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Statins, a critical review

LDL, the blood transport for cholesterol & fats
ldl-diagram.jpg

Pharma's myth and ignoring the cause 


1.   The cholesterol myth.  Numerous critics have pointed out that cardiovascular disease is not caused by higher levels of blood cholesterol or fats.  Pharma promotes the cholesterol myth and ignores the major causes. 


2.   Autopsy studies of fatal MI found that fats and cholesterol are 7%- 22% of the atheroma.


3.       Major cause of cardiovascular disease is pathogens living within the middle layer of artery walls.  It initiates the immune response which involves LDL and white blood cells. 


4.       It is in this immune function that the lipoprotein coating on LDL attaches to and neutralizes certain toxins produced by pathogens.


5.       Fructose a reactive sugar is consumed at 8 times the paleo level.  It damages the mitochondria which supply the ATP  molecule which  supplies the energy for over 90% of the reactions in the cells.  Lowering it is pathogenic.  Excess fructose has made humans the sickest of mammals. 

6.       Carbon monoxide mainly from tobacco and monosodium urate crystals damage the endothelial cells that keep pathogens from entering the artery walls.  Fructose stimulates the production of uric acid, and statins lower the ATP which keeps the endothelial cell properly functioning.  

7.       LDL is actively transported to the site of inflammation both to attach to toxins, and because its contents of cholesterol and fats are needed as part of the repair process, growing new cells.


8.       Statins, carbon monoxide,  and fructose are the main causes of cardiovascular disease . 


For confirmation from journal articles on primary role of infective agent enter into http://scholar.google.com/ terms such as bacteria + atherosclerosis or go to http://healthfully.org/rl/id9.html for collection of articles

For confirmation of cholesterol myth enter into http://scholar.google.com/ or http://www.amazon.com/ cholesterol myth, or go to http://healthfully.org/rl/id5.html  for collection of journal articlesfor documentaries.

Statins a 6 Page Critical Review   6/12/2022 http://healthfully.org/rc/id6.html  

STATINS Promotes cataracts diabetes, arterial and kidney disease, calcification, insulin resistance, atherosclerosis, etc.  Okuyama, Harumi, Peter Langsjoen, et al May 2016, Medicines and vegetables oils as hidden causes of cardiovascular disease and diabetes   https://www.karger.com/Article/Pdf/446704  FULL

abbreviations:    AD Alzheimer’s disease     AS Atherosclerosis     ATP Adenosine triphosphate    CHF coronary heart failure   CVD cardiovascular disease    LDL low density lipoproteins   TC total cholesterol

It is essential for you to understand how pharma (pharmaceutical 0industry) distorts, controls medical information, and guidelines, thus the practice of medicine--see Market Science and Misinformation  side effects.  Marketing pitch for the statins is based on high Total Cholesterol (TC) and LDL causing heart attacks, strokes and, Cardiovascular Disease (CVD); but CVD is caused by bacterial and viruses within the artery wall (tunica media) and the immune system’s response, thus lowering cholesterol doesn’t work--see Cholesterol Myth.  LDL has 2 functions, one is to as needed actively transport to cells cholesterol and triglycerides (fat), the other is its immune-system function:  it neutralizes (binds) toxins produced by pathogens—see.  LDL in the artery walls is a sign of pathogens causing inflammation.  Thus, the presences of LDL, cholesterol, and triglycerides in the plaque of artery walls is because of LDL’s immune function, and to promote the repair process, since triglycerides are essential components for cells and thus are needed for new cells replacing infected ones and repair of damaged ones in the artery wall.  LDL is like a fireman and lumber truck at a fire, a response to the pathogenic assault.  Lowering LDL hinders healing. 

The doggy clinical trials ran for marketing purposes fail to show significant reduction in deaths, so pharma markets statins based on lowering cholesterol and rigs the clinical guidelines.[1]  Marketing and influence trumps medical science.  The best-selling drug of all times is atorvastatin (Lipitor) by Pfizer has US sales $12.4 billion in 2008, and world-wide total sales of $131 billion by 2007, and that is one of 10 major statins on the market.  With 50% of the men and 36% of the women age 65 to 74 are taking statins (CDC/NCHS, Health, US, 2010); their human costs are incredible:  A) wasted healthcare funds, B) misdirected research efforts and dietary choices, C) the side effects are about 10-fold greater than the pharma-generated literature, and this includes dementia, cognitive decline, lower ATP production, and heart failure.  Using pharma’s studies, it is has been shown that women, those with congestive heart failure, and those above the age of 70  do not benefit from statins –but they still get statins.  The most profitable of all drugs buries alternatives that lower CVD[2]  The cholesterol myth sells drugs—watch YouTube documentaries.

Statins discovery and approval casts doubts.  In the early 1970s an extract from a fungus was shown reduce serum cholesterol, but the Japanese research stopped because of animal toxicity & cancer.  Using a similar extract Merck in 1978 developed Mevacor (lovastatin).  This “’Statin produced significant toxicity at high doses in a variety of animal species” (ibid 520).  Animal studies showed it caused cancer (given the 20-year latency in humans, a risk confirmed).  Merck tested low-dose Mevacor for homozygous familial hypercholesterolemia.  The FDA gave approval for this rare condition.  Once approved--as is the norm--the population base was expanded based on “marketing science”.  Because statins lower TC 30%, they were pushed as the only effective treatment for CVD.  But weak epidemiological association of elevated TC with CVD doesn’t demonstrate cause.   With in-house studies Merck and the manufacturers of the 9 me-too statins sold the world on “safe-and-effective”.  In Braunwald’s, Heart Disease, 8th Ed. P 2286: “safe, effective, and well-tolerated pharmacologic agents that have greatly expanded the therapeutic armamentarium available to the physician to treat disorders of lipid metabolism.”  But in Braunwald’s, p 1085 table, 3 of 4 listed studies didn’t support effective.  Merck’s JUPITER Study, 2008, is used to push primary prevention, but has major internal inconsistency:  the cooked results “do not support primary prevent of CVD”.  Moreover, “statin therapy and top athletics seem to be almost incompatible,”73% dropped out.”   Statins don’t extend life and their side effects are grossly under-reported.  Because statins don’t treat the causes of CVD, they are ineffective; thus there is a chorus of marginalized critics.

Cognitive decline and dementia: This pilot study found an improvement in cognition with discontinuation of statins … Statins may adversely affect cognition in patients with dementia” a cross over study of patients with dementia found taking statin cognitive -tested positive for AD, off statins no AD, back on statins AD, 2007.  Type 2 diabetes is now strongly associated with dementia however,  prior to statins a study found no cognitive decline with diabetes, the Framingham Heart Study.  There is a clear reason why statins would promote Alzheimer's” 2009 seminal.  The response by pharma is to fund dozens of studies to prove that statins prevent dementia; however, it was never approved by either guideline or the FDA to treat AD.  Moreover, cholesterol has a signaling function in the brain (and elsewhere) where it controls clustering of lipids and proteins.  Lowering cholesterol hinders cholesterol’s signalling functions.  The cholesterol controls the clustering of amyloid precursor protein with gamma secretase in GM1 lipid domains. Wiki 2022.  “Lowering CoQ10, causing mitochondrial dysfunction which is strongly associated with AD; lowering ATP production reduces the rate of removal of beta amyloid and tau proteins and Parkinson’s alpha synuclein,--all three protein have misfolded a consequence of lowered ATP by statins. 

Diabetes Statin therapy impairs insulin sensitivity and insulin secretion based on clinical and epidemiologic studies, increases risk up to 99% a metastudy found. The mechanism is through blocking CoQ10, thereby lowering the metabolism of glucose and increasing insulin resistance, which causes the large lipid droplets in the beta cells which lower the production of insulin to cause diabetic hyperglycosemia. Another found at 13 years for atorvastatin and rosuvastatin was 439 cases per thousand at 13 years, 2013 BMJ. Profitable guidelines require statins which increases insulin resistance, increases diabetes comorbidities.  

