High cholesterol levels, defined as total cholesterol greater than 240 mg/dL or low-density lipoprotein cholesterol greater than 160 mg/dL, can lead to the formation of cholesterol plaques, a process known as atherosclerosis. Although cholesterol-lowering medications called statins are known for their ability to slow the production of cholesterol, some research suggests they may actually reverse cholesterol plaques as well.
Significance of Atherosclerosis
Heart disease remains the leading cause of death for men and women in the United States, according to information provided by the Centers for Disease Control and Prevention. Atherosclerosis occurs when areas of damage in the walls of the blood vessels attract excess cholesterol, calcium, fat and other cellular debris to accumulate, forming plaques. As plaques get bigger, they restrict the flow of blood and make the blood vessels thick and hard, which can lead to heart disease. Lifestyle changes, like following a low-fat, low-cholesterol diet, and increases in physical activity can help lower blood cholesterol levels. For some, however, lifestyle changes are not enough.
About Statins
The term "statin" describes a class of medications prescribed to lower cholesterol levels. Because your liver produces approximately 75 percent of your total amount of cholesterol, inhibiting cholesterol production lowers your total cholesterol level. Statins, also known as HMG-CoA reductase inhibitors, inhibit the activity of the enzyme known as 3-hydroxy-3-methylglutaryl coenzyme A reductase, more simply called HMG-CoA reductase. This enzyme is vital to the chemical reactions necessary to make cholesterol. By inhibiting the activity of this enzyme, statin medications effectively slow down the production of cholesterol.
Lower Cholesterol vs. Plaque Reversal
Lowering your cholesterol level by taking a statin can help prevent the progression of atherosclerosis, but most clinical trials involving statin medications fail to show any evidence of plaque regression, according to a study published in the March 2006 "Journal of the American Medical Association." This research study utilized 40 mg per day of rosuvastatin to determine if this high-intensity dose would lower LDL cholesterol levels enough to actually induce a reversal of cholesterol plaque. The study found that 75 percent of the patients achieved an LDL cholesterol level of less than 70, with an average cholesterol reduction of 53.2 percent. Most importantly, the study found that most patients experienced a clinically significant regression in atheroma volume, which means the size of their current plaques diminished.
Role of HDL
In addition to lowering the level of LDL cholesterol, rosuvastatin effectively increases the level of high-density lipoprotein cholesterol. HDL cholesterol, referred to as the good cholesterol, picks up cholesterol from tissues and the blood vessels to return it to the liver to use to create bile acids. The "JAMA" study recorded a significant increase of 14.7 percent in HDL levels in the study patients. The magnitude of the LDL reduction and HDL increase at this intensive level of statin therapy contributed to the reversal of cholesterol plaques. Statin medications can induce side effects, some of which can be serious, such as liver damage and the breakdown of muscle tissue known as rhabdomyolysis, so consult with your doctor on whether high-dose statin therapy is safe for you.
References
- "Cellular Molecular Life Science"; Lipid-lowering Drugs; K. Pahan; May 2006
- MayoClinic.com; Statins: Are These Cholesterol-lowering Drugs Right for You?; February 2010
- "Journal of the American Medical Association"; Effect of Very High-Intensive Statin Therapy on Regression of Coronary Atherosclerosis; S. Nissen, et al.; March 2006
- American Heart Association: Cholesterol
- Centers for Disease Control and Prevention: Heart Disease
