More than 60 years of data collection and scientific research have revealed that a high serum cholesterol level, also known as hypercholesterolemia, increases your risk for cardiovascular disease. The Framingham Heart Study, initiated in 1948 and still providing valuable information, provides ample evidence that Americans with abnormal lipid levels suffer from an inordinate number of heart attacks and strokes related to atherosclerosis, or hardening of the arteries.
Drug Development
Since the 1960s, the pharmaceutical industry, anxious to capitalize on illnesses that largely result from Western lifestyles, has been busily developing medications that lower cholesterol levels. Among the various preparations that have shown some benefit in this regard -- and that have demonstrated some of the greatest clinical benefits -- are the statin drugs. Initially isolated from a fungus called Aspergillus terreus, lovastatin was the first such agent to be approved by the U.S. Food and Drug Administration.
How Statins Work
All statin medications lower total and LDL cholesterol levels through the same mechanism. These drugs interfere with an enzyme called HMG-CoA reductase, which is responsible for converting fatty acids into cholesterol. By inhibiting HMG-CoA reductase, statins decrease the amount of cholesterol manufactured in all of your cells. Although lower cholesterol levels don't necessarily translate into health benefits, statins have shown a remarkable ability to decrease arterial inflammation and other factors that contribute to atherosclerosis.
Statins and Muscle Problems
Although statins seem to be a near-panacea for the American epidemic of hypercholesterolemia, they have their fair share of side effects. One of the most common adverse reactions to statin therapy is a condition called myopathy, which can range from mild muscle soreness to frank destruction of muscle tissue. The cause of statin-induced myopathy is unclear, but some experts believe that the depletion of cholesterol within muscle cell membranes may play a role. Decreased concentrations of other molecules that require HMG-CoA reductase for their production, such as CoQ10 and mevalonate, may also contribute to myopathy.
Muscle Pain Not Universal
Although statin drugs are among the most widely prescribed pharmaceuticals in the country -- one in three American adults suffer from some form of coronary artery disease -- the prevalence of statin-induced myopathy is relatively low. According to a 2011 review in "Drug Safety," people who develop muscle problems while taking statin drugs may be genetically predisposed by any of a number of mechanisms, including differences in cell membrane receptors or variations in the liver enzymes that metabolize statins.
Considerations
Given the high prevalence of hypercholesterolemia and frank coronary heart disease that accompany the American lifestyle, you may eventually be taking a statin drug to decrease your chances for heart attack or stroke. If so, follow your doctor's instructions when it comes time to have your blood drawn to test your response to the medication. If you develop muscle weakness or tenderness while taking a statin, inform your physician immediately.
