So, your cholesterol’s a little high. You have a couple of risk factors for developing heart disease. Lifestyle changes (you know….the dreaded diet and exercise) haven’t done enough yet to lower your cholesterol. Your doctor just recommended that you take a statin drug to lower your cholesterol.
What do you do? Do they work for everyone to lower the risk of heart disease? According to one group of researchers, in certain groups of people, statins may do exactly the opposite. In some people, statins may actually raise the risk of heart attack.
In a perfect world, statins are designed to lower your “bad” LDL cholesterol. They accomplish this by preventing your body from using the building blocks it needs to create cholesterol. It’s also believed that statins cause your body to reabsorb the cholesterol already in your arteries. The combination of the two (i.e. lowering the bad cholesterol and cleaning out the cholesterol already cluttering up your arteries) sounds like it ought to be a winner and as Martha Stewart is fond of saying, a “it’s a good thing.”
However, statins may not be so good for everyone. Researchers just released results of the AtheroGene Study earlier this year and may have identified a risk group of persons for whom statins may increase, rather than decrease, their risk of heart attack. During the course of the study, the researchers followed a group of more than 1000 participants, all of whom had some time of coronary artery disease (CAD). Some participants were given statin drugs while others were not. As a part of the 5-year study, the phospholipid transferprotein (PLTP) levels were checked both at the beginning of the study and then tracked throughout and monitored against the final outcome for each patient.
PLTP is one of two lipid-transfer proteins that are present in human plasma (CETP being the second protein). This protein has long been linked to atherosclerosis and heart disease because it is known to be involved in the metabolism of HDL (good cholesterol) and LDL (bad cholesterol). At least one study suggests that PLTP is necessary for the formation of the HDL cholesterol. Prior to this study, researchers have not known the exact role that PLTP played with respect to heart disease.
The results of the study were interesting. Researches found that the levels of PLTP present in the participant at the beginning of the study were an indicator of whether or not they would suffer a heart attack. For participants taking stating drugs, those who had high levels of PLTP were found to actually be at an increased risk for having a heart attack. The researchers theorize that the high level of PLTP somehow blocks the statin drug from accomplishing its intended purpose and prevented the participant from receiving the full benefit of the drug, thereby increasing their risk of a cardiac event.
More tests are obviously needed to determine how PLTP interacts with the statin drugs and why the protective benefit of statins drugs are blocked by PLTP levels. While not the final word on PLTP and statin drug interactions, it is enough information to warrant asking your doctor to check your PLTP levels before beginning statin therapy to assess how your levels may impact the effectiveness of the statin.
Until next time, here’s wishing you a healthy heart.
(Disclaimer: I am not a physician and nothing in this article should be construed as giving medical advice. As with any medical decision, please consult your physician.)
Note: For more information on heart health related issues, please visit other “A Woman’s Heart” articles by this author.
Sources:
Possible Risk Group For Statin Use, Science Daily, 29 Mar 2009,
http://www.sciencedaily.com/releases/2009/03/090323143904.htm
J Lie, R de Crom, M Jauhiainen, T van Gent, R van Haperen, L Scheek, H Jansen, C Ehnholm, and A van Tol, Evaluation of Phospholipid Transfer Protein and Cholesteryl Ester Transfer Protein As Contributors to the Generation of Pre-Beta-High-Density Lipoproteins, Biochem J. 2001 December 1; 360 (Pt 2): 379-385, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1222238/
Statins: Are these cholesterol-lowering drugs right for you?, The Mayo Clinic,
http://www.mayoclinic.com/health/statins/CL00010/NSECTIONGROUP=2