Lately, statins, the common cholesterol-lowering drug, have been getting some bad press. There's the research linking its use to the development of diabetes, cataracts, muscle pain, and fatigue, not to mention one study suggesting a type of fat-soluble statin can contribute to sleep disorders. Some doctors say they're overprescribed and that many patients told to take them could just as effectively lower their heart disease risk with diet and exercise changes without the risk of statin side effects.
Well, here's some good news about the drug: Research just published in the journal Science Translational Medicine suggests that statin use might help lower the considerable heart disease risk of people with obstructive sleep apnea (OSA). This could be a big deal, since almost a quarter of men in the U.S. suffer from obstructive sleep apnea and it triples risk for stroke, high blood pressure, and cardiovascular disease. People with OSA stop breathing for 10 seconds or longer repeatedly during sleep, reducing the flow of oxygen in their bodies. The reduction in oxygen flow to tissues leads to a condition called hypoxia, which can damage organs over time.
To help them understand how hypoxia increases the risk of stroke and heart attacks, researchers studied protein, peptide, and DNA interaction via a laboratory technique called phage display in 76 patients at the Sleep Disorder Center at Columbia University. OSA sufferers appear to have higher amounts of a protein called CD59 inside rather than outside their endothelial cells, cells that play a major role in regulating blood flow. The decreased amount of CD59 suggests reduced immunity protection from attack, the authors wrote in their paper.
They also determined that patients who were taking statins had normal levels of surface CD59 compared to patients not taking the drug. "Our results [therefore] are likely cholesterol dependent, but we did not perform experiments that would delineate whether these effects are cholesterol-dependent or independent (pleiotropic)," says study co-author Dr. Sanja Jelic, associate professor of medicine at the Columbia University Medical Center.
In addition, statins appear to reduce the chance of attack on cell membranes, which causes inflammation that can lead to disease. Determining the precise mechanisms requires further research, however, Jelic says.
"OSA is an independent cardiovascular risk factor similar to diabetes, elevated LDL cholesterol, and smoking," he says. "If the beneficial effect of statins on blood-vessel health in OSA patients is confirmed in larger clinical trials, OSA may become an indication for statin therapy similar to diabetes."
Their research is likely to fuel the ongoing debate about whether the benefits of statins outweigh their risks. After years of urging caution, some doctors now say that many people who might benefit from the cholesterol-lowering drug aren't taking it, putting them at unneeded risk for cardiovascular problems.