Major cause for atherosclerosis: the major cause a failure of the systems which prevent pathogens from entering arteries and the cause stresses.  This has been demonstrated before 1920 by autopsy studies of plaque.  Statins because of its effects upon the mitochondrial rate of metabolism slow the production of ATP, adenosine triphosphate, which provides the energy for autophagy (repair systems) and immune systems among others, thereby causing endothelia dysfunction, and every others system in the body.  This allows the pathogens to colonize in the media tunica of the artery which can depending on type of pathogen, causes atherosclerosis.  They also hinder hyperplasia and restenosis, weaken fibrous plaque, delay the replacement of collagen, causes muscle changes, 2005, etc.    

Familial hypercholesterolemia isn’t associated with early death or shorter lifespan, moreover, they have a lower rate of cancer and infections, 2019 lectures, 16 min.  Moreover, in a 35-page seminal article a study of 1,000 patients, it found no shorter lifespan or early death, before the era of statins, 1966.  Guidelines treatment is high dose statins; they die early from statins, not hypercholesteremia. 

 

hypercholesterolemia, a condition that isn’t:  The only association of the lipid hypothesis with CVD is in the lowest quality studies.  Like weapons of mass destruction in Iraq, the repetition creates belief, and both are false.  Of  course, experts had exposed that, but they don’t have access to the media, give CME classes, write clinical guideline and medical textbooks.  Autopsy studies going back to 1915 have found between 7 and 22% of lipids in the coronary artery that leaked and caused the fatal MI.  Analysis of atheromas support the same.  The percentage of fibrogen increases and inflammation ends as it matures.  Population studies often involved fraud[3]   The Framingham Study found that those with the highest 20% cholesterol live the longest.  A summary of the shame is covered by Adams’ 2011.  The message is getting out on the BBC and ABD (Australia), but it is burred by advertisements and pill pushers.  The fat wing of that theory fares the same: because saturated fats don’t become rancid while unsaturated fat does--including in cell membranes.  The link to pathogens as to the western high fructose diet is well established.  The dietary fix is verboten.  How can the physicians treat a condition that isn’t a condition, that isn’t associated with poor health?  They shouldn’t. 

Epidemical and autopsy evidence:  Autopsy studies comparing several countries,[4] these studies have confirmed that those with low cholesterol have as much or more atherosclerosis than those with high serum cholesterol.  Confirming this is for the US is that those with the highest 20% cholesterol live longer than those with lower 80% (the Framingham Study).  Also confirming this is a major study of those with an MI whose blood measurement of cholesterol was taken in the hospital within 24 hours of the event.  Also confirming is the angiograms as to vascular occlusion and the TC reading.  For those death from trauma, 123 cases “No relationship was present in any age group. It is concluded that the incidence and severity of atherosclerosis in man is not directly correlated with the blood serum cholesterol content.”[5]  A list of other countries with the same findings, 6 articles in Prof. Uffe Ravnskov, Ignore the Awkward. P 44. 

Inflammation cytokine inflammation is caused by signaling in response to foreign substances including pathogens, and foreign objects such as a splinter.  During an inflammatory response cholesterol is loaded into immune cells including macrophages.  The cholesterol is a signal that activates cytokine production and other inflammatory responses.“  To hinder the healthful signaling response entails a worse prognosis.



[1] New guidelines (3/2014) based on a 10-year 7.5% risk for MI would put 87% of men and & 56% of women age 60-75 on statins.  These pharma friendly guidelines exaggerate the risk of MI 175% and expand statins use to nearly all men over 50 years.

[2] See the 8-page paper ”On Lifestyle Diet and Drugs, or 2-page summation. Two studies have shown using raw data that positive bias is 32%.for pharma’s clinical trials. Pharma’s business model drives them to marketing patented drugs for chronic conditions, most of which are ineffective.  

[3] Ben Goldacre Bad Pharma (2012) goes into the many of those ways. 

[4] Patterson, JC, Rosemary Armstrong, et al, Feb 1962 Serum lipid levels and the severity of coronary and cerebral atherosclerosis in adequately nourished men, 60 to 69 years of age  FULL  An autopsy study “failing  to show any impressive relationship between the serum lipid levels and the severity of disease”  at P 229  Hospitals were in London, Canada, “We conclude from these results that the validity of the ‘lipid theory’ of atherosclerosis remains unproved, as far as the coronary arteries are concerned.” 


