Cholesterol and statins: understanding their role in heart health
Cholesterol is a vital lipid or fat that supports various bodily functions, such as hormone production, vitamin D synthesis, and the formation of bile acids, which aid in fat digestion. Cholesterol is found in every cell of the body and is essential for maintaining cell structure and function. However, not all cholesterol has the same impact on health. There are two primary types of cholesterol:
Low-Density Lipoprotein (LDL): often called "bad" cholesterol, LDL transports cholesterol from the liver to the body’s cells. When LDL levels are too high, cholesterol can accumulate in artery walls, leading to the formation of plaques. This process, known as atherosclerosis, can narrow and harden the arteries, increasing the risk of cardiovascular events such as heart attacks and strokes.
High-Density Lipoprotein (HDL): known as "good" cholesterol, HDL helps remove excess cholesterol from the bloodstream, returning it to the liver for disposal. Higher levels of HDL are associated with a reduced risk of cardiovascular disease.
How statins work
Statins work by blocking an enzyme in the liver called HMG-CoA reductase, which plays a key role in cholesterol production. This action reduces the liver’s cholesterol output, helping to lower LDL levels in the bloodstream. However, since statins don’t reduce cholesterol absorption from food, maintaining a heart-healthy diet remains an important component of managing cholesterol levels.
Statins are among the most commonly prescribed medications worldwide and are typically prescribed for individuals who have high cholesterol or are at increased risk of cardiovascular disease. This group often includes people with conditions like atherosclerosis, hypertension, diabetes, or those who have experienced previous cardiovascular events.
Research shows that statins can reduce the risk of heart attacks, strokes and other cardiovascular complications, particularly when combined with healthy lifestyle changes such as regular exercise, a balanced diet and quitting smoking.[i]
Benefits of statins
Effectively lower LDL cholesterol levels, reducing the risk of cardiovascular events
Possess anti-inflammatory properties that help stabilise plaques within arteries, reducing the likelihood of rupture
Improve the function of the endothelium (the inner lining of blood vessels) which helps regulate blood pressure and prevent clot formation
Potential side effects
Common side effects include muscle pain, digestive issues and liver enzyme abnormalities
Rare but serious muscle damage, a condition known as rhabdomyolysis
An increased risk of developing type 2 diabetes, particularly those with poorly controlled glucose control and elevated body mass index[ii]
Potential depletion of coenzyme Q10 (ubiquinol), which is essential for energy production in cells
Long-term use might inhibit vitamin K2 activity, potentially leading to calcium build up in blood vessels[iii]
Cholesterol is essential for overall health, but maintaining a healthy balance, particularly by managing LDL levels, is crucial for preventing cardiovascular disease. Whether you're managing high cholesterol, considering statins, or looking for natural ways to support cardiovascular health, a holistic approach can make all the difference.
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References
[i] Statins and the Prevention of Heart Disease | Dyslipidemia | JAMA Cardiology | JAMA Network
[ii] Statins: pros and cons - PMC
[ii] Zhelyazkova-Savova MD, Yotov YT, Nikolova MN, et al. Statins, vascular calcification, and vitamin K-dependent proteins: Is there a relation? The Kaohsiung Journal of Medical Sciences. 2021 Jul;37(7):624-631. DOI: 10.1002/kjm2.12373. PMID: 33634559.