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Statins, the most popular drugs for lowering cholesterol in the blood and preventing heart attacks and strokes, have been labeled by the American research team as dangerous and having many serious side effects. As it turned out, the data was misread and the article had to be withdrawn. However, he lives in the secondary circulation of alternative medicine portals, revealing the truth about statins.
What are statins?
Statins used to lower blood cholesterol, especially its extremely harmful LDL fraction, are one of the most popular prescription drugs in the world. Only the two most famous statin preparations brought their manufacturers $ 30 billion last year. Statins, in addition to lowering cholesterol, have another effect: they reduce the number of strokes and sudden heart attacks, usually resulting in death.
In 2012, a team of doctors in Taiwan also found that patients who were prescribed stable doses of statins had a significantly reduced risk of dementia over the five-year study period compared with patients who did not take statins. In 2013, US oncologists found that statins inhibit the division of cancer cells in colorectal cancer.
In Poland, 6 out of 7 types of statins available on the global medical market are available, and in general, this drug is the first drug of choice for many doctors in the case of very high cholesterol or angina. They are also one of the most popular prescription drugs, because due to obesity, many Poles have elevated or very high levels of total cholesterol and LDL, and circulatory ailments are a scourge in Polish society. Therefore, it is worth using DuoLife ProCholterol, whose natural active ingredients support the maintenance of optimal blood cholesterol levels and have a protective effect on the circulatory system, heart and veins.
See more: Myths about cholesterol – who are at risk, statin treatment, diet [EXPLAINED]
Statins – action
Statins work by blocking an enzyme that is responsible for the production of cholesterol in the liver. Due to the action of statins, the liver begins to produce less cholesterol and at the same time it traps “bad cholesterol” from the blood. In addition, statins have a positive effect on preventing plaque rupture, which in turn reduces the risk of a heart attack.
Also check: Some statins contribute to diabetes
Statins – indications
Statins are used in cases of people diagnosed with atherosclerotic disease. This includes, inter alia, ischemic heart disease; heart attacks in people without cardiovascular disease; in the case of people whose cholesterol level is significantly increased despite the use of a proper diet; in the case of patients with coexisting other risk factors for cardiovascular diseases.
we recommend: Statins in post-stroke therapy
Statins – contraindications
As for the use of statins, there are some contraindications, mainly such as pregnancy or breastfeeding, but also hypersensitivity to statins and, most importantly, active liver diseases, when the activity of liver enzymes (alanine aminotransferase – ALAT, aspartate aminotransferase – ASPAT) exceeds three times the upper limit of normal.
Also read: Scientists postulate more frequent prescribing of statins
Statins – antiatherosclerotic effect
One of the indications for the use of statins is an increased concentration of total cholesterol and LDL fraction, which leads to the development of atherosclerosis. According to the data, this type of disorder occurs in the case of, for example, systemic lupus or rheumatoid arthritis (RA). It should be noted that complications related to this are the most common cause of mortality among patients and disability.
In addition, according to specialists, the risk of a heart attack in women with systemic lupus exceeds the population risk by up to five times. It should also be remembered that the development of the atherosclerotic process is associated with a chronic inflammatory process occurring in systemic diseases.
The studies performed showed some similarities between the development of atherosclerotic lesions and changes in RA. These similarities include a similar profile of inflammatory cytokines (TNFα, IL-6), as well as a higher concentration of metalloproteinases, CRP or adhesion molecules on endothelial cells and activation of T cells. the presence of antibodies that target endothelial cells and the activation of complement and the deposition of immune complexes in the vascular wall.
As it turns out, the effect of statins is very positive herebecause thanks to them, the main goal of treatment can be achieved, which is the stabilization of atherosclerotic plaque, which in turn was achieved through anticoagulant and antioxidant effects, suppression of the inflammatory process and protection of the vascular endothelium.
The achievement of the goal of stabilizing the atherosclerotic plaque has been confirmed in numerous studies such as, for example, MAAS, REGRESS and TARA. In the TARA (Trial of Atrovastatin In Rheumatoid Arthritis) study, it was proved that atorvastatin had an anti-inflammatory effect, while reducing the intensity of synovitis and improving the plasma lipid profile and inhibiting the activity of inflammatory mediators involved in the atherosclerotic process.