36 NEGATIVE EFFECTS:  One, Erectile dysfunction, it lowers testosterone , and  nitrous oxide thus causes erectile dysfunction (ED); a similar effect upon women for the steroids are synthesized from cholesterol.  Since both estradiol and testosterone are essential for optimal health, the lower of both promotes much more than the ischemic events they are taken to prevent.  Two, COX-2 inhibitor, just like Vioxx, which increased heart attacks (MIs) over 300%[1].  The American Heart Association warns: “accumulated evidence that non-steroidal, anti-inflammatory drugs [COX inhibitors], with the exception of aspirin; they increase  the risks for heart attack and stroke”--promote atherogenesis. Three, blocks production of Q10, which enters LDL and inhibits oxidative damage that causes atherogenesis, and.  Four, Plaque instability:  “Vulnerability of plaques to rupture and thrombosis is of greater clinical relevance than the degree of stenosis they cause” (Corti et al., 2003).  Statins affect plaque stability in a variety of ways.  The meta-lop-proteinases degrade extra-cellular matrix components and thus “weaken the fibrous cap and destabilize the lesions” -- Goodman and Gilman pharmacology, 11th Ed, p 950.  Rupture of plaque causes over 80% of MIs.  Statins inhibit secretion MMP-1, 3, & 9 from SMC, and microphages make plaque less stable.   Five, reduction in ATP:  Q10 is needed for the conversion of APD to ATP (adenosine-5-triphosphate), the source of energy for muscles contraction.  “ATP is often called the ‘molecular unit of currency of intracellular energy transfer including muscle contraction and for chemical reactions.  ATP transports chemical energy within cells for metabolism--Wikipedia.  “ATP is essential for normal heart muscle function, metabolism of cellular components and other activities in cell life.” reduction of 40% in CoQ10 is accepted.[2]  Six, The heart muscle under stress needs more ATP, not less.  This is why pharma excludes the elderly and those with coronary heart failure (CHF) from trials.   Thus, “the mean age of ME/CFS patients dying from CHF [coronary heart failure] are 2.5 years younger than the control group.”  CHF death rate  has tripled since 1989.  In a review of statins on depletion of Q10 concludes:  “As the potency of statin drugs increases and as the target LDL cholesterol level decreases, the severity of Q10 depletion increases and heart-muscle function declines. This tragic scenario may very well be prevented by using supplemental Q10 with all HMG CoA reductase inhibitors [statins]” and, and. Thus “Lower cholesterol, poorer outcome in CHF patients.”  Pharma ignores Q10 side effect.  Seven, All Statins inhibit the rate controlling enzyme HMGCR of the mevalonate pathway.  This pathway generates a range of other products in addition to cholesterol, including coenzyme Q10, heme-A, [dolichol], the production of dimethylallyl pyrophosphate (DMAP),  &  isopentenyl pyrophosphate (IPP), which serve as the basis for the biosynthesis of molecules used in processes as diverse  as terpenoid synthesis, protein prenylation and isoprenylated proteins  which have pivotal roles in cell biology and human physiology and potential relevance to benefits as well as risks of statins.  Drugs, such as the statins, stop the production of mevalonate by inhibiting HMG-CoA reductaseWiki.  “The Mevalonate pathway is important for, cell membrane maintenance,  hormones, protein anchoring, and N-glycosylation.  It is also a part of steroid biosynthesisWiki.  Dolichols are isoprenoids  synthesized from mevalonate. They are vital to the process of Glycoprotein formation in the endoplasmic reticulum of cells. In this capacity it is critical to the formation of the Glycoproteins involved in neuro-peptides, cell identification, cell messaging and Immune defense.  Reduced bioavailability of dolichols can affect every cellular process in the bodyWiki.  And this is only a partial list.  Eight, Cholesterol is essential for life.  “It is the precursor for the biosynthesis of steroid hormones, bile acids, vitamin D, and is an essential component of cell membranes for proper permeability.  Effects include pancreatic and hepatic dysfunction, ED, diabetes[3], muscle weakness and myopathy (muscle disease). The myelin is a cholesterol base coating around nerve cells[4] (Wiki).  Nine, Cognitive, the reduction Q10 & cholesterol for the myelin sheath causes cognitive decline--especially in the elderly where it often leads to an incorrect diagnosis of Alzheimer’s disease (AD)and of neuropathy.  Ten, Causes Parkinson’s  and Alzheimer’s diseases.  These conditions are associated with low level of cholesterol—at Uffe p 56.   In addition, I view the accumulation of amyloid and tau proteins, which are toxic to the brain and found in excess in all AD patients is a result of lowered brain metabolism that diminishes the rate of the removal of those proteins.  Lower ATP thus is causative of AD.  Eleven Causes cancer a confirmation of earlier animal studies—summary of cancers, 25% increase and.  Twelve  Stimulates atherosclerosis and heart disease by blocking the vital CoQ10, heme A, vitamin K2 (the cofactor for matrix Gla-protein activation) and biosynthesis of selenium containing proteins, one of which is vital glutathione peroxidaseat 2015.  This article states that “statins stimulate atherosclerosis and heart failure”, and then provides the mechanisms.  Thirteen Causes Interstitial lung disease is similar to emphysema in that it is a progressive condition that affects alveolar epithelium and other tissues.  Of FDA reported side effects, it is 1/40th.  Fourteen, at ten years statins doubles the rate in women, at.  Fifteen,  diabetes is 46% more common, a 5.9 year study found at  Diabetes doubles to triples the mortality rate.  The number for senior must be at least twice that given their prevalence of insulin resistance for which type-2 diabetes in an advance from of (see work of Dr. Joseph Kraft).  See appendix for how statins cause diabetes.  Women ae at much higher rate on statins.  Sixteen Polyneuropathy, damage affecting peripheral nerves, features weakness, numbness, pain, etc. is 26 times more common after 2 years on statins compared to general matched population—at.  Seventeen Side effects account for the poor compliance in the elderly (75% stop within 2 years).  Poor compliance also occurs with elite athletes (see 1st pg.).  Eighteen “Statins inhibit the synthesis of vitamin K2, the cofactor for matrix Gla-protein activation, which in turn protects arteries from calcification.”  This accumulation of calcium is causal for atherosclerosis—one test for AS is the calcium score.  Nineteen “Statins inhibit the biosynthesis of selenium containing proteins, one of which is glutathione peroxidase serving to suppress peroxidative stress” at 2015.  The reduction in glutathione entails increased oxidative damage, thus statins are causal for all the conditions associated with oxidative stress—quite a long list, see RAGE & diseases.  Twenty  “An impairment of selenoprotein biosynthesis may be a factor in congestive heart failure, reminiscent of the dilated cardiomyopathies seen with selenium deficiencyat 2015.  Twenty one “Statins inhibit the synthesis of vitamin K2, the cofactor for matrix Gla-protein activation, which in turn protects arteries from calcification.”  Calcification is the major causes of the stiffness of arteries in atherosclerosis. This article by 7 Japanese professors is titled Statins stimulate atherosclerosis and heart failure:  pharmacological mechanisms. Twenty-two, reduced production of heme A.  In the important respiratory protein cytochrome c oxidase, heme A plays an important role in the oxygen center.  Lowering heme, A production through the melavonate pathway has many adverse effects.  Twenty-three Adversely effects the mitochondria by lowering the level of CoQ10 which among its other functions acts as an antioxidant protecting the  membrane and mtDNA.  Twenty-four Statin administration cause deficiency in selenium which is causal for myopathy.  Twenty-five treating the wrong cause, cholesterol, entails failure to research for and develop effective treatments for CVD.  The major causes have, pathogens in the artery walls; thus statins are ineffective.  Three out of 4 major studies of secondary prevention (ALL-HAT, ASCOT, & PROSPER) failed to find life extension from statins (Table 42-78, Braunwald’s Supra, p 1085).  This consistent failure even though scientific fraud (politely called Positive bias) is their business norm.  Such negative results explain why pharma uses surrogate endpoint of lower cholesterol instead of lives saved.  This table stands in opposition to the “safe & effective” claim (p 2286), which is pharma’s mantra, a mantra supported by their marketing studies and guidelines. Junk science is the norm (p 3) on TNT trial.  Twenty-six  Primary prevention of high risk patient is of no benefit huge meta-study found, in JAMA.  Twenty-seven fails to extend life of those with familial hypercholesterolemia (those with extremely high cholesterol)[5] at.  Twenty-eight Liver functions are worse and a few cases of liver failure (rhabdomyolysis), at.  Twenty-nine, with long-term usage study (8.4 years) a 30% increase in acute kidney injury at Feb 2016.   Thirty, drug interaction with serious side effects are common, considering that over half of senior in their 6th decade have taken statins, and seniors average age 72 average 6 drugs according to a hospital emergency admission study (polypharmacy); 36 drug interactions.  Thirty-one, both low-fat diet and statin drug treatment increase susceptibility to Alzheimer’s,” 2009 seminal.  To this I hold that the reduced production of ATP results in a reduced rate of removal of tau protein, beta amyloid, and misfolded alpha synuclein which is causal for Lewy body dementia and Parkinson’s disease.   Thirty-two, statins in blocking HMG-CoA by 40% reduce the production of beta hydroxybutyrate by that amount, a brain derived neurotropic factor (BDNF), and thus blocks a major compound which promote a healthy brain.  HMG-CoA is converted to BDNF in 2 steps.  Statins thereby promote dementia.   Thirty-three, dose increasing side effects are the norm.  A study of 50 consecutive heart patients taken off statin and given CoQ10, the report on initial visit:  (fatigue 84% to 12% at one year, myalgia 64% to 6%, dyspnea 58% to 12%, memory loss 8% to 4%, Swedish journal, 05.  Thirty-four weight gain:  Since statins through the lower of CoQ10 lowers the product of the energy molecule ATP it must lower the rate of metabolism and if all others things don’t change (such as appetite reduction from nausea) then statins must promote sedentary lifestyle through reduced rate of metabolism.  Thirty-five, Cumulative effect: many of the effects are a result of promotion of mitochondrial dysfunction and lower CoQ10, which cause a lower production of ATP; this causes the large variety of side effects known as conditions associated with the western diet (CAWD) which is driven by the lower production of ATP.  Thus, all of the long list of conditions of CAWD are increased by use of a statin.   Thirty six, Anti-inflammatory effect:  is a response to a positive-healing process, therefore reducing the response increase the virulence of pathogenic causes and slows the repair processes.  Lowering inflammation compromises the immune system.  For this reason statins effect upon prostaglandins statins like the NSAIDs doesn’t inhibit atherogenesis, an inflammatory process—see Vioxx, and. 




[1] A reasonable assessment of total early deaths from the selective COX-2 inhibitors in the US would be over 200,000; and a much greater number for the non-selective COX inhibitors, the NSAIDs—but for aspirin.  Celebrex is still on the market, and though warnings about all COX inhibitors warning that they promote CVD, the oft-heard sales message prevails. 

[2] After 3 months treatment of healthy patients with a poor TC using pravastatin or simvastatin, the total cholesterol and CoQ10 (Q10) were lowered 40%, when compared to the placebo group.  “A diminution of Q10 availability may be the cause of membrane alteration with consequent cellular damage”Journal of clinical Pharmacology.  This finding is supported in other studies and widely accepted—summary article.  

[3] In a cohort study a 63% increased incidence of diabetes, NEJN 2015 also. The WHI trial found a 48% increase for women, see.        

[4]  The 2nd cause for neuropathy, the first low Q10.  The two are additive.

[5] In the study the average cholesterol level was 331 (norm is below 200).  Our studies provide no evidence that familial hypercholesterolemia appreciably shortens life of affected individual, ether male or female.  On the contrary, they show that high level of serum cholesterol are clearly compatible with survival into the seventh and eight decades.



