Cholesterol Medications: Not just to lower your cholesterol levels
Cholesterol medications (statins or HMG-CoA Reductase Inhibitors)
are used to lower levels of fats (or lipids) in the blood (such
as cholesterol and triglycerides). These medications help to lower
bad cholesterol (LDL – low density lipoproteins), lower triglycerides
and boost good cholesterol (HDL – high density lipoproteins).
Current statins on the Canadian market include:
However, cholesterol medications do more than just lower cholesterol.
Several studies have shown that statin benefits go beyond cholesterol
reduction. Other benefits include improvement of endothelial function
and stabilization of atherosclerotic plaque. This article will
review some of the recent data discovered regarding further beneficial
effects of statin medications.
Atherosclerosis is a process where particles of cholesterol and
other substances settle inside the endothelium (walls of blood
vessels) causing the formation of a plaque or blockage. This build
up of plaque is one of the main causes of heart disease and stroke.
Plaque builds up and causes blood vessels to become narrower preventing
blood from moving through the vessels easily. Plaque can also break
off the walls of the blood vessels resulting in the formation of
blood clots that can partially or totally block the flow of blood
through the vessels. When a blood clot causes total blockage and
prevents blood from reaching the heart, this can result in a heart
attack. When a blood clot causing total blockage prevents blood
from reaching the brain, this can result in a stroke.
The endothelium also plays a role in this process. The endothelium
is the innermost lining of the blood vessel and has direct contact
with the blood. An unhealthy endothelium contributes to the constriction
and thickening of blood vessels. This allows blood cells to accumulate
and stick to the blood vessels which contributes to the development
of the atherosclerotic plaque. A healthy endothelium has been described
as being like a Teflon® coating on the inner walls of the vessel
with its non-stick quality enhancing the flow of blood. An unhealthy
endothelium instead acts like Velcro® which grabs blood cells
and packs them against the inner wall of the blood vessel1.
Research has shown that the beneficial effects of statins has
to do with their ability to stabilize an atherosclerotic plaque
and improve the endothelial function. Studies have shown that statins
can stabilize a plaque by preventing the plaque from fissuring
(or breaking). Statins have been theorized to improve the endothelial
function by improving the blood flow through the blood vessels
that is dependent on the endothelium. In addition, statins may
stabilize some of the substances that can affect the endothelium.
In conclusion, statins are very effective medications for improving
cholesterol levels (ie total cholesterol, LDL, HDL and triglycerides).
In addition to this benefit, more and more research suggests that
statins play a greater role through their beneficial effects on
atherosclerosis and endothelium.
CCRF would like to thank The Rouge Valley Health System Cardiac Rehabilitation Services for their contribution to the website.
The articles, on the Cardiac Health Foundation of Canada website, are presented with the understanding that the Foundation is providing information only and not rendering medical advise. Please check with your family physician, specialist or health care professional before implementing any of the ideas expressed in these articles.