DO CHOLESTROL LOWERING MEDICATION LOWER THE CHANCES OF CARDIOVASCULAR DISEASES? WHAT DO YOU THINK?

The purpose of this article is to increase awareness about cholesterol lowering medication. Do not drop, skip or stop taking your cholesterol lowering medication without consultation of your physician. Now to understand how cholesterol lowering medication increases HEART FAILURE risk, we will first discuss about Co- enzyme Q10.

What is Co- enzyme Q10?
Co- enzyme Q10 is highly lipophilic molecule which chemical structure is very similar to Vitamin K. It is also known as Ubiquinone (UQ). Co-enzyme Q10 has very beneficial and protective effects as,
1. Decrease levels of CO- enzyme Q10 increase the risk of heart diseases such as cardiomyopathy (enlargement of wall of heart) and the most significantly heart failure.
2. Decrease level of Co-enzyme Q10 increase the level of CRP (C-reactive protein) and IL- 6 which lead to high inflammation and ultimately increases the risk of heart attacks and strokes.
3. Co-enzyme Q 10 is potent antioxidant and improves blood vessels health and reduces risk of atherosclerosis.
4. It also inhibits peroxidation of lipid and lipoprotein.
5. Co-enzyme Q 10 not only improves blood pressure but also lower the risk of second heart attack and reduces death from heart failure.
6. It has critical role in production of ATP in mitochondria (cellular energy production) which turn food into energy and fights against damage to your body’s cell.

MEDICATION AND ILLNESS WHICH ARE RESPONSIBLE FOR DEPLETION OF CO-ENZYME Q10
Bi phosphonates (for arthritis), anti-depressant, contraceptive, hormone replacement therapy and chiefly statins (on long term basis) causes depletion of co- enzyme Q10 in both blood and muscles tissues. Similarly certain illness like COVID infection, Influenza, reproductive, liver, neurological and pulmonary disorders and cardiovascular disease are responsible for deficiency of Co-enzyme Q10 in the body.

HOW STATINS WORK?
Stains by inhibiting liver enzyme HMG COA reductase in mevalonate pathway reduces cholesterol synthesis. Liver is main target organ for its pharmacological action. COA reductase is rate controlling enzyme for cholesterol synthesis in mevalonate pathway. This same pathway is also shared for CO-ENZYME Q10 synthesis. By reducing cholesterol synthesis, it showed its heart protective effects while on the other hand, by reducing Co-enzyme Q10 synthesis it also increases heart failure risk.

HOW LONGTERM USE OF STATINS INTENSIFY RISK OF HEART FAILURE?
On long term basis, not only statins but other cholesterol lowering medication like fibrates (reduces circulatory Co-enzyme Q10 level) and gemfibrozil (reduces serum level of Co-enzyme Q10) also increases incidence of heart failure. As we already discussed, that Co-enzyme Q10 is essential for energy production. Heart is the most energy demanding organ because of continuous contractile activity of heart muscles in order to supply blood to all over the body. For this energy supply, heart relay on efficient mitochondrial function and energy production. While heart failure is characterized by mitochondrial dysfunction, less myocardial ATP production and abnormal calcium handling So we can say that, cholesterol lowering medication especially statins reduce Co-enzyme Q10 level in myocardial muscles, blood and muscles tissues which is responsible for mitochondrial dysfunction and less myocardial ATP production and ultimately lead to heart failure and intensify cardiomyopathy.

CONCLUSION
Despite the heart protective effects of cholesterol lowering medication, now it is clear from the aforementioned discussion that on long term basis, it also intensifies the risk of heart failure and other heart related diseases along with other side effects.