Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms Expert Review of Clinical Pharmacology

Harumi Okuyama outlines the research that lead to his paper that argues statins stimulate atherosclerosis and heart failure.

Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms’ published in Expert Review of Clinical Pharmacology in February 2015.
Downloads: 19,080*
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Our review on cholesterol-lowering drugs, statins, was published in the Expert Review of Clinical Pharmacology in 2015, and had been downloaded from the journal website over 19,000 times by September 2016.

“…we have reached the conclusion that statins actually stimulate atherosclerosis and heart failure”

Industry sponsored clinical literature on the effectiveness and safety of cholesterol lowering drugs, statins, changed dramatically after the implementation of the European Union penal regulation on ethical clinical trials in 2004. No significant beneficial effects of statins in objective endpoints such as mortality rates from cardiovascular disease (CVD) or all-cause mortality have been reported after the regulations were implemented. We live in an age where bias must be considered when reading industry sponsored literature describing the benefits and risks of pharmaceuticals. On the other hand, many scientists have elucidated the mechanisms of statin actions through prenyl intermediates in cholesterol biosynthesis. Taken together, we have reached the conclusion that statins actually stimulate atherosclerosis and heart failure. Many types of adverse effects of statins can be explained pharmacologically.  

“…it is difficult to publish a paper criticizing current medical dogma”

Generally, it is difficult to publish a paper criticizing current medical dogma. Peter Langsjoen, a clinical cardiology practitioner who first reported the usefulness of supplementing coenzyme Q10 to patients treated with statins, had an opportunity to submit a paper to Expert Review of Clinical Pharmacology, and my group joined him in writing this review. We were fortunate to have peer reviewers who were open minded enough to consider contradictory theories and data which have not been previously described in this field.  

My group had been critically reading papers on the causal relationship of cholesterol and CVD and we published a book describing the fall of the cholesterol hypothesis and the importance of the omega-6/omega-3 fatty acid ratio for the prevention of CVD. Pharmacological and biochemical aspects of statin effects were emphasized in this review.

“…our review is helping those who were skeptical of the reported safety and effectiveness of statins to give logical rationale for their suspicions and uncertainties”

Many health professionals do not believe pharmaceutical propaganda as it does not reflect the reality of their clinical practice and they are not fully convinced by the conclusions from the meta analyses of the pharmaceutical trials, especially those published before the new regulation. In fact, we did not consider papers published before 2004 which reported notable effects of statins in preventing CVD. Most probably, our review is helping those who were skeptical of the reported safety and effectiveness of statins to give logical rationale for their suspicions and uncertainties. After the recent lipid nutrition conference here in Japan, I became more optimistic than before in changing the direction of cholesterol-lowering medications.

Harumi Okuyama graduated from the University of Tokyo, Graduate School of Pharmaceutical Sciences, PhD degree granted in 1968. Served as Professor of biochemistry at Nagoya City University and at Kinjo Gakuin University, Japan and as a visiting professor at Baylor College of Medicine, University of Illinois at Chicago, USA, Dalian Medical University, Dalian University, China and Toyama University, Japan. Major interest is lipid nutritional biochemistry. The first president of the Japan Society for Lipid Nutrition.

* Data recorded August 21, 2016.