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The link between statins, atherosclerosis, and lack of vitamin K

The link between statins, atherosclerosis, and lack of vitamin KCholesterol-lowering statins are among some of the most widely sold medical drugs. However, there is growing disagreement about their preventive effect on atherosclerosis and cardiovascular diseases, which are linked to many other factors than cholesterol levels alone. It turns out that statins also block the body’s production of vitamin K2, a nutrient that contributes to removing calcium from the bloodstream. A new study that is published in Medical Sciences concludes that atherosclerosis is more prevalent among statin users than among non-users, regardless of any cardiovascular diseases that have already been diagnosed. In other words, statins actually increase your risk of clogged-up arteries and that contradicts the traditional view. The new study supports earlier research, and it has been known for years that statins also block the endogenous synthesis of coenzyme Q10 and vitamin D, both of which are important for the heart and circulatory system.

Coronary occlusion is the leading cause of death worldwide. Atherosclerosis consists of oxidized LDL cholesterol, fat, and calcium deposits. Cholesterol is traditionally considered the culprit in all of this but it is important to note that cholesterol is in fact an essential compound. Our liver produces most of our cholesterol from carbohydrate. The substance is a structural part of cell membranes and the body uses cholesterol to produce hormones, vitamin K2, vitamin D, and Q10. We therefore need a to have a certain amount of cholesterol in our system. Besides, it is not only cholesterol that affects the risk of atherosclerosis, other factors are also involved.

An estimated 200 million people or more worldwide take statins to lower their cholesterol levels and to prevent atherosclerosis

The new study focuses on statins, vitamin K2, and atherosclerosis

In the new study, the researchers looked closer at the relation between statins, atherosclerosis, and vitamin K2 for a number of reasons. Firstly, statins inhibit the endogenous production of vitamin K2 that is synthesized from cholesterol. Secondly, vitamin K2 helps activate certain proteins that affect the circulatory system. Matrix GLA protein, MGP, is primarily found in the blood vessels where it binds to calcium that is transported to bone tissue. That way, vitamin K2 effectively prevents atherosclerosis (by reducing calcium in the bloodstream) . Also, vitamin K2 activates osteocalcin, a protein that deposits calcium in our bones and that helps prevent osteoporosis.
More specifically, vitamin K2 activates a process called carbolyxation which is necessary to help MGP bind calcium ions in the bloodstream and to help osteocalcin embed the calcium ions in bone tissue. Both uncarboxylation and undercarboxylated MGP and osteocalcin increase the risk of atherosclerosis, osteoporosis, and bone fractures.
In the new clinical study, the scientists wanted to look closer at the relation between statin use, coronary occlusion, and vitamin K2-dependent proteins in two individual groups of people. One group was diagnosed with cardiovascular disease (CVD), while the healthy participants in the control group had a moderate risk of developing CVD. The groups were also divided into statin users and non-users.

The scientists measured the following vitamin K2-dependant proteins:

ucMGP: uncarboxylated Matrix GLA-Protein
This biomarker helps predict coronary occlusion

cOC: carboxylated osteocalcin
Necessary for binding calcium and embedding it in bone tissue

ucOC: undercarboxylated osteocalcin
Marker of vitamin K2 deficiency
Causes low calcium affinity
Increases the risk of osteoporosis and bone fractures

GRP: Gla-rich protein
A recently discovered protein that counteracts atherosclerosis by preventing crystal formations

The scientists also measured the participants’ CAC (Coronary Artery Calcium) score that shows how much calcium is deposited in the coronary arteries. Most of our calcium is stored in our bones and teeth but if we have too much calcium in our arteries it tends to get deposited as plaque. With increasing time, the plaque hardens, causing atherosclerosis and narrowing of the arteries. This increases the risk of heart attack or stroke.
A scanning of the calcium deposits in the coronary arteries is a good way of estimating the risk of developing cardiovascular disease.

Study results: Higher rate of atherosclerosis among statin users

It turned out the statin users had a higher CAC score than the non-users. Also, the CAC score was higher among patients with diagnosed cardiovascular disease compared with the control group. There was a direct link between levels of ucOC and CACS in the group of statin users but not among the non-users.
The significantly elevated levels of ucOC among statin users indicated that they lacked vitamin K. Levels of ucMGP and GRP were the same among statin users and non-users. In addition, there was no relation between ucMGP or GRP and CACS.
The researchers say that the results of their study support existing evidence that shows the relation between statin use and atherosclerosis. The study reveals, at least to a certain degree, the possible mechanisms by which statins increase calcium deposits in the artery walls, and it is primarily by preventing the function of vitamin K-dependent proteins that are necessary for protecting the cardiovascular system.
It is therefore a paradox that statins are so widely prescribed when they actually increase the risk of atherosclerosis.

Statin therapy and supplements that prevent side effects

The jury is still out with regard to defining normal cholesterol levels and whether statins are necessary – unless you suffer from familial hypercholesterolemia. Nonetheless, more and more doctors and scientists recommend combining statin therapy with supplements of vitamin K2 and Q10 to prevent uncomfortable and potentially serious adverse effects. Vitamin D supplementation is also relevant. The use of cholesterol-lowering statins, as mentioned earlier, interferes with the body’s synthesis of all three essential compounds.

  • More than 600,000 Danes use cholesterol-lowering drugs (primarily statins)
  • About 40 percent take them as primary prevention which means that they are generally healthy individuals
  • Approximately 60 percent take the medicine as therapy for cardiovascular disease that has already been diagnosed
  • Many statin users suffer from metabolic syndrome and type 2 diabetes and have unstable blood sugar levels

References:

Maria D. Zhelyazkova-Savova et al. Statins, vascular calcification, and vitamin K-dependent proteins: Is there a relation? Medical Sciences 26 February 2021

Okyama et al. Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms. PubMed.gov 2015

Linda J Dobberstein. Statin Drugs Cause Atherosclerosis and Heart Failure. Wellness Resources 2015

Pernille Lund. Sådan får du styr på dit blodsukker. Ny Videnskab. 2013

Pernille Lund. Q10 – fra helsekost til epokegørende medicin. Ny videnskab 2014

Livet på statiner (ku.dk)

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