36 NEGATIVE EFFECTS:  One, Erectile dysfunction, it lowers testosterone , and  nitrous oxide thus causes erectile dysfunction (ED); a similar effect upon women for the steroids are synthesized from cholesterol.  Since both estradiol and testosterone are essential for optimal health, the lower of both promotes much more than the ischemic events they are taken to prevent.  Two, COX-2 inhibitor, just like Vioxx, which increased heart attacks (MIs) over 300%[1].  The American Heart Association warns: “accumulated evidence that non-steroidal, anti-inflammatory drugs [COX inhibitors], with the exception of aspirin; they increase  the risks for heart attack and stroke”--promote atherogenesis. Three, blocks production of Q10, which enters LDL and inhibits oxidative damage that causes atherogenesis, and.  Four, Plaque instability:  “Vulnerability of plaques to rupture and thrombosis is of greater clinical relevance than the degree of stenosis they cause” (Corti et al., 2003).  Statins affect plaque stability in a variety of ways.  The meta-lop-proteinases degrade extra-cellular matrix components and thus “weaken the fibrous cap and destabilize the lesions” -- Goodman and Gilman pharmacology, 11th Ed, p 950.  Rupture of plaque causes over 80% of MIs.  Statins inhibit secretion MMP-1, 3, & 9 from SMC, and microphages make plaque less stable.   Five, reduction in ATP:  Q10 is needed for the conversion of APD to ATP (adenosine-5-triphosphate), the source of energy for muscles contraction.  “ATP is often called the ‘molecular unit of currency of intracellular energy transfer including muscle contraction and for chemical reactions.  ATP transports chemical energy within cells for metabolism--Wikipedia.  “ATP is essential for normal heart muscle function, metabolism of cellular components and other activities in cell life.” reduction of 40% in CoQ10 is accepted.[2]  Six, The heart muscle under stress needs more ATP, not less.  This is why pharma excludes the elderly and those with coronary heart failure (CHF) from trials.   Thus, “the mean age of ME/CFS patients dying from CHF [coronary heart failure] are 2.5 years younger than the control group.”  CHF death rate  has tripled since 1989.  In a review of statins on depletion of Q10 concludes:  “As the potency of statin drugs increases and as the target LDL cholesterol level decreases, the severity of Q10 depletion increases and heart-muscle function declines. This tragic scenario may very well be prevented by using supplemental Q10 with all HMG CoA reductase inhibitors [statins]” and, and. Thus “Lower cholesterol, poorer outcome in CHF patients.”  Pharma ignores Q10 side effect.  Seven, All Statins inhibit the rate controlling enzyme HMGCR of the mevalonate pathway.  This pathway generates a range of other products in addition to cholesterol, including coenzyme Q10, heme-A, [dolichol], the production of dimethylallyl pyrophosphate (DMAP),  &  isopentenyl pyrophosphate (IPP), which serve as the basis for the biosynthesis of molecules used in processes as diverse  as terpenoid synthesis, protein prenylation and isoprenylated proteins  which have pivotal roles in cell biology and human physiology and potential relevance to benefits as well as risks of statins.  Drugs, such as the statins, stop the production of mevalonate by inhibiting HMG-CoA reductaseWiki.  “The Mevalonate pathway is important for, cell membrane maintenance,  hormonesprotein anchoring, and N-glycosylation.  It is also a part of steroid biosynthesisWiki.  Dolichols are isoprenoids  synthesized from mevalonate. They are vital to the process of Glycoprotein formation in the endoplasmic reticulum of cells. In this capacity it is critical to the formation of the Glycoproteins involved in neuro-peptides, cell identification, cell messaging and Immune defense.  Reduced bioavailability of dolichols can affect every cellular process in the bodyWiki.  And this is only a partial list.  Eight, Cholesterol is essential for life.  “It is the precursor for the biosynthesis of steroid hormones, bile acids, vitamin D, and is an essential component of cell membranes for proper permeability.  Effects include pancreatic and hepatic dysfunction, ED, diabetes[3], muscle weakness and myopathy (muscle disease). The myelin is a cholesterol base coating around nerve cells[4] (Wiki).  Nine, Cognitive, the reduction Q10 & cholesterol for the myelin sheath causes cognitive decline--especially in the elderly where it often leads to an incorrect diagnosis of Alzheimer’s disease (AD)and of neuropathy.  Ten, Causes Parkinson’s  and Alzheimer’s diseases.  These conditions are associated with low level of cholesterol—at Uffe p 56.   In addition, I view the accumulation of amyloid and tau proteins, which are toxic to the brain and found in excess in all AD patients is a result of lowered brain metabolism that diminishes the rate of the removal of those proteins.  Lower ATP thus is causative of AD.  Eleven Causes cancer a confirmation of earlier animal studies—summary of cancers, 25% increase and.  Twelve  Stimulates atherosclerosis and heart disease by blocking the vital CoQ10, heme A, vitamin K2 (the cofactor for matrix Gla-protein activation) and biosynthesis of selenium containing proteins, one of which is vital glutathione peroxidaseat 2015.  This article states that “statins stimulate atherosclerosis and heart failure”, and then provides the mechanisms.  Thirteen Causes Interstitial lung disease is similar to emphysema in that it is a progressive condition that affects alveolar epithelium and other tissues.  Of FDA reported side effects, it is 1/40th.  Fourteen, at ten years statins doubles the rate in women, at.  Fifteen,  diabetes is 46% more common, a 5.9 year study found at  Diabetes doubles to triples the mortality rate.  The number for senior must be at least twice that given their prevalence of insulin resistance for which type-2 diabetes in an advance from of (see work of Dr. Joseph Kraft).  See appendix for how statins cause diabetes.  Women ae at much higher rate on statins.  Sixteen Polyneuropathy, damage affecting peripheral nerves, features weakness, numbness, pain, etc. is 26 times more common after 2 years on statins compared to general matched population—at.  Seventeen Side effects account for the poor compliance in the elderly (75% stop within 2 years).  Poor compliance also occurs with elite athletes (see 1st pg.).  Eighteen “Statins inhibit the synthesis of vitamin K2, the cofactor for matrix Gla-protein activation, which in turn protects arteries from calcification.”  This accumulation of calcium is causal for atherosclerosis—one test for AS is the calcium score.  Nineteen “Statins inhibit the biosynthesis of selenium containing proteins, one of which is glutathione peroxidase serving to suppress peroxidative stress” at 2015.  The reduction in glutathione entails increased oxidative damage, thus statins are causal for all the conditions associated with oxidative stress—quite a long list, see RAGE & diseases.  Twenty  “An impairment of selenoprotein biosynthesis may be a factor in congestive heart failure, reminiscent of the dilated cardiomyopathies seen with selenium deficiencyat 2015.  Twenty one “Statins inhibit the synthesis of vitamin K2, the cofactor for matrix Gla-protein activation, which in turn protects arteries from calcification.”  Calcification is the major causes of the stiffness of arteries in atherosclerosis. This article by 7 Japanese professors is titled Statins stimulate atherosclerosis and heart failure:  pharmacological mechanisms. Twenty-two, reduced production of heme A.  In the important respiratory protein cytochrome c oxidase, heme A plays an important role in the oxygen center.  Lowering heme, A production through the melavonate pathway has many adverse effects.  Twenty-three Adversely effects the mitochondria by lowering the level of CoQ10 which among its other functions acts as an antioxidant protecting the  membrane and mtDNA.  Twenty-four Statin administration cause deficiency in selenium which is causal for myopathy.  Twenty-five treating the wrong cause, cholesterol, entails failure to research for and develop effective treatments for CVD.  The major causes have, pathogens in the artery walls; thus statins are ineffective.  Three out of 4 major studies of secondary prevention (ALL-HAT, ASCOT, & PROSPER) failed to find life extension from statins (Table 42-78, Braunwald’s Supra, p 1085).  This consistent failure even though scientific fraud (politely called Positive bias) is their business norm.  Such negative results explain why pharma uses surrogate endpoint of lower cholesterol instead of lives saved.  This table stands in opposition to the “safe & effective” claim (p 2286), which is pharma’s mantra, a mantra supported by their marketing studies and guidelines. Junk science is the norm (p 3) on TNT trial.  Twenty-six  Primary prevention of high risk patient is of no benefit huge meta-study found, in JAMA.  Twenty-seven fails to extend life of those with familial hypercholesterolemia (those with extremely high cholesterol)[5] at.  Twenty-eight Liver functions are worse and a few cases of liver failure (rhabdomyolysis), at.  Twenty-nine, with long-term usage study (8.4 years) a 30% increase in acute kidney injury at Feb 2016.   Thirty, drug interaction with serious side effects are common, considering that over half of senior in their 6th decade have taken statins, and seniors average age 72 average 6 drugs according to a hospital emergency admission study (polypharmacy); 36 drug interactions.  Thirty-one, both low-fat diet and statin drug treatment increase susceptibility to Alzheimer’s,” 2009 seminal.  To this I hold that the reduced production of ATP results in a reduced rate of removal of tau protein, beta amyloid, and misfolded alpha synuclein which is causal for Lewy body dementia and Parkinson’s disease.  Cholesterol is a signal molecule which prevents the clustering of lipids, that function is compromised by statins.  Thirty-two, statins in blocking HMG-CoA by 40% reduce the production of beta hydroxybutyrate by that amount, a brain derived neurotropic factor (BDNF), and thus blocks a major compound which promote a healthy brain.  HMG-CoA is converted to BDNF in 2 steps.  Statins thereby promote dementia.   Thirty-three, dose increasing side effects are the norm.  A study of 50 consecutive heart patients taken off statin and given CoQ10, the report on initial visit:  (fatigue 84% to 12% at one year, myalgia 64% to 6%, dyspnea 58% to 12%, memory loss 8% to 4%, Swedish journal, 05.  Thirty-four weight gain:  Since statins through the lower of CoQ10 lowers the product of the energy molecule ATP it must lower the rate of metabolism and if all others things don’t change (such as appetite reduction from nausea) then statins must promote sedentary lifestyle through reduced rate of metabolism.  Thirty-five, Cumulative effect: many of the effects are a result of promotion of mitochondrial dysfunction and lower CoQ10, which cause a lower production of ATP; this causes the large variety of side effects known as conditions associated with the western diet (CAWD) which is driven by the lower production of ATP.  Thus, all of the long list of conditions of CAWD are increased by use of a statin.   Thirty six, Anti-inflammatory effect:  is a response to a positive-healing process, therefore reducing the response increase the virulence of pathogenic causes and slows the repair processes.  Lowering inflammation compromises the immune system.  For this reason statins effect upon prostaglandins statins like the NSAIDs doesn’t inhibit atherogenesis, an inflammatory process—see Vioxx, and. 


