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On this World Heart Day, we consider the problems and possibilities of the world's most frequently prescribed medication for heart problems, cholesterol-lowering statin drugs, including the all-too-common experience that taking statins causes weight gain.

I know way too much about atherosclerosis and heart disease.

In May of 2012 I had a widowmaker (left anterior descending artery) heart attack. I survived, but a week later I had another heart attack. Three months and three heart surgeries after that, I had a third heart attack followed by a cardiac arrest.

I'm not actually dictating this article through a seance. I happened to have my cardiac arrest in a well-equipped hospital at the exact moment three nurses came in to my room for three different reasons and a heart surgeon was walking down the hall, and there was an operating room open. The surgeon finally shocked me back to life and then spent a couple of hours putting a balloon inside my heart to keep me alive. Two more heart procedures followed.

But I've had nearly as many problems with the statins — cholesterol lowering drugs — like millions of other heart patients dutifully take for my heart as I have had with my heart itself.

Cholesterol Isn't the Only Cause of Atherosclerosis

Although their number is declining, many doctors espouse the long-discredited view that cholesterol somehow builds up in the bloodstream and then coats the linings of blood vessels something like hard water build up in a pipe. That's completely not how the process of atherosclerosis works.

Atherosclerosis, or hardening of the arteries, doesn't occur in all the blood vessels.

With few exceptions, cholesterol builds up into plaques in arteries, not veins. Moreover, cholesterol doesn't build up everywhere in an artery. It tends to accumulate and calcify in parts of arteries that are injured, either by mechanical stress, where pressure builds up in a "bend" in the artery, for instance, or where the lining of the artery has been infected by bacteria.

Cholesterol accumulates where arteries are inflamed, and usually very sick people have mostly healthy arteries with just a few very short segments that are closed.

Primary Benefit of Statin Drugs Probably Is Fighting Inflammation

Statins interfere with an enzyme that the liver needs to make cholesterol, and statins lower cholesterol, but the most effective statin drugs, like Crestor, only coincidentally cause drastic reductions in total cholesterol and LDL. Their primary benefit is stopping the inflammation that causes the immune system to attack cholesterol-rich linings of arteries, halting the process of accumulation and calcification that actually causes "clogs" in the circulatory system.

But that's not necessarily a good thing.

Continue reading after recommendations

  • Drug Watch, Defective Drugs: Crestor, http://www.drugwatch.com/crestor/, accessed 10 September 2013.
  • Vidyarthi M, Jacob P, Chowdhury TA. Oral use of "Low and Slow" Rosuvastatin with Co-Enzyme Q10 in patients with Statin-Induced Myalgia: Retrospective case review. Indian J Endocrinol Metab. 2012 Dec.16(Suppl 2):S498-500. doi: 10.4103/2230-8210.104144. PMID: 23565478 [PubMed]
  • Photo courtesy of Okko Pyykkö by Flickr : www.flickr.com/photos/data_op/2218557783/
  • Photo courtesy of Panthro by Wikimedia Commons : en.wikipedia.org/wiki/File:Atorvastatin40mg.jpg