Have a healthier heart: love your heart by reading up on the latest news on cholesterol—and its real role in cardiovascular disease

If this country's cholesterol guidelines were fully implemented, most of the Western world's adult population would be taking cholesterol-lowering statin drugs, according to research published in the British Medical Journal. Based on the latest figures available, Lipitor was the top-selling drug in the world for the five years leading up to 2005, with annual sales of $12.9 billion in that year. Yet lowering cholesterol may not be as healthy as we believe.

"Cholesterol is essential for life," says Peter Langsjoen, MD, a cardiologist in Tyler, TX. "It has been extraordinarily vilified."

Twenty-five years ago, experts didn't know about lipoproteins and good and bad cholesterol, say Stephen T. Sinatra, MD, and James C. Roberts, MD, co-authors of Reverse Heart Disease Now. LDL (low-density lipoprotein) and HDL (high-density lipoprotein) were named by a researcher who spun blood plasma in a centrifuge. When they separated, LDL floated to the top while HDL sank.

Contrary to popular wisdom, cholesterol, with the exception of oxidized LDL (see p. 49), is a substance our bodies need to function normally. "Fifty percent of brain tissue is cholesterol," says Langsjoen. The cholesterol in the brain doesn't come from the blood but is made by brain cells, and statin drugs cross the blood-brain barrier and block the brain's ability to make adequate cholesterol. Memory loss, insomnia, personality changes and road rage are some of the consequences, he explains, particularly among people over age 65 and even more so among those over age 80.

CoQ10 and Statin Drugs

Many studies have shown that CoQIO is necessary for a healthy heart and can reverse heart disease. Every muscle in the body needs CoQ10 to produce energy, and the heart muscle, having the greatest energy requirement, has the greatest concentration of this nutrient. However, our natural production of CoQ10 peaks in our 20s and declines thereafter. With the main food sources of CoQ10 being organ meats, not usually a part of today's diets, we are prone to a deficiency, especially from middle age onward.

Langsjoen has been studying CoQ 10 and heart disease since 1983. He points out that statins block production of CoQ10 in every cell, including the heart. "Fatigue is the most common symptom, in skeletal muscles as well as the heart," he says.

Supplements are a practical source of the nutrient, but in order to be absorbed well, they should be taken with fatty food. Langsjoen recommends 100mg daily of CoQ10 with a fatty meal or, for maximum absorption, opening up a capsule, mixing the contents with a nut butter and chewing the combination. To determine individual needs, CoQ10 blood levels can be tested. (See "Your Heart Health Resource Guide," p. 49.)

Skewed Research

Research that began in 1948 examined the correlation between cholesterol, diet and heart disease and formed the basis for today's cholesterol guidelines. But now it seems that not all the data that was available supported the conclusions.

Sinatra and Roberts note that one of the key studies underlying today's emphasis on lowering cholesterol was the Seven Countries Study. Although 20 countries had relevant data, only seven of these were used to "prove" the hypothesis that lowering cholesterol decreases risk for heart disease. When data from all 20 countries is included, the hypothesis fails.

Sinatra and Roberts also note that cholesterol protects us against bacterial infection, cancer and respiratory failure, and that higher cholesterol levels correlate with fewer car accidents and suicides. "Years of blaming cholesterol as the bad boy of heart disease have distorted the image of a totally necessary ingredient for the body's normal functioning," these authors say.

Lowering Cholesterol: Risk or Benefit?

Researchers at the University of California, San Diego, are examining the effects of statin drugs in the Statin Effects Study. Their observations about earlier research include:

* Healthy men who lower LDL cholesterol levels with statin drugs are less likely to die of heart disease but just as likely to die of other causes.

* Middle-aged men who are otherwise at high risk of heart disease probably receive more benefit than harm from statin drugs.

* There is no research to support the premise that statin drugs lower death rates among women, although they do reduce the rate of heart attacks.

* Among people over age 75, higher cholesterol seems to be protective against heart arrhythmias, atrial fibrillation and strokes.

The Real Culprits

Inflammation is the real risk factor we should be worried about, according to Sinatra and Roberts, and too much refined sugar and high-fructose corn syrup in our diets is a major contributing factor. Eliminating these sweeteners along with processed food and trans fat, while adding healthy fats, wholesome food and regular exercise, is all part of the solution, along with the fight supplements.