Healthy people with high cholesterol do not benefit from statins, according to research

According to 2020 data from the American Heart Association, about 40 million adults in the United States regularly take statins to lower their cholesterol and reduce their risk of heart disease and stroke.

However, many of them do not benefit from these drugs, based on new research from David Diamond, a neuroscientist and cardiovascular disease researcher in the Department of Psychology at the University of South Florida.

Diamond and his co-authors reviewed the literature from medical studies involving patients taking either a statin or a placebo. They then narrowed their review to look at study participants with elevated levels of low-density lipoprotein (LDL) cholesterol, the so-called “bad” cholesterol, which can be lowered with a statin. Some people with high LDL also had high triglycerides (fat in the blood) and low high-density lipoprotein (HDL), the “good cholesterol,” putting them at the highest risk of heart attack.

But others with high LDL were very different. They had low triglycerides and high HDL, which meant they were healthier. People with optimal triglyceride and HDL levels typically exercise, have low blood pressure and low blood sugar, and have a low risk of heart attack.

Diamond and his co-authors asked two questions: If people are at low risk of heart attack because they have optimal triglycerides and HDL, but they also have high LDL, does that increase their risk? Also, would these people benefit from lowering their LDL with a statin?

Their results, published in the journal Current opinion in endocrinology, diabetes and obesity, showed that LDL alone has “a very weak association” with heart disease and stroke. Their review went even further, showing that there was no benefit when people with high LDL and optimal triglycerides and HDL received a statin.

Diamond placed the findings in a diet and lifestyle context.

People who are not overweight, have low blood sugar, exercise, and eat a low-carb diet typically have optimal triglycerides and HDL, and sometimes have high LDL. Our results show that people with this healthy diet and lifestyle combination and high LDL levels showed no benefit from taking a statin.”

David Diamond, neuroscientist and cardiovascular disease researcher, Department of Psychology, University of South Florida

The authors say their report also challenges the long-held claim that low-carb diets, often high in saturated (animal) fats, contribute to heart disease. This claim has been around for nearly 50 years, dating back to the time when cardiologist Robert Atkins was challenged before a US Senate Subcommittee on Nutrition and Human Needs in 1973 about the potential dangers of his high-fat Atkins diet.

“High blood pressure, obesity, smoking and high blood sugar are the leading causes of heart disease,” Diamond said. “Cholesterol is an innocent bystander, and saturated fat in the diet has been unfairly demonized.”

Diamond acknowledges that his research has been controversial and has garnered strong support, along with criticism from some within the medical community who have questioned his views on LDL and statins. He cautions that this is to raise awareness and should not be taken as medical advice.

Diamond’s interest in the link between LDL cholesterol and the risk of heart disease and stroke is personal.

About 25 years ago he was overweight and diagnosed with high triglycerides and low HDL, a potentially deadly combination. His doctor told him he was at high risk of heart disease and prescribed a statin to lower his LDL cholesterol. Instead of taking the medication, Diamond began studying nutrition and heart disease.

“I’ve learned that my problem is that I ate too many carbohydrates — bread, potatoes and sugar,” Diamond said. “I’ve been able to control my weight and reduce my risk of heart disease with a low-carb diet. That’s when I became obsessed with linking cholesterol to heart disease.”

Diamond has since published more than a dozen articles debunking the consensus that cholesterol causes heart disease. His most recent paper included a review of the medical literature that linked statins to numerous side effects, including the development of diabetes, damage to muscles and kidneys, and impaired brain function.

“Certain statins have been linked to cognitive impairment because they impair the brain’s ability to produce cholesterol, which is essential for creating new brain connections and forming memories,” Diamond said.

According to Diamond, people with obesity and diabetes may benefit from taking a statin because the drugs not only lower LDL but also block excessive clotting and inflammation, two known risk factors for heart disease.

For those who prefer to take medication rather than make diet and lifestyle changes, Diamond has a message: “People who take a statin may not know that they are a little bit less likely to have a heart attack or stroke, but this Reverse effects of statins can harm them.”

Co-authors of the study were Professor Ben Bikman of Brigham Young University and Paul Mason, a physician in New South Wales, Australia.