Statins may help with dementia, Parkinson’s, cancer, stroke and more

Statin drugs are known to reduce levels of cholesterol. Their primary use is aimed at helping to prevent cardiovascular disease. But there is evidence that statins may be useful in a number of other disease states, from dementia, to Parkinson’s, to various cancers.

There are a number of statin drugs available. They function by inhibiting an enzyme that is necessary for cholesterol synthesis. Blocking this enzyme, which is named 3-hydroxy-3-methyl-glutaryl-CoEnzymeA (HMGCoA) reductase (HMG-CoA reductase), also decreases production of a number of other intermediate compounds that are precursors of cholesterol. Among these is mevalonate (more on the importance of this later.)

Statins also have some other effects, in addition to lowering cholesterol.

Statins are anti-inflammatory



Inflammation occurs when the tissues in the body respond to some type of irritant, infection or to cellular injury.

The inflammatory response is an effort to limit damage and initiate repair. Sometimes the inflammatory response needs to be controlled when it is too robust and may be causing associated damage to the tissues where it occurs. Statins and other anti-inflammatory medications, like non-steroidal anti-inflammatory drugs (NSAIDs), can help control this response and decrease the pain and swelling that are happen.

Statins also stabilize the plaque that builds up in arteries, and treating other diseases

Statins also stabilize the plaque that builds up in arteries. Theoretically, the more stable the plaque is, the less likely it is to serve as a site where a blood clot can occur in an artery, leading to a heart attack or possibly a stroke. Statins also seem to act to inhibit the formation of clots in these arteries as well.

Information has been accumulating that statins may be effective in treating other diseases. Some of these are: dementia, Parkinson’s disease, some forms of cancer, high blood pressure and, possibly, some others.

One study shows that a particular statin, simvastatin, seems to reduce the risk of both dementia and Parkinson’s disease in an older patient population (65 years and over.) The study used data from a large number of patients. The authors concluded that simvastatin can reduce the incidence of both dementia and Parkinson’s in a significant number of treated patients. Also, regarding statins decreasing the risk of dementia, see European Society of Cardiology (ESC) Congress 2013. Abstracts #1609, P4077.

Some research has shown that statins might not only be able to prevent some cancers, but they might also be able to act in conjunction with some chemotherapy drugs to improve the outcome of cancer treatments. As mentioned previously, the effects here might be related to the statins’ ability to decrease the production of mevalonate.

[S]everal preclinical studies indicate that statins may have cancer chemopreventive properties. The mechanistic data suggest that statins’ chemopreventive potential against cancer through their inhibition of the mevalonate pathway [54]. The mevalonate pathway is an important metabolic pathway that provide cell with bioactive molecules which play a key role in multiple cellular processes such as membrane integrity, cell signaling, protein synthesis, and cell cycle progression [55]. Statins’ inhibition of HMG-CoA reductase prevents the conversion of HMG-CoA to mevalonate, and thereby reduce levels of mevalonate and its downstream products, probably resulting in control of tumor initiation, growth, and metastasis [56], [57].
Increasing evidence also suggests that statins might enhance the antitumor activity of various cytokines and chemotherapeutic agents. In a phase 2 study of irinotecan, cisplatin, and simvastatin for untreated extensive-disease small cell lung cancer (ED-SCLC), the results indicated that the addition of simvastatin to irinotecan and cisplatin might improve the outcome of heavy smokers with ED-SCLC [58]. And another phase 2 study of gefitinib plus simvastatin versus gefitinib alone showed that simvastatin might improve the efficacy of gefitinib in that subgroup of gefitinib-resistant non-SCLC patients [59]. Because this field is new, only a few clinical trials have been reported so far. Therefore, the combined treatment of tumors with statins and anticancer drugs is an area of research that warrants future study.  (For additional information, see #53-60 from the linked research.)

This study presented some additional evidence that statins can act to lower blood pressure, even if given to patients who have normal cholesterol levels. Some of the evidence supports previous claims that statins could lower blood pressure. Though the author doesn’t recommend the routine use of statins as antihypertensive agents, he suggests that further research in this area might prove useful.

Statins may also have a role in reducing future strokes in some patients who have already suffered a stroke.

They may be useful in the treatment of chronic kidney disease in some patients.

Statins seem to decrease the recurrence of prostate cancer after initial treatment either via surgery or after internal radiotherapy treatment.

Current research is also looking at other diseases where statins might prove useful. Several of these diseases have an inflammatory component and statins may prove beneficial here.

Statins are not without risk

While the statins may be beneficial in a number of conditions, not just in cardiovascular disease, they are by no means totally benign drugs. They can have potentially serious, sometimes fatal, consequences. Most people have heard that statins can cause muscle pain. They can also, rarely, produce a reaction (rhabdomyolysis – destruction of muscle tissue) that can be fatal. And given with some other drugs (e.g., niacin, gemfibrozil and others) or foods (grapefruit juice), the risk of side effects from taking statins increases. There may also be a slight increase in the risk that a patient taking a statin could develop diabetes.

However, all drugs have side effects — we’ve all seen the commercials on TV, with the announcer in the most soothing voice possible informing us that the drug could kill us — and not every drug will work well for every patient. Before starting any prescription medication, consult with your doctor and discuss the risks and benefits of the medication.

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Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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