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, according to 2020 American Heart Association data.
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 the literature of medical trials involving patients taking either a statin or a placebo. They then narrowed their review to look at study participants with high levels of low-density lipoprotein (LDL) cholesterol, the so-called “bad cholesterol,” which can be lowered with a statin. Some people with high LDL also had high triglycerides (fats in the blood) and low high-density lipoprotein (HDL), the “good cholesterol,” which put them at the highest risk for heart disease. having a heart attack.
But others with high LDL levels were very different. They had low triglycerides and high HDL, which meant they were healthier. People with optimal triglyceride and HDL levels usually exercise, have low blood pressure and blood sugar, and have a low risk of heart attack.
Diamond and his co-authors posed two questions: If people are at low risk of heart attack due to optimal triglycerides and HDL, but also have high LDL, does this increase their risk? Also, would these people 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, showing that when people with high LDL and optimal triglycerides and HDL were given a statin, there was no benefit.
Diamond put the results in a diet and lifestyle context.
People who are not overweight, have low blood sugar, exercise, and follow a low carbohydrate diet usually have optimal triglycerides and HDL, and sometimes high LDL . Our results show that people who had this healthy combination of diet and lifestyle, as well as high LDL, showed no benefit from taking a statin.”
David Diamond, Neuroscientist and Cardiovascular Researcher, Department of Psychology, University of South Florida
The authors say their review also challenges the long-held claim that low-carb diets, which are often high in saturated (animal) fats, contribute to heart disease. This claim has persisted for nearly 50 years, ever since 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 major drivers of heart disease,” Diamond said. “Cholesterol is an innocent bystander, and saturated fat in the diet has been wrongly demonized.”
Diamond acknowledges that his research is controversial and has garnered strong support, as well as criticism from some members of 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 association 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 for developing heart disease and prescribed him a statin to lower his LDL cholesterol. Instead of taking the drug, Diamond began her study on diet and heart disease.
“I learned that my problem was that I ate too many carbs – bread, potatoes and sugar,” Diamond said. “I was able to control my weight and reduce my risk of heart disease through a low carb diet. In the process, I became aware of the obsession with linking cholesterol to heart disease.”
Diamond has since published more than a dozen articles on the flaws in the consensus that cholesterol causes heart disease. His latest article included a review of the medical literature linking statins to numerous adverse effects, including the development of diabetes, muscle and kidney damage, and impaired brain function.
“Some statins have been linked to cognitive impairment because they interfere with the brain’s ability to produce cholesterol, which is essential for making new brain connections and forming memories,” Diamond said.
Diamond says people who are overweight and have diabetes can benefit from taking a statin because, in addition to lowering LDL, the drugs block excess clotting and inflammation, two known risk factors for disease. cardiac.
However, for those who would rather take medication than make dietary and lifestyle changes, Diamond has a message: “People taking a statin might not realize that they are somewhat less likely to have a heart attack or stroke, but the side effects of the statin can harm them.”
The co-authors of the study were Professor Ben Bikman from Brigham Young University and Paul Mason, a doctor from New South Wales, Australia.
University of South Florida
Diamond, DM, et al. (2022) Statin therapy is not warranted for someone with high LDL cholesterol on a low carbohydrate diet. Current opinion in endocrinology Diabetes and obesity. doi.org/10.1097/MED.0000000000000764.