One  POSITIVE EFFECTS:  12) Statins, like aspirin, reduce clotting and thus the risk for thrombosis.  Statins “down-regulate transcriptional activities of NF-kappa B, AP-1, and HIF-1a with coordinate reduction in expression of pro-thrombotic and inflammatory cytokines” at 2006.  But rather than promote as an anti-inflammatory drug, and thereby thus by extension aspirin, pharma pitches only lowering total cholesterol.[6]  Pharma is against aspirin because aspirin lowers significantly lowers the risk for CVD, dementia, and cancer. 




[1] A reasonable assessment of total early deaths from the selective COX-2 inhibitors in the US would be over 200,000; and a much greater number for the non-selective COX inhibitors, the NSAIDs—but for aspirin.  Celebrex is still on the market, and though warnings about all COX inhibitors warning that they promote CVD, the oft-heard sales message prevails. 

[2] After 3 months treatment of healthy patients with a poor TC using pravastatin or simvastatin, the total cholesterol and CoQ10 (Q10) were lowered 40%, when compared to the placebo group.  “A diminution of Q10 availability may be the cause of membrane alteration with consequent cellular damage”Journal of clinical Pharmacology.  This finding is supported in other studies and widely accepted—summary article.  

[3] In a cohort study a 63% increased incidence of diabetes, NEJN 2015 also. The WHI trial found a 48% increase for women, see.        

[4]  The 2nd cause for neuropathy, the first low Q10.  The two are additive.

[5] In the study the average cholesterol level was 331 (norm is below 200).  Our studies provide no evidence that familial hypercholesterolemia appreciably shortens life of affected individual, ether male or female.  On the contrary, they show that high level of serum cholesterol are clearly compatible with survival into the seventh and eight decades.

[6] A very important distinction is that downregulating the inflammatory process is healthful only for certain pathologies and high-risk situation such as an ischemic event from underlying atherosclerosis.  This benefit occurs at the expense of reducing immune system functions and certain healing processes.  The inflammatory system is there for a purpose, and in healthy people taking regularly an anti-inflammatory drug  do more harm, than good. It is better to treat the primary cause than the secondary effect.  


cholesterol synthesis, statin (HMG-CoA) blocks
cholesterol-synthesis-flow-chart-sm.jpg
vital synthesis of ubiquinoe (Q10), etc.



On statins:  Since “cholesterol synthesis occurs mostly at night” (Wiki).  If you must lower TC it should be done at night.   with short half-life[1] support a slow-release pill or long acting: Zocor 2, Lipitor 14, Crestor 19 hours. niacin 35 min


Sorting it out, RECOMMENDATIONS (for myself):  Atherogenesis is caused pathogens within the artery walls.  This initiates  an inflammatory immune response by macrophages.  LDL which has an immune response is actively transported into the artery walls where it contents cholesterol and triglycerides form new and repair damaged cells.   Because of this transport process, lowering LDL doesn’t affect the formation of plaque, thus statins don’t stop plaque formation (see illustration).  The 32% drop in deaths from heart attacks and strokes (1960 to 1992) occurred prior to statins, the percentage of smokers dropped from 46% to under 20%, and a pack a day increase the death rate from heart attacks by over 100%.  With statins’ wide use, mortality rate has remained constant.  Mevacor was approved in 1987; only 60,000 taking it by 1990.  Reduced death rate was from a reduction in smoking that goes along with taking a heart-healthy drug, and because of scientific fraud committed in industry funded studies—studies are a marketing tool.  Statins reduce quality of life for the elderly: a large Canadian study had 75% dropout by 2 years, and 80% in a NJ study.  Very common and under reported side effects are fatigue, muscle weakness & cramps, mental confusion, pancreatic and liver dysfunction, diabetes, indigestion, cognitive decline, erectile dysfunction, & lower libido, especially for the elderly.  Lowering TC with statins doesn’t affect the young unstable plaque that causes 95% MIs because pathogens are the cause of the plaque formation.  What to do:  I wouldn’t take a statin because they do not reduce mortality; they aren’t worth their side effects & expense.  Lifestyle changes of low carbohydrate-sugar diet lowers damage to endothelial cells on the artery walls.  Damage is caused mainly by glycation by fructose (a net 15 times the rate of glucose, 7.5 times more reactive and in the cells at least twice as long because glucose is metabolized first before fructose).   Avoid carbon monoxide (cigarettes main source) which exacerbates the damage.  Endothelial cells block the migration of pathogens.  Saturated and monounsaturated fats are the best source of energy.  Everyone should take the antioxidants ascorbic acid and Q10, prevent oxidative damage.  Take 325 mg aspirin[2] uncoated daily to prevent blood clots that forms when plaque leaks from a coronary artery thus lowering ischemic events, etc5.  Low dose aspirin is ineffective because of tolerance after 1 year.  Take the natural estrogen (estradiol) & progesterone at menopause.   Estrogen[3] lowers risk of CVD 50%, osteoporosis and much more.  For elderly men testosterone lowers risk & increases survival from an MI.  Pharma attacks hormones & aspirin because they work.  Read Marking Science, be skeptical of medical “wisdom.”   If you still want to lower total cholesterol, then take 250 mg slow release niacin or inositol hexanicotinate  at night, when it is effective.  Insulin produced following meals blocks the lipid lowering effect of niacin inositol & statins.  High dose during the day is a pharma ploy to reduce the use of niacin. 


JK has exercised vigorously since 1975; takes 325 mg uncoated aspirin daily since 1992-2017 and started again in 2020; DHEA 30 mg sublingually since 2002 testosterone high dose since 2004; low-sugar low carb diet 2014, 300 mg CoQ10, and vitamin C 2000 mg (as calcium ascorbate) since 2014.  Intermittent fasting (skipping breakfast) since 2015, high saturated fat diet since 2016.  Results:  JK is 78 (2021) with excellent muscle tone and strength, no joint pain, blood pressure averages 125/75, BMI 23, and runs 50 miles a month or more.  JK is happily retired with a significant other, and is writing a book on why humans are the sickest of mammals.  JK lements the amount of harm caused by the high sugar western diet, and has through the website and occasional class taught how our diet makes us the sickest of mammals. 


