Cholesterol has an important place in human metabolism. It is located in the membranes of our cells, strengthening them, and forms the building block of many hormones such as vitamin D and testosterone and estrogen. Therefore, cholesterol is found in almost every organ and its presence is vital. Our body's source of cholesterol comes from two places: the cholesterol we get from food and the cholesterol produced by our liver. Since cholesterol has very important functions in our body, if the consumed cholesterol is insufficient (not taken from food enough), our liver further increases cholesterol production to compensate for this. The "bad cholesterol" that we often hear about is actually LDL, the cholesterol produced by our liver, which is "packaged" by the liver and secreted into the blood, and undergoes some changes, getting its name. LDL particles distribute the cholesterol produced by the liver to different organs in the body. Thanks to this distribution, as we mentioned at the beginning, vitamin D and hormones are synthesized, and the cells in our body strengthen their membranes with cholesterol. The remaining LDL particles are collected back by the liver.
The amount of LDL circulating in an individual's veins depends on that individual's genetics, nutrition and environmental factors.
The reason why LDL is called “bad cholesterol” is this: When LDL particles become oxidized while circulating in the blood (oxidation can be thought of as a kind of rust and deterioration), they damage the vascular walls and cause It starts the process leading to atherosclerosis (hardening of the arteries). Atherosclerosis can also block the cardiovascular vessels and lead to heart diseases. Considering this situation, it can be concluded that the risk of atherosclerosis is directly proportional to the amount of LDL ("bad cholesterol"). Based on this logic, it can be concluded that lowering LDL with medications or nutritional changes reduces cardiovascular diseases.
Although there is some truth in this, low or lowering LDL level does not always reduce cardiovascular diseases. It does not mean that it is or will be. There are individuals whose LDL level is quite high and whose heart vessels are not blocked. Likewise, there are people whose LDL level is at normal levels or slightly higher than normal and they have a heart attack. Moreover, lowering the LDL level with medications does not always reduce the risk of heart disease.
On the other hand, statin group drugs (lipitor, crestor, etc.), especially those that have been around for the last thirty years, lower LDL. It has led to significant improvements in reducing cardiovascular diseases. Many clinical studies have shown that these drugs lower LDL levels and reduce cardiovascular diseases. However, in addition to lowering LDL levels, these drugs also have other independent effects: preventing thickening of the vascular wall and reducing inflammation. These mechanisms are also thought to have an effect on reducing cardiovascular diseases. Therefore, the fact that these drugs reduce cardiovascular diseases is not just about lowering LDL.
Statin drugs have side effects, and these can have a very negative impact on life for some people. Particularly muscle weakness and muscle aches are common side effects that cause many patients to quit these medications. There are also less common side effects: these drugs can slightly increase blood sugar, and - in some individuals - cause mental confusion.
Maintaining cardiovascular health and preventing diseases is extremely important for every individual. However, focusing only on lowering LDL ("bad cholesterol") would be the wrong approach. Factors such as smoking, hypertension and diabetes significantly increase the risk of cardiovascular diseases. Managing these factors (quitting smoking, controlling blood pressure and sugar) and eating right and appropriate will significantly reduce the risk. On the other hand, a person has age, genetics, and family history that they cannot change. Considering all these interveneable and non-intervenable factors, an individual can make a program with his doctor to prevent and treat cardiovascular diseases.
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