Also check: Statins lower the risk of colon cancer
Statins – anti-inflammatory effect
As the conducted research shows, statins have an anti-inflammatory effect and this is a key issue in the case of rheumatoid diseases, the essence of which are chronic inflammatory processes. There are many pro-inflammatory cytokines (e.g. TNFα, IL-1, IL-6) in the rheumatoid synovium of joints that are released into the bloodstream and sustain inflammation.
According to specialists, statins have shown: a decrease in the synthesis of pro-inflammatory cytokines; induction of synoviocyte apoptosis; decrease in CRP concentration; inhibition of the inflammatory response of monocytes through transcription factors. However, it should be noted that this type of effect only appears to be exhibited by some statin flu, and not by all of them.
The anti-inflammatory effect was shown by lipophilic statins (e.g. fluvastatin), while hydrophilic statins (e.g. pravastatin), which are characterized by much worse penetration into hepatic cells, through the blood-brain barrier and into the vascular endothelium, had a weaker effect than lipophilic statins, which are penetrate tissues better and show a greater pleiotropic effect, e.g. in the cell wall, which, unfortunately, is associated with a higher incidence of side effects.
Statins – immunomodulatory effect
According to the conducted studies, statins have the possibility of immunomodulatory effects in the case of connective tissue diseases, especially in rheumatoid arthritis. Their actions include: inhibition of interferon-induced expression of class II histocompatibility antigens on the surface of macrophages and inhibition of CD40, CD86 and CD8 molecules on the surface of antigen presenting cells; inhibition of adhesion and costimulation of leukocytes; reduction of the production of Th1-secreted cytokines (IL-2, TNFα, interferon γ); stimulation of anti-inflammatory cytokines by Th2 (IL-4, IL-5, IL-10).
In systemic lupus, according to data from 2004 based on many documented cases, the disease appeared to be caused by the use of statins. We are talking about diseases resembling cutaneous lupus, systemic lupus or dermatomyositis.
The immunomodulatory effect of statins is suggested by the presence of antinuclear antibodies in some of the subjects. In addition, specialists have observed the occurrence of lupus-like symptoms in patients using statins. It should be added, however, that in most cases they were mild and disappeared after discontinuation of statins.
Also check: Statins reduce the risk of heart disease in women
Statins – bone metabolism
According to specialists statins affect bone metabolism due to inhibition of bone tissue resorption and intensification of bone formation. It should be added here that in this case lipophilic statins have the greatest influence. It should be mentioned, however, that the conducted studies did not give clear answers. On the one hand, the effects of statins were sometimes associated with a reduction in fracture incidence, sometimes not.
At this point, specialists point out the fact that men were assessed in the studies, which was associated with a low risk of fractures, and at the same time there were problems with distinguishing between osteoporotic and traumatic fractures.
However, in the case of studies on postmenopausal women, it turned out that statins had a positive effect on the increase in bone mineral density. In another study on a group of about 50%, a reduction in the risk of fractures was found with the use of statins.
Worth knowing: Taking statins may protect against Parkinson’s disease
Statins – gout
Statins also work well for people with gout. This is due to the metabolic syndrome that occurs in this case, which includes, among others: arterial hypertension, obesity, glucose intolerance, dyslipidemia. Importantly, there is a high probability of developing premature atherosclerosis.
According to specialists, statins also reduce uric acid levels, but the side effects, such as the interaction of statins and colchicine, cannot be forgotten.
Statins – harmfulness
The downside to statins is that once you start taking them, you have to continue treatment for the rest of your life, or until a new drug is invented to replace them. The discontinuation of their use means a very quick return of cholesterol in the blood to the areas of emergency.
In general, well-tolerated statins have side effects. The most serious is myopathy – disturbances in the functioning of muscle cells leading to loss of strength and weakness. However, myopathy occurs in about 1 percent. taking the drug, although the weakness of taking statins is felt by a larger group of users.
