DHA enhances the effectiveness of statin medication

Like the omega-3 fatty acid EPA, DHA also enhances the effectiveness of statin medication in patients with high blood lipids by lowering triglycerides by about 27%.

In previous studies it was reported that patients taking statin medications to lower their LDL-cholesterol (“bad”) levels experienced additional hearth health benefits when they added EPA (eicosapentaenoic acid, a long-chain omega-3 fatty acid) to their treatment. Besides lowering their LDL-cholesterol levels, they had significantly fewer major coronary events, such as a heart attack or coronary bypass surgery, less unstable angina (chest pain because of heart disease) and fewer other non-fatal heart problems. What made these findings even more surprising is that they occurred in a large sample of Japanese patients with high cholesterol and triglyceride (blood fat) levels who already consume much more fish and long-chain omega-3 fatty acids than most people in western countries. In these 61-year-old patients, increased intake of EPA improved their heart health.

A new study from Australia reported that in a sample of 45 patients taking statins to improve their blood lipids, the addition of tuna oil to their treatment provided greater heart health benefits than statins alone. These patients had both high cholesterol and triglyceride levels. They were divided into 3 groups: one taking just over 1 g/day of DHA (docosahexaenoic acid, a long-chain omega-3 fatty acid abundant in tuna oil), another taking just over 2 g/day of DHA and a control group consuming olive oil. Tuna oil also contains about 25% EPA in addition to DHA. After 3 and 6 months, the investigators measured their patients’ blood lipid levels.

Over the course of the study, all patients consuming tuna oil saw their blood triglyceride levels fall. Those taking the highest dose, 2 g of DHA/day, experienced a significant drop in their triglycerides after only 3 months. At 6 months, their triglycerides remained significantly lower, but did not decrease further. In the group taking 1 g/day of DHA, their triglycerides fell at both 3 and 6 months, but the drop did not reach statistical significance.

These 2 studies and previous reports of fish oil and blood lipids indicate that patients taking statin medications may obtain additional heart health advantages by consuming marine omega-3s – the long-chain ones, EPA and DHA – found abundantly in fatty fish or fish oil supplements. These fatty acids have the advantage over other drugs in being well tolerated, safe and without adverse side effects. In this case, food can be your medicine!

Potential negative side effects of anti-cholesterol drugs

There are a number of side effects that could occur as a result of taking cholesterol reducers, but fortunately, side effect frequency is low. Muscle aches can occur with statin use and must be immediately reported to a physician. Certain cholesterol-lowering medications can also produce abnormal liver function in approximately 2 percent of the population, which can be diagnosed by periodic liver enzyme testing. In rare cases, this may lead to liver failure. Patients with moderate or severe liver disease should not take statins. For the most part, abnormal liver function is reversible when the statin is discontinued.

A rare, but potentially fatal side effect of some cholesterol-reducing drugs (statins and certain fibrates) is rhabdomyolysis, a severe muscle reaction in which muscle cells break down, releasing their contents into the bloodstream. Physicians can monitor patients for this complication by checking muscle enzyme levels (e.g., creatine phosphokinase [CPK]) in the blood. It most often affects the muscles in the back or lower calves. Some patients report no symptoms and in rare cases rhabdomyolysis can lead to kidney or other organ failure and death. Patients should report any of the following symptoms of rhabdomyolysis to their physicians immediately:

1) Muscle cramps, pain, swelling, weakness, stiffness and/or tenderness
2) Fever
3) Dark urine
4) Nausea and/or vomiting
5) Malaise (a general feeling of illness or discomfort)

Risk of this severe complication appears to be higher in elderly patients, those taking high doses of statin and those taking statins in conjunction with a fibrate (e.g., fenofibrate, gemfibrozil). In 2001, one type of statin, called cerivastatin was voluntarily withdrawn from the market by its manufacturer due to reports that fatal cases of rhabdomyolysis had been significantly more common with cerivastatin than with other approved statin drugs.

Statins carry a very low risk of side effects to the nervous system, including tingling, numbness and burning pain. These manifestations are known as peripheral neuropathy.

Very low LDL cholesterol produces greatest decrease in risk of atherosclerotic disease

According to US and German researchers, reducing LDL cholesterol to levels considerably below current recommended targets appears to provide greater protection in patients with established atherosclerotic disease.

The lowest risk was seen in patients who had achieved levels below 64 mg/dL.
Further analysis showed that that risk of individual events including fatal and non-fatal myocardial infarction and stroke were significantly reduced with lower LDL levels. Also, deaths from any cause or non-cardiovascular causes, were lowest in patients with the lowest on-treatment LDL levels.

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