Statin use not responsible for healthy people with high cholesterol

TAMPA, Fla. (September 20, 2022) – According to 2020 data from the American Heart Association, about 40 million adults in the United States regularly take statins to lower their cholesterol levels and reduce their risk of heart disease and stroke.

However, many of them do not benefit from these drugs based on new research from David Diamond, a neuroscientist and cardiovascular disease researcher in the Department of Psychology at the University of South Florida.

Diamond and his co-authors reviewed literature from medical studies in which patients took a statin or placebo. They then narrowed their assessment to look at study participants with elevated levels of low-density lipoprotein cholesterol (LDL), the so-called “bad cholesterol,” which can be reduced with a statin. Some individuals with high LDL also had high triglycerides (fat in the blood) and low high-density lipoprotein (HDL), the “good cholesterol,” which put them at the highest risk of heart attack.

But others with high LDL were very different. They had low triglycerides and high HDL, which meant they were healthier. People with optimal triglycerides and HDL levels typically exercise, have low blood pressure and low blood sugar, and have a low risk of heart attack.

Diamond and his co-authors asked two questions: If people have a low risk of heart attack based on optimal triglycerides and HDL, but they also have high LDL, does that increase their risk? Would these people further benefit from lowering their LDL with a statin?

Their findings, published in the journal Current Opinion in Endocrinology, Diabetes and Obesity, showed that LDL alone has a “very weak association” with heart disease and stroke. Their review went further and showed that when people with high LDL and optimal triglycerides and HDL were given a statin, there was no benefit.

Diamond placed the findings in a diet and lifestyle context.

“People who are not overweight, have low blood sugar, exercise, and eat a low-carb diet typically have optimal triglycerides and HDL, and sometimes they have high LDL,” he said. “Our findings show that the people who had this healthy combination of diet and lifestyle, as well as high LDL, had no benefit from taking a statin.”

The authors say their review also challenges the long-held claim that low-carb diets, which are often high in saturated (animal) fat, contribute to heart disease. That claim has lasted for nearly 50 years, dating back to when cardiologist Robert Atkins was challenged about the potential dangers of his high-fat Atkins diet before a U.S. Senate Subcommittee on Nutrition and Human Needs in 1973.

“High blood pressure, obesity, smoking and high blood sugar are the leading causes of heart disease,” Diamond said. “Cholesterol is an innocent bystander and saturated fat in the diet has been unfairly demonized.”

Diamond acknowledges that his research is controversial and has resulted in strong support, along with criticism from some within the medical community who have challenged his views on LDL and statins. He cautions that it is intended to raise awareness and should not be taken as medical advice.

Diamond’s interest in the link between LDL cholesterol and the risk of heart disease and stroke is personal.

About 25 years ago, he was overweight and diagnosed with high triglycerides and low HDL, a potentially deadly combination. His doctor told him he was at high risk of developing heart disease and prescribed a statin to lower his LDL cholesterol. Instead of taking the medication, Diamond began studying nutrition and heart disease.

“I found that my problem was that I was eating too many carbohydrates — bread, potatoes, and sugar,” Diamond said. “I have been able to control my weight and reduce my risk of heart disease with a low-carb diet. In the meantime, I have become aware of the obsession with linking cholesterol to heart disease.”

Diamond has since published more than a dozen articles about shortcomings in the consensus that cholesterol causes heart disease. His latest paper reviewed the medical literature linking statins to numerous side effects, including the development of diabetes, muscle and kidney damage, and impaired brain function.

“Certain statins have been linked to cognitive impairment because they interfere with the brain’s ability to produce cholesterol, which is essential for creating new brain connections and forming memories,” Diamond said.

According to Diamond, overweight and diabetic people may benefit from taking a statin because, in addition to lowering LDL, the drugs block excessive clotting and inflammation, two known risk factors for heart disease.

For those who prefer to take drugs rather than make changes in their diet and lifestyle, Diamond has a message: “People who take a statin may not appreciate that they are a little less likely to have a heart attack or stroke, but the adverse effects of the statin can harm them.”

Co-authors of the study were Brigham Young University Professor Ben Bikman and Paul Mason, a physician in New South Wales, Australia.

About the University of South Florida

The University of South Florida, a global high-impact research university dedicated to student success, generates an annual economic impact of more than $6 billion. In the past 10 years, no other public university in the country has risen faster in the US News and World Report national university rankings than USF. Serving more than 50,000 students on campuses in Tampa, St. Petersburg, and Sarasota-Manatee, USF has been designated a premier state research university by the Florida Board of Governors, placing it in the most elite category of the state’s 12 public universities . USF has gained widespread national recognition for its success in graduating underrepresented minority and low-income students at a rate equal to or greater than white students and higher-income students. USF is a member of the American Athletic Conference. Learn more at www.usf.edu.

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