In the last two years, there have also been reports suggesting that statins may contribute to the development of diabetes, especially in the elderly – but this relationship has not been proven, although drugs containing them have been on the medical market since 1980.
It is also worth adding that another of the undesirable effects of statins is their increase in serum liver enzymes, which occurs in 0,5-2% of cases. In addition, statins can also cause various ailments, such as visual disturbances, headaches, insomnia, rash, joint pain, or problems with the digestive tract. If such symptoms occur, consult a doctor as soon as possible.
Check it out: Statins in post-stroke therapy
Statins – controversy
The biggest controversy over statins began with the British Medical Journal (BMJ). This journal, along with another – The Lancet – serve as Nature ‘and Science for medical practitioners. Publishing in them is a very great professional achievement, and the conditions for accepting the publication are very strict.
A real sensation, in a negative sense, was the material published in the BMJ this spring by a renowned research team from Harvard Medical School led by Prof. John Abramson, a clinician with a strong scientific background. The graph in the study and the description of the research clearly suggested that statins not only do not prevent heart attacks, strokes or infarctions, but are indifferent in therapy, and 18-20 percent. those taking them experience severe side effects including myopathies and the deterioration of the pancreas leading to diabetes.
Shortly thereafter, the British Medical Journal published the results of a clinical trial by Dr. Aseem Malhotra, a cardiologist from Great Britain, who explained the sudden exit of patients and their debilitating syndromes with the lack of statin action and their severe side effects.
Both articles turned out to be BMJ hits with the highest number of downloads from around the world. Research groups were also formed to check how severe the side effects reported by Abramson’s syndrome are. One of the researchers was a British scientist and cardiologist, noble for heart attack research, Sir Rory Collins of the University of Oxford.
Collins carefully read the work of Abramson’s team, considering it essential, and then decided to check how the Americans came to these conclusions. The more he looked at the results of the Harvard Medical School team, the less consistent it seemed. He wrote a letter to Abramson asking him to respond to the doubts presented in 20 points, to which he replied practically repeating the arguments from the article.
In the end, Collins could not stand it and in April this year. wrote a long polemic to the BMJ about the work of Abramson’s team, calling the Americans’ results unreliable. Faced with this position, the BMJ asked Abramson to address the allegations. A month later came a repentant explanatory letter from Harvard Medical School.
It turned out that the awarded scientists, when drawing a graph after laboratory tests, read the data … the opposite. In this way, less than two percent of statins affected by side effects has turned into 20 percent. suffering from severe side effects. At the same time, Dr. Aseem Malhotry withdrew his work, explaining that he had suggested the results of the work of prof. Abramson in data interpretation.
The British Medical Journal wrote a note that both papers would be withdrawn, but did not hide them from the pages of the journal. Meanwhile, they started popping up on alternative medicine and conspiracy sites like HealthinsightUK.org. The work of the Abramson team from a scientific error turned into an alternative research paper revealing the truth about statins, and was still pulled from the BMJ websites.
Due to the occurrence of this phenomenon and the fact that not all doctors could reach the information about the mistake made by the team of prof. Abramson, prof. In an open letter, Collins demanded that government institutions such as the UK Department of Health, General Medical Council and the Academy of Medical Sciences decide on the case, and also check whether the standards for accepting test reports at the BMJ are indeed met. Only Collins’ position on the British medical market allowed for such action: someone with less experience and professional position for publicly questioning the standards in one of the largest scientific medical journals would probably be punished with professional ostracism.
August 2 this year Ultimately, an independent audit team led by Dr. Iona Heath of the Royal College found that the British Medical Journal did not need to hide the articles, but that their download was blocked. However, the prevalence has already occurred, and it is likely that doctors will begin to hesitate to decide whether to prescribe statins. Perhaps, as the Daily Mail says, the whole statin row was not a coincidence. According to the newspaper, for a year there have been rumors in the medical market of a new, excellent cholesterol-lowering drug to replace statins. Currently, however, it is several times more expensive than cheap statin drugs, and its promotion will probably cost several hundred million dollars or even 1 billion dollars. Excluding statins from use as a potentially dangerous drug would be a gift of fate for the manufacturer of a new drug.
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