CARDIOVASCULAR DISEASE - Folic Acid, Statin, Vegetable, Vitamin B6, Vitamin B12, Vitamin C
In this editorial which questioned the increased use of statin drugs for cardiovascular disease risk reduction, some criticisms included; trials did not compare statins with dietary management, and there had been some exaggeration on the evidence in terms of relative rather than absolute risk.

Statin drugs are being given to an ever greater number of low-risk individuals, and there is a question with regard to their economic benefit in this situation.

Statin drugs have been presumed to lower cardiovascular disease risk by inhibiting the enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, which is a critical step in the pathway of cholesterol synthesis, thereby reducing cholesterol and atherosclerosis. There appears to be other mechanisms by how statin drugs may show benefit in cardiovascular disease, which include stimulation of nitric oxide, which can enhance endothelial function. Some statins have also been noted to reduce C-reactive protein. Elevated homocysteine can affect endothelial function adversely and can be lowered by folic acid, vitamin B6 and vitamin B12.

It is noted that 5-methyltetrahydrofolate, which is the main circulating metabolite of folic acid, increases nitric oxide production as well as reduces homocysteine levels. There are compounds in vegetables called glitazones that may protect the endothelium from damage by inhibiting leukocyte adhesion. Vitamin C has been known to stimulate nitric oxide and reverse endothelial dysfunction. Vitamin C stabilizes and increases intracellular concentrations of the essential endothelial cell nitric oxide-synthase cofactor tetrahydrobiopterin. “Statins and Micronutrients: Unanswered Questions,” McKee M, Moat SJ, McDowell I, J R Soc Med, October 2004;97(10):459-460.

Dr. Bob Comment: As I have been writing about, the statin drugs are not what they are hyped up to be. If they even help at all, it may not be from reducing cholesterol synthesis in the liver. The vitamins mentioned above are all safe and effective, and produce real reductions in cardiovascular risk at a fraction of the cost of statin therapy, and without the adverse effects. Try to accomplish your health goals non-pharmacologically whenever possible. Almost everyone should take several thousand milligrams of vitamin C per day.

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