Statins are certainly one of the most widely used drugs in the history of medication and they have reshaped the treatment of cardiovascular disease, with an estimated one billion people around the world prescribed them daily. Statins are guideline recommended and do play a role in treating patients with heart disease. It is however important to identify the patients most likely to benefit.
Recently, statins were the focus of a podcast by functional medicine expert Dr Mark Hyman. He was joined by Dr Aseem Malhotra, a UK cardiologist, who is a founding member of Action on Sugar and on the board of trustees for the UK health charity, The King’s Fund. Dr Malhotra’s has researched statins in depth and advises a more nuanced discussion between patients and doctors before prescribing statins.
His book – A Statin Free Life – challenges the idea that statins should be embraced as a panacea for preventing and treating heart disease. Partly because it’s not necessarily the case that LDL cholesterol – which statins lower – are always the problem and, also, because statins are not without inherent risks.
It’s essential that patients fully understand the benefits and risks about statins as well as an improved understanding of the role of statins in preventing and managing heart disease. But that they should also be aware that there is a further, possibly more powerful option, which is functional medicine.
The problem of cholesterol
Cholesterol is a type of fat, or lipid, made in the liver and circulated around our body through the bloodstream as it plays a vital role in how your body works and is essential for making and repairing cells.
However, fatty deposits can build up on the artery walls and lead to the arteries narrowing known as atherosclerosis. If the coronary arteries that supply the heart become blocked, then it can result in a heart attack.
The narrative for many years has been that there is ‘good’ and ‘bad’ cholesterol. Low-density lipoprotein (LDL) cholesterol is thought to be ‘bad’ because it carries cholesterol to your arteries where it may collect in the artery walls and lead to atherosclerosis. High-density lipoprotein (HDL) cholesterol was considered ‘good’ because it transports cholesterol to your liver where it was expelled from the body.
Statins are very effective at lowering LDL cholesterol which is why they have been so widely prescribed. However, an increasing number of studies show that HDL cholesterol may not be so beneficial as was previously thought and one recent study found that it correlated to a higher risk of heart disease in women.
Researchers have also found increasing evidence that high levels of LDL cholesterol are not always linked to heart disease. As Dr Malhotra explains: “It’s a useless biomarker in terms of predicting someone’s risk of heart disease and therefore we shouldn’t obsess about lowering it.”
Statins or lifestyle changes?
Statins benefits are stronger for those in the high-risk category, such as those who have already had a heart attack or those diagnosed with severe blockages. Yet most prescriptions for statins are not for these patients. They are used as preventative medication and the evidence points to minimal benefit in terms of life expectancy when set against the potential risks and side effects.
Taking statins also does not protect you from the consequences of unhealthy living and adopting real and effective lifestyle changes, including a healthy diet, being active and limiting stressors, should always be the first line of defence.
Confused? You are not alone. For more information on risks and benefits of statins and on a functional medicine approach to treating heart disease, call and book a consultation with Dr Konrad Grosser on 01622 538 103or via kentcardio@kims.org.uk today.