Expanding the market:  Statins are claimed by industry funded studies and their dupes as lowering the risk for dementia, as a treatment for NAFLD (fatty liver disease).  The latter would add 100 million more users.  Statins following guidelines is given to diabetics adding a potential 90 million.  Statins are recommended as part of the treatment for Alzheimer’s disease, and is recommended for treating children with hypercholesterolemia, and there are other prophylactic uses.  We are back in the snake-oil days with NIH stamp of approval and mass marketing.  Pharma spends 4-times more on physicians than on the public; don’t blame the pill poppers and pill pushers, for pharma has a hot sale’s pitch that creates social patterns of behavior.  Sell the fluff and burry the evidence.  Humans are a social animal, marketing works.


Text, application

Description automatically generated


The HMG-CoA reductase pathway, which is blocked by statins via inhibiting the rate limiting enzyme HMG-CoA reductase. Reduces the first compound in the chain, mevalonic acid an average 40%, thereby reduces all subsequent products shown.




[1]  Half-life (t½) the time that it takes for the concentration in blood plasma of a substance to reach one-half of its initial measured level “(Wiki). 

[2]  Aspirin very significant risk reduction of most major cancers and Alzheimer’s disease, plus it reduces mortality from stage I, II, III cancer over 40%, and by 4 mechanism atherogenesis.  The long-term risk for stomach bleeding is about 4%; comparable to other NSAIDs and many other drugs.  Pharma’s attack with FDAs help is market driven.  Low does not have an anti-inflammatory effect and tolerance develops to its anti-platelet effect.

[3] For many benefits of natural HRT, and testosterone for men; and don’t believe the marketing science about hormones. 

     


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TERMS:  Primary prevention for those with high cholesterol only.  Secondary prevention for those with pre-existing cardiovascular disease (CV).  

Opinion Leader: an authority in a specialty who receives substantial income from pharma.  Cardiovascular Disease (CVD) any disease, whether congenital or acquired, of the heart and blood vessels.  Cholesterol Profile (TC) the lab report listing the various components of cholesterol.  Coronary Heart Disease (CHD) atherosclerotic arterial deposits (atherosclerosis).   Congestive Heart Failure (CHF)/ heart failure (HF) occurs when the heart muscle is unable to maintain adequate circulation of blood in the tissues of the body or to pump out the venous blood returned to it by the venous circulation.  Myocardial Infraction (MI) a heart attack.  

HMG-CoA reductase inhibitors (statins).


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Animal studies are a very good indicator for potential side effects in humans:  The original studies are done on animals to find out if a drug is effective and safe.  Unfortunately when pharma funded they own the results and as part of normal business do not published unfavorable results.  However, since such studies are fairly inexpensive, a number of them of animal studies are part of graduate work supervised by a professor, and are published.  Others, like this review are written by the manufacturer, in this case Merck.  The article mentions the side effects and then concludes that they don’t occur in “human therapeutic doses.”  A large body of evidence contradicts this rosy conclusion.  It is very disappointing that the top tier journal Nature published this article, which is a sales pitch for Lipitor, dressed up as a review of the research. (see the published summation below to dispel doubt)  For example the effects upon testosterone and CoQ10 are not mentioned—though there is significant literature on their suppression by Lipitor and other statins.   


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Below is an example of marketing science.  It is a review of the research on Mevicor (Lovastatin) by Merck (hardly unbiased in their dismissal of the relevance of animal studies).  Worth reading as to risk factors since animal studies have a high carryover to humans.   Tolbert left out the “c” word cancer, for which this side effect in animals is be repeatedly brought up.  Since most cancers have a 20-year lag time (such as cigarettes) from exposure, short-term clinical trials will not expose this risk.  It took for example 30 years for cancer to be associated with DES, a synthetic estrogen, and 50 years for MPA (methoxyprogesterone, which is still on the market). 


SIDE EFFECTS ANIMALS:  Statins produce significant toxicity at high doses in a variety of animal species. These effects include increases in hepatic transaminases, atypical focal hyperplasia of the liver, squamous epithelial hyperplasia [ORGAN ENLARGEMENT] of the rat fore-stomach (an organ not present in man), cataracts, vascular lesions in the central nervous system (CNS), skeletal muscle toxicity, testicular degeneration and, although the statins are clearly not genotoxic, tumours of the liver and other sites (details can be found in the product circulars of the individual statins). It has been shown, where it has been practical to conduct the experiment, that these effects can be prevented by administering mevalonate 29,30, the product of the reaction catalysed by HMG-CoA reductase.  This indicates that these toxic effects are mostly, if not entirely, attributable to extreme inhibition of the enzyme at high doses 29.  So Merck, and the regulatory agencies considering the marketing application submitted by Merck, were faced with a wide range of animal toxicological effects, as well as the history of compactin and the known central role of the cholesterol biosynthesis pathway in many physiological processes, including the production of steroids and cell membranes.  [The structure Lovastin is quite similar to compactin, whose toxicity in animal studies resulted from it not being tested clinically; nevertheless Merck went forward.]  Compactin was withdrawn from the market for ]   Fortunately, except for rare cases of myopathy and marked but asymptomatic increases in hepatic transaminases, none of the adverse effects found in animals occur at human therapeutic doses.” Nature Reviews Drug Discovery 2, 517-526 (July 2003) | doi:10.1038/nrd1112.  This Merck scientist is referring to life-threatening and rare muscle destruction caused by statins.  However, its impact upon quality of life for those above the age of 50 is gradual and thus subtle--the degree increases with age. 


Author’s affiliations: A. Tolbert, Merck Research Laboratories, Rahway, New Jersey 07065, USA.
Email: 
jonathan_tobert@merck.com

APPENDIX

How statins promote diabetes, by blocking malonyl-CoA, which is the first step in converting the excess glucose into triglycerides.  Extending the excess glucose causes more release of insulin and the turn on the PP producing furctose:  The liver starts actively making triglycerides from excess glucose when it is supplied with glucose that cannot be oxidized or stored as glycogen. This increases the concentration of malonyl-CoA, the first intermediate in fatty acid synthesis, leading to the inhibition of carnitine acyltransferase 1, thereby preventing fatty acid entry into the mitochondrial matrix for β oxidation. This inhibition prevents fatty acid breakdown while synthesis occurs.  https://en.wikipedia.org/wiki/Carnitine#Regulation_of_fatty_acid_%CE%B2_oxidation

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Pharma's myth and ignoring the cause 

1.   The cholesterol myth.  Numerous critics have pointed out that cardiovascular disease is not caused by higher levels of blood cholesterol or fats.  Pharma promotes the cholesterol myth and ignores the major causes.

2.       Major cause of cardiovascular disease is pathogens living within the middle layer of artery walls.  It initiates the immune response which involves LDL, HDL, and white blood cells. 

3.       It is in this immune function that the lipoprotein coating on LDL attaches to and neutralizes certain toxins produced by pathogens.

4.       Reactive chemicals such as simple sugar fructose and carbon monoxide can potentiate the process resulting in the formation of plaque within the artery walls by damaging the endothelial cells lining the artery walls thereby reducing the barrier of the endothelia cells to blood borne pathogens. 

5.       LDL is actively transported to the site of inflammation both to attach to toxins, and because its contents of cholesterol and fats are needed as part of the repair process.. 

 

For confirmation from journal articles on primary role of infective agent enter into http://scholar.google.com/ terms such as bacteria + atherosclerosis or go to http://healthfully.org/rl/id9.html for collection of articles

For confirmation of cholesterol myth enter into http://scholar.google.com/ or http://www.amazon.com/ cholesterol myth, or go to http://healthfully.org/rl/id5.html  for collection of journal articlesfor documentaries.

1.      

For confirmation from journal articles on primary role of infective agent enter into http://scholar.google.com/ terms such as bacteria + atherosclerosis or go to http://healthfully.org/rl/id8.html for collection of articles.

For confirmation of cholesterol myth enter into http://scholar.google.com/ or http://www.amazon.com/ cholesterol myth, or go to http://healthfully.org/rl/id5.html  for collection of journal articles—for documentaries.






Why is that much money being wasted on a patented statin???


