statins, your cholesterol and your heart
According to a study in the Nov. 6 issue of the New England Journal of Medicine (PM Ridker et al), healthy men and women with normal cholesterol levels may significantly reduce their risk of developing or dying from heart disease (including chest pain, coronary bypass grafting or stenting), heart attacks and stroke by taking a crestor, a member of the cholesterol-lowering drug family of “statins”. This study by Ridker et al was also described on CNN.com.
While statins are used currently to treat only people with high levels of cholesterol, the people in this study all had healthy cholesterol levels but had an elevated level of high sensitivity C-reactive protein (hs-CRP), which is a non-specific marker of inflammation. Over the last few years, CRP has become an increasingly important adjunct clinical parameter used to decide whether a person with borderline cholesterol should start statin therapy. This study further adds significance to the role of CRP in reflecting a person’s risk for cardiovascular disease.
Moreover, the exact mechanism through which statins exert their beneficial effects remains unclear. Certainly statins lower cholesterol but they have other ancillary effects as well. In the laboratory setting, statins have been shown to have pleiotrophic effects–even inhibiting HIV replication! However, there is now a lot of evidence to suggest statins have a significant anti-inflammatory effect. And because inflammation is thought to play an important role in atherosclerotic cardiovascular disease, an anti-inflammatory effect by statins may synergize with their cholesterol lowering effects. This is also consistent with recent controversy over the effectiveness of other cholesterol lowering drug familes (such as fibrates–e.g. TriCor or Lopid, bile acid seqeuestrants–e.g. cholestyramine, and niacin).
keywords: cholesterol, statins, crestor, heart disease, heart attack, stroke
