Statin Drugs Should be Used Sparingly

Cholesterol lowering drugs like Lipitor, known as statins, are prescribed when patients present with high cholesterol, esp. elevated LDL, the so-called bad cholesterol.  The thought is that they will prevent heart attacks and strokes, and heart disease is clearly the number one killer in the US.  Unfortunately, while statins have some strong evidence of benefit for patients who have already had heart attacks, referred to as secondary prevention, there are only a few studies that have shown that they can reduce the risk of a first heart attack and quite a number of people have to take the meds to prevent one person from having a cardiac event.  And at least 11 large trials indicated that statins were not effective in primary prevention. So there have been questions of the benefit of these drugs and there are some common side effects that must be weighed versus the benefits, including muscle pain and brain fog. And now there is a new study that examines some mechanisms by which statins may actually promote calcification of the arteries to the heart rather than prevent it.

While statin drugs have been prescribed to reduce calcification of the arteries in the heart, this new study provides evidence that statins may actually cause coronary artery calcification.  In addition, statins can be toxic to the mitochondria, impairing muscle function in the heart and blood vessels through the depletion of CoQ10 and ‘heme A’ and, consequently, ATP generation. This paper demonstrated that statins inhibit the synthesis of vitamin K2, which is an important cofactor for matrix Gla-protein activation. This is responsible for the protection of the arteries from calcification. In addition, statin drugs inhibit the biosynthesis of selenium-containing proteins such as glutathione peroxidase that suppresses peroxidative stress. An impairment of selenoprotein biosynthesis may be a contributing factor in congestive heart failure similar to cardiomyopathies seen with selenium deficiency. The epidemic of heart failure and atherosclerosis, therefore, may paradoxically be aggravated by the prevalent use of statin medication. The researchers propose that the current statin treatment guidelines be seriously re-evaluated.

1. Okuyama H1, Langsjoen PH, Hamazaki T, et al. Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms.Expert Rev Clin Pharmacol. 2015 Mar;8(2):189-99.