Last year, rosuvastatin (Crestor) was the most prescribed brand name drug in the US, with 22.3 million prescriptions filled and $5.8bn (£3.9bn; €5.5bn) in sales.1 Worldwide 2013 sales were $8.2bn, the third highest for any branded drug.   Given the longstanding, continuing evidence of rosuvastatin’s comparative lack of clinical benefits and increasing evidence of risks, how did this happen? The short answer is that of statins still on the market, the milligram for milligram cholesterol lowering potency of rosuvastatin exceeds all others, a fact exploited in advertising campaigns. But what about actually improving health, preventing heart attacks and strokes?  http://www.bmj.com/content/350/bmj.h1388?etoc=   Sidney Wolf, 3/17/15

Pfizer's Lipitor (atorvastatin), which lost US patent protection in 2011.  as a result of the settlement will now be able to sell its products on an exclusive basis in the US between May 2 and July 8, 2016.  The substance patent for Crestor expires on January 8, 2016, but AstraZeneca won a six-month extension under the US paediatric trials incentive programme. http://www.pmlive.com/pharma_news/astrazeneca_settles_with_generic_rivals_in_crestor_patent_challenge_469203

^^^^^^^^^^^^Non-technical summation 

Statins and cholesterol:  Cardiovascular disease (CVD) results from pathogens within the artery walls that cause an inflammatory response by macrophages which results in the formation of plaque.  The risk of infectious bacteria and viruses colonizing the artery walls is increased by artery endothelial dysfunction (cells which line the artery walls and thereby control the entry into the underlying tissue). Major causal factors for endothelial dysfunction is a result of insulin resistance, and overstuffing cells with glucose..  Insulin resistance is caused by the high sugar (fructose) western diet.  Thus low carb low sugar diet is the first line of prevention and healing.  Carbon monoxide--main source smoking—can significantly exacerbate endothelial dysfunction.  Fructose and carbon monoxide are reactive chemicals which damage the endothelial cells.  A lower level of LDL doesn’t prevent the active transport of LDL as part of the immune-healing response, statins slow the healing process.  A large body of evidence has demonstrated that cholesterol and triglycerides are mere bystanders, and that pathogen cause the inflammation resulting in atherosclerosis.  see and watch documentaries.  Statins are the biggest scam in pharma’s history.  And it made all the worse not only by chasing after causes which don’t protect against CVD, but also because of their affect upon quality of life, which very significantly affect those above the age  of 60.  Cholesterol is used to synthesize numerous essential compounds and is part of cell membranes.  Lowering its production—typically 40%--has many side effects.  Statins also lower the production of CoQ10 by 40%.  CoQ10 has an essential function in the production of ATP, the body’s energy molecule.  Statins for all these reasons should not be taken..




TERMS

Cardiovascular Disease (CVD) any disease, whether congenital or acquired, of the heart and blood vessels.

Cholesterol Profile (CP) the amounts of High density, low density, and very low density lipoproteins, of triglycerides, and other blood borne compound that are indicators for angiogenesis.   

Circulatory failure occurs when in the blood the concentration of oxygenated hemoglobin in the arterial blood, or the vascular bed is responsible for the inadequate cardiac output. 

Congestive Heart Failure (CHF) heart failure in which the heart muscle is unable to maintain adequate circulation of blood in the tissues of the body or to pump out the venous blood returned to it by the venous circulation.

Coronary Failure (CF) heart failure in which the heart muscle is deprived of the blood necessary to meet its functional needs as a result of narrowing or blocking of one or more of the coronary arteries.

Coronary Heart Disease (CHD) a disease of the heart and coronary arteries that is characterized by atherosclerotic arterial deposits that block blood flow to the heart, causing myocardial infraction. 

Endotoxin, the toxic protoplasm liberated when a microorganism dies and disintegrates.   Toxic substance bound to to the bacterial cell wall and releasedwhen the bacterium ruptures or disintegrates. Endotoxins consist of lipopoly- saccharide and lipoprotein complexes.  The protein component determines the antibody type that can react with the endotoxin molecule to produce an immune reaction.  Endotoxins are rarely fatal, although they often cause fever.   

Heart Failure (HF) is a pathophysiological state in which the heart is unable to pump blood at a rate commensurate with the requirements of the metabolizing tissues or can do so only from an elevated filling pressure.   I t is usually, but not always caused by a defect in myocardial contraction, i.e., by myocardial failure

HMG-CoA reductase inhibitors (statins), the enzyme they inhibit, which is the method by which lower cholesterol.

Meta-study consists of grouping together studies according to a set of criteria and then calculating the summation of finding.  Cochrane Library consists of hundreds of such meta-studies without funding from PhARMA. 

Morbidity rate the relative incidence of a particular disease in a specific locality

Myocardial Infraction (MI) heart attack

Primary prevention for those with high cholesterol, but no other health problems

Sarcopenia the loss of muscle mass causing weakness.  Statins contribute to this through lowering of CoQ10, and thereby affecting exercise and physical exertion, which are needed to maintain muscle mass and tone. 

Secondary prevention for those with pre-existing cardiovascular disease (CV)

Sepsis, the poisoned condition resulting from the presence of pathogens or their toxins.   The severe infection caused by pathogenic organisms, especially bacteria, in the blood or tissues.  If untreated, a localized infection, as in the respiratory or urinary tracts, can lead to infection in the blood stream and widespread inflammation, characterized by fever, chills, and other symptoms and later septic shock.  Chronic infection is a causal factor for CVD.

Thought Leader because of being PhARMA friendly a few administrators and researchers perform various well-paid services for PhARMA, such as a researcher, author of textbooks, head of clinic, and giving educationals.  They become known as an expert in their specialty.  
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Below is an example of marketing science.  It is a review of the research on Mevicor (Lovastatin) by Merck (hardly unbiased in their dismissal of the relevance of animal studies).  Worth reading as to risk factors since animal studies have a high carryover to humans.   Tolbert left out the “c” word cancer, for which this side effect in animals is be repeatedly brought up.  Since most cancers have a 20-year lag time (such as cigarettes) from exposure, short-term clinical trials will not expose this risk.  It took for example 30 years for cancer to be associated with DES, a synthetic estrogen, and 50 years for MPA (methoxyprogesterone, which is still on the market). 

.   

SIDE EFFECTS ANIMALS:  Statins produce significant toxicity at high doses in a variety of animal species. These effects include increases in hepatic transaminases, atypical focal hyperplasia of the liver, squamous epithelial hyperplasia [ORGAN ENLARGEMENT] of the rat fore-stomach (an organ not present in man), cataracts, vascular lesions in the central nervous system (CNS), skeletal muscle toxicity, testicular degeneration and, although the statins are clearly not genotoxic, tumours of the liver and other sites (details can be found in the product circulars of the individual statins). It has been shown, where it has been practical to conduct the experiment, that these effects can be prevented by administering mevalonate 29,30, the product of the reaction catalysed by HMG-CoA reductase.  This indicates that these toxic effects are mostly, if not entirely, attributable to extreme inhibition of the enzyme at high doses 29.  So Merck, and the regulatory agencies considering the marketing application submitted by Merck, were faced with a wide range of animal toxicological effects, as well as the history of compactin and the known central role of the cholesterol biosynthesis pathway in many physiological processes, including the production of steroids and cell membranes.  [Since the toxicity of the very similar in structure compactin, whose toxicity in animal studies resulted from it not being tested clinically, that the same occurred for Lovastin, but Merck went forward. Compactin was withdrawn from the market for ]   Fortunately, except for rare cases of myopathy and marked but asymptomatic increases in hepatic transaminases, none of the adverse effects found in animals occur at human therapeutic doses.” Nature Reviews Drug Discovery 2, 517-526 (July 2003) | doi:10.1038/nrd1112

Author’s affiliations: A. Tolbert, Merck Research Laboratories, Rahway, New Jersey 07065, USA.
Email: 
jonathan_tobert@merck.com

CHOLESTEROL    from http://en.wikipedia.org/wiki/Cholesterol

Cholesterol, from the Ancient Greek chole- (bile) and stereos (solid) followed by the chemical suffix -ol for an alcohol, is an organic molecule. It is a sterol (ormodified steroid),[3] and an essential structural component of animal cell membranes that is required to establish proper membrane permeability and fluidity. Cholesterol is thus considered within the class of lipid molecules. In addition to its importance within cells, cholesterol also serves as a precursor for the biosynthesis of steroid hormones, bile acids, and vitamin D.[4] Cholesterol is the principal sterol synthesized by animals; in vertebrates it is formed predominantly in the liver.

