If the art of medical science were more clear-cut, then there would be no confusion when it comes to treating illness and disease. However, science sometimes creates more questions than it answers. Furthermore, experts are not always in agreement when it comes to determining the proper treatment for certain diseases. Such is the case with the topic of cholesterol levels, atherosclerosis, and the use of cholesterol-lowering statin medications. The effectiveness and usefulness of these medications come into question from time to time, despite evidence that these medications may prevent death from heart disease.
9. What Is Atherosclerosis?
Atherosclerosis is a condition in which the blood vessels become clogged with clots or “plaques” of fat. As the blood vessels narrow, the heart has to work harder to pump oxygen-rich blood to the organs and tissues that need it. The American Heart Association lists three possible reasons that fatty deposits may form on the interior of blood vessel walls. High blood pressure may be one contributor to atherosclerosis. A second possibility is cigarette smoking. Lastly, high levels of LDL, or bad cholesterol, may cause atherosclerosis.
8. Complications of Atherosclerosis
Once fatty plaque deposits have formed on blood vessel walls, your body has a greater risk of developing other forms of heart disease. As the blood vessel walls thicken, they may become hardened and impassable. When the coronary arteries become blocked, you may suffer angina or heart pain as the heart muscle is deprived of blood. Meanwhile, the carotid arteries carry blood to your brain. When these vessels become blocked, you may suffer a stroke due to lack of blood supply to the brain. Furthermore, chronic kidney disease may develop when atherosclerosis blocks blood flow to your kidneys.
7. What Do We Know About Cholesterol?
Cholesterol is a substance your liver manufactures in order to make cell membranes, certain hormones, vitamin D, and bile acids. You may also obtain cholesterol from foods. Cholesterol is carried in your bloodstream in little packets called lipoproteins. High-density lipoproteins (HDL) are considered good forms of cholesterol since they transport cholesterol to your liver for elimination. Low-density lipoproteins (LDL) are considered bad forms of cholesterol because they contribute to the buildup of fatty deposits in blood vessels. The CDC reports that high cholesterol levels about double your risk of heart disease compared to individuals with lower blood cholesterol levels.
6. What Raises Bad Cholesterol Levels?
Preventing your blood cholesterol levels from reaching high levels requires knowing what factors raise your cholesterol. Medline Plus lists several factors that may increase your risk of high cholesterol. Consuming processed, high-fat foods such as red meat, dairy, fast food, and fried items can raise your cholesterol. If you spend a lot of time sitting and refrain from exercising, you may increase your risk of high cholesterol. Smoking also contributes to the risk of high cholesterol. Factors beyond your control may include heredity, age, and race.
5. How do Statin Medications Work?
Sometimes your doctor may prescribe medicine to lower your cholesterol levels. The statins are a group of medications that lower cholesterol by blocking the activity of an enzyme called HMG-CoA reductase. This enzyme plays a role in cholesterol production in the liver. Lovastatin, fluvastatin, pravastatin, rosuvastatin, and simvastatin are all names of statin medications. Your physician may prescribe one of these medications to be used alongside healthy lifestyle practices in order to decrease your risk of atherosclerosis and heart disease.
4. Research That Suggests Statins Are Ineffective
The medical community has long linked high cholesterol with heart disease. However, in 2013, a study published in BMJ Open Journal suggested that cholesterol-lowering statins did not prevent hospitalization or death in elderly frail men. A second study also reported the lack of a link between high LDL levels and atherosclerosis in elderly individuals. These findings prompted a wave of reports that statin medications are a “waste of time” and that heart disease should be prevented through dietary and lifestyle changes.
3. 2018 American Heart Association Scientific Session Guidelines
Johns Hopkins Medicine announced that the 2018 American Heart Association Scientific Session calls for two changes in the prevention of atherosclerosis and heart disease. The first is that medical personnel should aggressively use statins to treat high cholesterol levels when warranted. The second is that medical staff should use risk assessment tools to determine which patients would benefit from statin therapy and which patients would not. This approach also calls for making lifestyle changes when possible in the fight against atherosclerosis and heart disease. JAMA reports that clinical studies have proven that statins effectively prevent heart disease and save lives.
2. The Best Candidates for Statin Therapy
While statin medications can lower LDL cholesterol levels and prevent heart disease, not everyone is a good candidate for their use. According to the American Heart Association, the New Guidelines for Statin Use involve assessing your risk of heart disease and choosing a course of treatment accordingly. Adults between the ages of 40 and 75 may fall into the categories of low, borderline, intermediate, and high risk, and should consider the use of statins accordingly. Adults between 20 and 39 years old may use lifestyle changes to decrease their cholesterol levels, unless they are considered high-risk.
1. Other Methods for Preventing Heart Disease
An individual and his or her doctor may determine that lifestyle changes are appropriate for treating high cholesterol. Consuming a diet that emphasizes lean proteins, whole grains, leafy greens, and fresh fruit can help to decrease cholesterol levels. Patients should avoid or limit foods high in cholesterol such as egg yolks, fatty cuts of meat, fried foods, processed food items, and junk food. Engaging in regular physical exercise is also beneficial for lowering cholesterol levels. Walking, hiking, jogging, or swimming are all good forms of heart-healthy exercise.