Heart disease and stroke are a main cause of death throughout Europe and North America, a problem that is becoming more prevalent around the world. According to the US health organization, Centers for Disease Control and Prevention, heart disease is responsible for 25% of the country’s deaths annually, which equates to 600,000 people.
Diet and lifestyle choices such as smoking, drinking alcohol, and eating foods rich in sugar and saturated fat play a role in this expanding health concern. A study by the School of Public Health at London’s Imperial College discovered that since 1980 obesity levels had nearly doubled among men and women globally. This is a concerning worldwide trend, given that excess body weight is known to be a major risk factor for cardiovascular disease (CVD).
Lurking behind many cases of heart disease lies low-density lipoprotein (LDL) cholesterol, often referred to as ‘bad’ cholesterol. Britain’s cholesterol charity, Heart UK, states that “6 out of 10 people are at increased risk because they have raised cholesterol”. The charity calls it a ‘cholesterol crisis’ and, in 2014, launched the National Cholesterol Campaign to raise awareness — led by its president, Dame Judi Dench. The campaign highlighted that “changes to our diet and lifestyle…with the help of medication in some cases” can reduce the devastating impact of CVD. In the UK in 2010, a third of deaths were caused by CVD.
The key weapon in the fight against high cholesterol is a group of medicines called statins, which lower levels of LDL cholesterol in the blood. Because of their effectiveness, around seven million people in the UK take statins. Originally, people identified by medical professionals with a 20% risk of developing CVD were offered statins. Now, UK healthcare advisory body, the National Institute for Health and Care Excellence (NICE), recommends that statin use is widened to include people with only a 10% risk of a heart attack or stroke.
Linda Main, Dietetic Advisor at cholesterol charity, Heart UK, told Antiaging Nutrition: “statins are very effective at lowering LDL cholesterol and at preventing heart disease and are generally safe and well tolerated.”
In the US, both the American Heart Association (AHA) and the American College of Cardiology (ACC) have called for statins to be prescribed to anyone considered at a theoretical risk of a heart attack within 10 years. However, across the US and Europe, many fiercely oppose this suggestion. While people agree that statins make sense for those at high risk of heart attack or stroke, the consensus breaks down at the idea of extending them to otherwise healthy adults.
While doctors and government agencies continue to recommend widespread statin prescription, new research is steadily revealing there may be a darker side to this wonder drug.
A study by Finnish researchers was recently released demonstrating a 46% increased risk of developing diabetes for Caucasian men taking statins, even after adjusting for confounding factors such as age, weight, and lifestyle. The authors, from the Institute of Clinical Medicine at the University of Eastern Finland and Kuopio University Hospital, were quick to point out that these results may not carry across to all demographics. Conversely, given their conclusions that "the association of statin use with increased risk of developing diabetes is most likely directly related to statins decreasing both insulin sensitivity and secretion”, it seems possible that these results could have implications for the wider population.
Another paper, published in the scientific journal Movement Disorders, seems to suggest that, contrary to previous reports, statins may also have negative outcomes for Parkinson’s disease risk. Though the researchers involved suggested that their work should not be taken as a blanket recommendation against statins, it certainly strengthens arguments that statins are overprescribed and that more research is needed into their long-term impact on general health.
Some statins have also been implicated in potential cases of memory loss, though such cases are rare and many reports rely on anecdotal or insufficiently rigorous evidence. Given that statins are predominantly prescribed to the elderly, however, who are already at risk of cognitive degeneration, these concerns warrant further investigation. Cholesterol, which statins inhibit, is crucial for cell membrane integrity and function in the brain and elsewhere; excess inhibition through inappropriate dosage or prescription may well be responsible for damage to cognitive function.
Another concern for aging consumers of statins are possible links to increased incidence of cataracts, currently the leading cause of vision loss in the US, particularly in older individuals. Researchers from the San Antonio Military Medical Center, Texas, reported in a paper published in JAMA Ophthalmology that, accounting for other risk factors, those taking statins had a 27% higher chance of developing cataracts than non-users.
Ironically, the greatest challenge facing the ubiquity of statin use may come from the frontline of the medical community itself. While government bodies still support recommendations for widespread prescription of statins, albeit somewhat more pragmatically in recent years, doctors themselves are airing increasingly concerning questions about the drug group. A story in Pulse last year revealed that two thirds of UK GPs have ignored advice to offer statins to larger numbers of patients.
In an article in the The Telegraph, British GP Haroun Gajraj described his own experiences with statins after being prescribed them by his doctor over fears of high cholesterol. After dutifully taking them for eight years, Gajraj decided one day that he would stop — and he has never looked back. After only three months off statins, and with the help of a low-sugar (but not fat) diet, Gajraj found his LDL levels lower than they had ever been while taking statins. He also reported an optimal fasting blood glucose level, and lower white blood cell count — an indicator of decreased inflammation within the body.
What this seems to indicate, and what research is now showing, is that statins may not be the hero of the piece, nor saturated fat the villain. In fact, nutrition experts and governments are increasingly cautioning against sugar, not fat, which may bring the widespread prescription of statins into question.
There are a number of less obviously attributable side effects of statins too — particularly myopathy: muscle pain, tenderness and weakness. Statins have been found to decrease Coenzyme Q10 (CoQ10) levels in the body, which is important for healthy muscle function.
Statin drugs work by blocking the branch of the metabolic pathway that produces both cholesterol and the naturally occurring CoQ10. In its role as an antioxidant, CoQ10 helps fight the free radicals that cause health problems by damaging cells and DNA.
Canadian health authorities have introduced a warning about CoQ10 depletion on statin labels, and, in 2014, the US FDA cautioned about the potential for muscle damage. While both these bodies back statin use to combat heart disease, their precautions help regular users make informed decisions.
Linda Main is aware of the suggested link between reduced levels of CoQ10 and statin-related muscle pain and damage, telling us that: “improvements in muscle symptoms following CoQ10 supplementation have been reported in a number of individual cases.”
The established link between statins and CoQ10 raises the question of whether regular statin users should take a CoQ10 supplement. Of course, not all patients suffer from adverse side effects when taking statins. It can depend on variables such as physical make-up or the type of drug that a physician prescribes. Common statins include atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin.
The international medical research journal Biofactors published a review highlighting that among 35 patients with heart failure, those who took CoQ10 as a supplement experienced “significant improvements” in symptoms and a greater capacity to exercise than those on placebos.
Some studies have indicated that CoQ10 might also help with high blood pressure, age-related macular degeneration, and even chronic fatigue syndrome. In both human and animal studies, CoQ10 has been shown to compensate for immune deficiencies caused by aging and disease.
Regardless of whether you take statins, CoQ10 levels start to decrease from around the age of 35. However, you can give the enzyme a boost by eating a diet rich in fruit and vegetables, as well as foods such as:
But perhaps a more convenient way to maintain good CoQ10 levels is to take a regular CoQ10 supplement. Antiaging Nutrition offers this supplement as CoQ10 SR Slow Release capsules capsules (30 capsules at $25.99) — the most effectively absorbed CoQ10 supplement available.
Given the clear link between CoQ10 depletion and muscle health, if you are taking statins, you might like to talk to your doctor about a CoQ10 supplement.
Statins bring the reassurance of lowering your risk of CVD, and by adding CoQ10, you can keep both your heart and your muscles fighting fit.