To Your Health

Statin drugs reduce serum cholesterol levels, but there is intense controversy over whether this translates into a reduction in deaths from heart attacks

Q. I am 42 years old, a type II diabetic, and I was surprised to read recently that the statin medicine I am taking to lower my cholesterol may not lower my risk of dying from a heart attack. Are there any nutrients that will actually lower this risk?

A. "Statin" drugs reduce serum cholesterol levels, but there is intense controversy over whether this translates into a reduction in deaths from heart attacks. At stake is the more than $25-billion-per-year income that pharmaceutical companies reap from the sale of statin drugs, and they have been accused of manipulating results to obtain more favorable outcomes. At present, in spite of claims and counterclaims, the best answer seems to be "we don't really know."

Statins reduce cholesterol production in the liver by interfering with an enzyme called "HMG CoA reductase." This enzyme is also used in the process of making coenzyme Q-10, a major vitaminlike antioxidant that we are able to make to some extent, and thus it is not ordinarily considered a nutrient we must have in our diets. The problem is that when HMG-CoA reductase is blocked, in order to reduce cholesterol production, synthesis of coenzyme Q-10 is also blocked. Younger people are able to make more coenzyme Q-10, so HMG-CoA reductase produces few side effects in people under the age of 40 years or so, but as we age and lose some of our ability to produce our own coenzyme Q-10, the effect of HMG-CoA reductase becomes more significant. Unfortunately, statins are most often prescribed to people older than 40.

Fortunately, statins are not the only HMG-CoA reductase inhibitors available, but few physicians know that vitamin C is a safe and effective alternative to statins. However, your "60 mg/day RDA" amount of vitamin C will not do this job. Research indicates that it requires about 2,000-3,000 mg/day of vitamin C to significantly inhibit HMG-CoA reductase, an amount that has been recommended by scientists such as Linus Pauling and Roger J. Williams since the 1970s. Unlike the statins, vitamin C promotes the production of coenzyme Q-10 and, also unlike statins, vitamin C lowers the blood levels of lipoprotein (a), a particle in blood similar to LDL-cholesterol. Elevated lipoprotein (a) is a predictor of heart disease for which no medical remedy is currently available.

Vitamin C alone is inadequate to completely protect you against heart disease. Other antioxidants, in particular vitamin E, vitamin A, and selenium, should be part of your strategy to prevent a heart attack. Lysine, an amino acid important in making collagen, is often deficient (or out of balance) even in the diet of meat-eating Americans. When used with vitamin C supplements, lysine supplements can be used in the body to make L-carnitine, an important energy transporter needed especially by the heart muscle. The omega-3 fatty acids, which keep inflammation under control, must be kept balanced with omega-6 fatty acids.

Finally, in addition to obvious lifestyle changes, including regular exercise, learn to relax. In research published in the American Journal of Cardiology (Oct. 15, 2005, p.1064-1068), a simulated panic attack induced heart abnormalities in twice as many people who were prone to panic attacks as compared to people who are not prone to panic. Our minds still have an immense influence over our bodies.

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