High cholesterol remains a health issue of concern in the United States. According to the Centers for Disease Control and Prevention, just over one-third of American adults over age 20 had high LDL, or "bad," cholesterol levels. Of that number, less than one-half are being treated to manage their condition and reduce their risk for heart disease. Statin drugs are a class of prescription medication used to lower LDL and total cholesterol levels. The IMS Institute for Healthcare Informatics estimates that Americans spent nearly $20 billion in 2010 on cholesterol medication. However, these drugs differ in their solubility.
What Are Statin Drugs?
Statin drugs include familiar names such as Lipitor and Crestor. These drugs lower total cholesterol to reduce your risk of a heart attack or stroke by targeting the liver and its role in cholesterol production. These drugs can be either fat or water soluble, denoting the substance in which they dissolve. This basic difference can make an impact on the effects these drugs have. Fat-soluble statins include lovastatin, simvastatin and atorvastatin. Water-soluble statins include pravastatin, fluvastatin and rosuvastatin. These drugs may be available as generics or as brand-name medications, depending upon the type.
Blood-Brain Barrier
The concern regarding their solubility rests with the possible impacts they have on brain function. Normally, your brain is protected by the blood-brain barrier that prevents toxins from entering the brain tissues. Water-soluble statins cannot enter your brain, but fat-soluble statins can. In addition to your liver, your brain also produces cholesterol. The question remains whether or not fat-soluble statin drugs can affect brain function.
Cholesterol and the Brain
Your brain uses cholesterol in order to produce neurotransmitters. These chemicals provide a means for nerve impulses to travel. They regulate some of the most basic of life functions. For example, serotonin regulates sleep and blood pressure. Noradrenaline affects your nervous system's fight-or-flight response to stress and stimuli from the environment. If statins lower total cholesterol, the concern is their impact on brain cholesterol and its uses.
Evidence
Scientists are delving into this question of statin drugs and the brain. A study by the Parque Tecnológico de Ciencias de la Salud in Spain, published in the January 2011 issue of the “Journal of Alzheimer's Disease,” found that fat-soluble statin drugs provide a protective effect on the brain, though the precise mechanism is unclear. Researchers tested nine statin drugs and found that simvastatin, sold as Zocor, provided the best protection. The fact that these statin drugs are fat soluble may mean they offer additional health benefits than water-soluble medications. If you have concerns, discuss the use of statin drugs with your doctor.
References
- Centers for Disease Control and Prevention; Vital Signs: Prevalence, Treatment, and Control of High Levels of Low-Density Lipoprotein Cholesterol --- United States, 1999 to 2002 and 2005 to 2008; February 4, 2011
- IMS Institute for Healthcare Informatics; The Use of Medicines in the United States: Review of 2010; April 2011
- Harvard Medical School; Cholesterol, the Mind, and the Brain; February 23, 2007
- Brain Explorer: Neurological Control
- “Journal of Alzheimer's Disease"; Statins as Neuroprotectants: A Comparative In Vitro Study of Lipophilicity, Blood-Brain-Barrier Penetration, Lowering of Brain Cholesterol, and Decrease of Neuron Cell Death; S. Sierra, et al.; January 2011



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