In a nutshell, statins work (to lower cholesterol levels) in the following way: 1: They lower cholesterol synthesis in the liver.
2: The liver starts running out of the cholesterol needed to make VLDLs.
3: The liver then has to increase the number of LDL receptors to pull cholesterol back in to make more VLDLs.
4: More LDL is dragged back into the liver, as a result of which...
5: The LDL level in the blood falls.
So now you know.
Very simple really.
But if you think that the only action of statins is to reduce the synthesis of cholesterol in the liver, then you are very much mistaken.
Statins do many other things.
Drugs are very rarely like Koch's 'magic bullets' of yore, designed to pick off one precise bacterium, or enzyme, or biochemical action, in the body.
With most drugs, putting them into the body is a bit like handing a five-year-old an Uzi 9mm machine gun in a hostage situation, then hoping that when the ammo runs out the net result will be that more bad guys got killed than good guys.
Sometimes yes, sometimes no.
Take steroids, for example.
This is a class of drugs that act just about everywhere in the body, and they can be used to treat a huge range of different conditions.
For example: Eczema.
Organ transplantation - to prevent rejection.
Rheumatoid arthritis.
Ulcerative colitis.
Asthma.
Injection into tennis elbow.
Inability to win a gold medal at the Olympics.
How precise is that? Not very.
And how about thalidomide, designed initially to treat morning sickness, but found to create terrible limb deformities in babies? However, the very action that stops limbs from forming properly in unborn children also stops tumors growing by preventing the formation of new blood vessels.
Currently, thalidomide is the hottest new thing in cancer treatment.
Or Viagra.
Developed to treat angina, found to create long-lasting erections by the students enrolled in clinical studies.
And no, they did not get many unused Viagra tablets back.
Interestingly, Viagra may now have come full circle as it is increasingly being used to treat pulmonary hypertension (high blood pressure in the lungs).
Finally, and perhaps most pertinent to this discussion, is the drug aspirin.
Aspirin started life as a painkiller, mainly.
About 40 years ago, it was found to 'thin' the blood by stopping platelets sticking together.
Consequently, aspirin is now used to prevent heart attacks.
Who would ever have guessed? I n short, drugs almost always have a wide range of different actions.
Some expected, some completely unexpected.
And statins are no exception to this rule.
Thus, it is fully 'possible that statins may have 'coincidental' effects on preventing heart disease that have nothing whatsoever to do with lowering LDL levels.