How cholesterol really works

Cholesterol may not be the best way to measure one’s risk of heart disease. Studies on the use of statin drugs are showing that controlling inflammation is the mechanism by which the risk of heart disease is decreased. In fact, a study of a nonstatin drug called Zetia showed that drugs designed solely to reduce cholesterol without reducing inflammation actually increase ones risk of heart disease. (1) Zetia, in particular, while lowering cholesterol, actually increased the accumulation of fatty plaques in the arteries and increased the patient’s risk of a heart attack. Another new nonstatin drug, torcetrapib, was recently pulled from the market in 2006. Studies of this drug showed that, while raising HDL levels and lowering LDL in the 15,000 people, the cholesterol altering effect of the drug, in fact, caused more heart attacks and strokes.(2)
The best way to battle heart disease is not to focus on lowering cholesterol numbers but to focus on lowering inflammation with a proper diet and appropriate exercise. Statin drugs are still effective at lowering inflammation but should be used only as a last resort.

(1) Ridker PM, Cannon CP, Morrow D, Rifai N, Rose LM, McCabe CH, Pfeffer MA, Braunwald E; Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 (PROVE IT-TIMI 22) Investigators. C-reactive protein levels and outcomes after statin therapy. N Engl J Med. 2005 Jan 6;352(1):20-8.
(2) Kastelein JJ, van Leuven SI, Burgess L, Evans GW, Kuivenhoven JA, Barter PJ, Revkin JH, Grobbee DE, Riley WA, Shear CL, Duggan WT, Bots ML; RADIANCE 1 Investigators.Effect of torcetrapib on carotid atherosclerosis in familial hypercholesterolemia. N Engl J Med. 2007 Apr 19;356(16):1620-30.