statins reconsidered
Statins vs. the alternatives
Statins lower cholesterol by inhibiting HMG CoA reductase, an enzyme that helps the body make cholesterol, explains Mark Houston, MD, director of the Hypertension Institute of Nashville and author of What Your Doctor May Not Tell You About Heart Disease (Grand Central, 2012). “T is reduces total cholesterol, LDL cholesterol, and triglycerides,” he says. T at’s helpful because, in the bloodstream, LDL (low-density lipoprotein, or “bad” cholesterol) and triglycerides increase infl ammation, oxidative stress, and immune dysfunction that cause plaque buildup on artery walls, restricting blood fl ow and leading to heart disease and possible heart attack. But simply lowering bad cholesterol doesn’t address the underlying problem, says Houston. T at’s partly because plaque tends to develop where artery-wall lining has already been damaged—by high blood pressure, diabetes, chronic infl ammation, or an autoimmune disorder. Scientists don’t yet fully understand why these conditions cause arterial deterioration, but they do know lowering bad cholesterol is only one piece of the puzzle.
Indeed, mounting research shows raising HDL (high-density lipoprotein, or “good” cholesterol) may be equally important for reducing CVD risk. HDL mops up excess cholesterol in the blood and takes it to the liver for breakdown. So the higher the HDL level (60–80 mg/dL is optimal), the less “bad” cholesterol in the blood. In a new study in T e American Journal of Cardiology, increased HDL levels translated to lower CVD risk among diabetics. Adopting a holistic plan to improve heart health— one that includes smart diet and lifestyle strategies—is most likely to lead to long-term wellness. “You cannot take your statin, and then go eat at McDonald’s and expect it to work,” says Mark Hyman, MD, founder of T e UltraWellness Center in Lenox, Massachusetts. Even lowering your LDL level to the optimal range (less than 100 mg/dL) isn’t a magic bullet, he says. In a 2009 study of nearly a quarter million people hospitalized with coronary artery disease, almost half had optimal LDL levels. T at’s because LDL particles vary in size, says Houston. Small, dense LDL tends to clog arteries; large, fl uff y particles can fl oat right through. Unless your LDL is very low (less than 60 mg/dL), he adds, statins aren’t especially good at targeting problematic small particles— which means that although the drugs may have lowered your LDL, you might still be at risk. Moreover, research shows statins tend to work best for people who already have a history of heart disease and heart attacks. A 2010 research review found that statins did not prevent mortality among those who were just at risk of developing heart disease because of family history, high cholesterol, and other factors. And although statins are considered safe drugs, their use can have downsides. Potential adverse eff ects include muscle weakness and breakdown, liver dysfunction, and possible links to memory loss and nerve damage, says Houston.
TOP HEART HEALTH SUPPLEMENTS
5 34 deliciousliving | february 2012
Coenzyme Q10 Fish oil Niacin
Red yeast rice Vitamin D3
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