François Poulletier de la Salle first identified cholesterol in solid form in gallstones in 1769. However, it was not until 1815 that chemist Michel Eugène Chevreul named the compound "cholesterine".[5][6]  Since cholesterol is essential for all animal life, each cell synthesizes it from simpler molecules, a complex 37-step process that starts with the intracellular protein enzyme HMG-CoA reductase [what statins block]. However, normal and particularly high levels of fats (including cholesterol) in the blood circulation, depending on how they are transported within lipoproteins, are strongly associated with the progression of atherosclerosis.  For a man of about 68 kg (150 pounds), typical total body-cholesterol synthesis is approximately 1 g (1,000 mg) per day, and total body content is approximately 35 g, primarily located within the membranes of all the cells of the body. Typical daily dietary intake of additional cholesterol, in the United States, is 200–300 mg.[7]  Most ingested cholesterol is esterified, and esterified cholesterol is poorly absorbed. The body also compensates for any absorption of additional cholesterol by reducing cholesterol synthesis.[8] For these reasons, cholesterol intake in food has little, if any, effect on total body cholesterol content or concentrations of cholesterol in the blood.  Cholesterol is recycled. The liver excretes it in a non-esterified form (via bile) into the digestive tract. Typically about 50% of the excreted cholesterol is reabsorbed by the small bowel back into the bloodstream.

Function[edit]

Cholesterol is required to build and maintain membranes; it modulates membrane fluidity over the range of physiological temperatures. The hydroxyl group on cholesterol interacts with the polar head groups of the membrane phospholipids and sphingolipids, while the bulky steroid and the hydrocarbon chain are embedded in the membrane, alongside the nonpolar fatty-acid chain of the other lipids. Through the interaction with the phospholipid fatty-acid chains, cholesterol increases membrane packing, which reduces membrane fluidity.[11] The structure of the tetracyclic ring of cholesterol contributes to the decreased fluidity of the cell membrane as the molecule is in a trans conformation making all but the side chain of cholesterol rigid and planar.[12] In this structural role, cholesterol reduces the permeability of the plasma membrane to neutral solutes,[13] protons, (positive hydrogen ions) and sodium ions.[14]

Within the cell membrane, cholesterol also functions in intracellular transport, cell signaling and nerve conduction. Cholesterol is essential for the structure and function of invaginated caveolae and clathrin-coated pits, including caveola-dependent and clathrin-dependent endocytosis. The role of cholesterol in such endocytosis can be investigated by using methyl beta cyclodextrin (MβCD) to remove cholesterol from the plasma membrane. Recently, cholesterol has also been implicated in cell signaling processes, assisting in the formation of lipid rafts in the plasma membrane. Lipid raft formation brings receptor proteins in close proximity with high concentrations of second messenger molecules.[15] Cholesterol levels can change how quickly surface proteins move within the plasma membrane[16] and also the efficiency of magnetic capture of cells.[17] In many neurons, a myelin sheath, rich in cholesterol, since it is derived from compacted layers of Schwann cell membrane, provides insulation for more efficient conduction of impulses.[18]

Within cells, cholesterol is the precursor molecule in several biochemical pathways. In the liver, cholesterol is converted to bile, which is then stored in the gallbladder. Bile contains bile salts, which solubilize fats in the digestive tract and aid in the intestinal absorption of fat molecules as well as the fat-soluble vitamins, ADE, and K. Cholesterol is an important precursor molecule for the synthesis of vitamin D and the steroid hormones, including the adrenal gland hormones cortisol andaldosterone, as well as the sex hormones progesteroneestrogens, and testosterone, and their derivatives.[4] Some research indicates cholesterol may act as an antioxidant.[19]

Dietary sources

Fat intake also plays a role in blood-cholesterol levels. This effect is thought[by whom?] to come about by changes in the quantity of cholesterol and lipoproteins that are synthesized by the body. Isocalorically replacing dietary carbohydrates withmonounsaturated and polyunsaturated fats has been shown to lower serum LDL and total cholesterol levels and increase serum HDL levels, while replacing carbohydrates with saturated fat was shown to increase HDL, LDL, and total cholesterol levels.[29] Trans fats have been shown to reduce levels of HDL while increasing levels of LDL.[30] Based on such evidence and evidence implicating low HDL and high LDL levels in cardiovascular disease (see Hypercholesterolemia), many health authorities advocate reducing LDL cholesterol through changes in diet in addition to other lifestyle modifications.[31] The USDA, for example, recommends that those wishing to reduce their cholesterol through a change in diet should aim to consume less than 7% of their daily energy needs from saturated fat and fewer than 200 mg of cholesterol per day.[32] An alternative view is that any reduction to dietary cholesterol intake could be counteracted by the organs compensating to try to keep blood cholesterol levels constant.[33] Other research has found that an increase in the consumption of saturated fats and cholesterol decreases overall serum cholesterol. [34].

Regulation of cholesterol synthesis[edit]

Biosynthesis of cholesterol is directly regulated by the cholesterol levels present, though the homeostatic mechanisms involved are only partly understood. A higher intake from food leads to a net decrease in endogenous production, whereas lower intake from food has the opposite effect. The main regulatory mechanism is the sensing of intracellular cholesterol in the endoplasmic reticulum by the protein SREBP (sterol regulatory element-binding protein 1 and 2).[37]

 

Plasma transport and regulation of absorption

Cholesterol  is transported in the circulatory system within lipoproteins, complex discoidal particles that have an exterior composed of amphiphilic proteins and lipids whose outward-facing surfaces are water-soluble and inward-facing surfaces are lipid-soluble; triglycerides and cholesterol esters are carried internally. Phospholipids and cholesterol, being amphipathic, are transported in the surface monolayer of the lipoprotein particle.  In addition to providing a soluble means for transporting cholesterol through the blood, lipoproteins have cell-targeting signals that direct the lipids they carry to certain tissues. For this reason, there are several types of lipoproteins in blood, called, in order of increasing density, chylomicrons, very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). The more lipid and less protein a lipoprotein has, the less dense it is.  VLDL molecules are produced by the liver and contain excess triacylglycerol and cholesterol that is not required by the liver for synthesis of bile acids. 

LDL molecules, therefore, are the major carriers of cholesterol in the blood, and each one contains approximately 1,500 molecules of cholesterol ester. LDL molecules, therefore, are the major carriers of cholesterol in the blood, and each one contains approximately 1,500 molecules of cholesterol ester.  Now within the cell, the cholesterol can be used for membrane biosynthesis or esterified and stored within the cell, so as to not interfere with cell membranes.  These LDL molecules are oxidized and taken up by macrophages, which become engorged and form foam cells. These cells often become trapped in the walls of blood vessels and contribute to atherosclerotic plaque formation. Differences in cholesterol homeostasis affect the development of early atherosclerosis (carotid intima-media thickness).[40] These plaques are the main causes of heart attacks, strokes, and other serious medical problems, leading to the association of so-called LDL cholesterol (actually a lipoprotein) with "bad" cholesterol.[39]

HDL particles are thought to transport cholesterol back to the liver for excretion or to other tissues that use cholesterol to synthesize hormones in a process known as reverse cholesterol transport (RCT).[41] Having large numbers of large HDL particles correlates with better health outcomes.[42] In contrast, having small numbers of large HDL particles is independently associated with  atheromatous disease progression in the arteries.  HDL particles (especially large HDL) have been identified as a mechanism by which cholesterol and inflammatory mediators can be removed from atheroma. Increased concentrations of HDL correlate with lower rates of atheroma progressions and even regression.

 

Metabolism, recycling and excretion

Cholesterol is oxidized by the liver into a variety of bile acids.[46] These, in turn, are conjugated with glycine, taurine, glucuronic acid, or sulfate. A mixture of conjugated and nonconjugated bile acids, along with cholesterol itself, is excreted from the liverinto the bile. Approximately 95% of the bile acids are reabsorbed from the intestines, and the remainder are lost in the feces.[47] The excretion and reabsorption of bile acids forms the basis of the enterohepatic circulation, which is essential for the digestion and absorption of dietary fats. Under certain circumstances, when more concentrated, as in the gallbladder, cholesterol crystallises and is the major constituent of most gallstones. 

 

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