prevent artery blockages and heart attack, and they have been very effective, in combination with abstinence from tobacco, low-cholesterol diet and daily exercises.
Statins for Alzheimer’s, MS, osteoporosis, and cancer also?
A study shows that those patients taking a form of statin or another for at least 6 months had 39 percent lower risk of Alzheimer’s. It is postulated that cholesterol augments the production of beta amyloid (A-beta), the protein that is the suspected as the culprit in Alzheimer’s. Statins are also being studied today as a possible treatment for Multiple Sclerosis, an autoimmune disease that destroys myelin, the fatty sheath around nerve cells in the brain and spinal cord, leading to paralysis. On top of this, there are clinical observations that people on statins for 4 years or more had a 20 percent reduction in cancer risk, especially of the liver and prostate. Statins also show potential in protecting persons against osteoporosis and aortic valve disease. All these possible additional benefits from statins are being investigated and verified at the present. These will take a few years to confirm. In the meantime, there is no doubt that statins, in combination with a healthy lifestyle outlined above, are effective in preventing heart attack and other acquired cardiovascular diseases. These medications should only be taken under the supervision of a physician because of some potential adverse side effects.
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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]
