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Many people and a distressingly large number of doctors have what could be called a plumber's view of cholesterol.
The arteries are like pipes, in this view, and just as chalk can accumulate inside pipes, cholesterol can build up in blood vessels. If you keep calcium out of water, you prevent chalky buildup in pipes, so if you keep cholesterol out of your bloodstream, you won't get atherosclerosis.
This simplistic view of atherosclerosis is just plain wrong.
For one thing, atherosclerosis doesn't occur in all the body's "pipes." It's found in arteries, not veins, and it is not even found everywhere in arteries. Cholesterol deposits accumulate in the bend and turns of arteries, where there is increased pressure, where the lining of the artery is under greater stress.
The "clogs" that cause atherosclerosis, additionally, aren't really cholesterol. They are a mixture of cholesterol-laden cells that pumped in calcium that should have gone to bones. These cells die and harden. The resulting plaque gradually closes the blood vessel, but even when it is 90 percent occluded, some blood gets through. It's only when the plaque bursts or a blood clot forms that there is a heart attack or other kinds of injury in other organs.
If Cholesterol Doesn't Cause Atherosclerosis, Why Lower It?
The majority of people who have heart attacks don't have high cholesterol. You can have high cholesterol levels and not have atherosclerosis, and you can have low cholesterol levels and have severe atherosclerosis. The factor that seems to make a difference in whether you have a heart attack isn't whether your LDL cholesterol is high or low, but whether it is variable. The greater the swings in your cholesterol levels, up or down, the more likely you are to have a heart attack. This is actually a good reason for staying on a statin, a cholesterol lowering drug once you start it.
However, it turns out that lowering cholesterol isn't the only thing that statin drugs do. They also reduce inflammation. If you already have moderate to severe atherosclerosis, the statin drug makes keep the "cap" on a cholesterol deposit from bursting and blocking a blood vessel. Even though some cardiologists become fanatic about lowering cholesterol, from 200 mg/dl to 25 mg/dl, for example, cholesterol levels are just one factor in the risk of heart attack and other cardiovascular incidents. Controlling blood pressure and blood sugar levels are at least as important. Moreover, if you don't take special care to diet, if you don't already have cardiovascular disease, taking a statin may give it to you.
Statin Side Effects Your Doctor May Not Tell You About
Cholesterol plaques in the linings of arteries don't harden until their cells absorb unusual amounts of calcium. These cells don't absorb large amounts of calcium unless there is a shortage of vitamin K2. Ironically, this is a vitamin found in relative abundance in egg yolks and fatty cheeses. Statin drugs suppress the synthesis of vitamin K2 in the body, increasing the calcification of cholesterol in the linings of the arteries. Statins also suppress the formation of glutathione, which reduces the oxidative stress that activates the white blood cells that feed on cholesterol and get stuck in the linings of arteries.