How low is LDL cholesterol when using PCSK9 inhibitors?

People with genetic mutations that cause LDL cholesterol to reach 30 mg/dL live exceptionally long lives. Can we replicate this effect with medications?

The data are from large trials of cholesterol lowering with statin drugs suggests The incidence of cardiovascular diseases such as heart attacks would be close to zero if LDL cholesterol could be lowered to less than 60 mg/dL for first-time prevention and about 30 mg/dL for those trying to prevent another condition. But is lower actually better? Is it safe to have LDL cholesterol levels that low?

We didn’t know until PCSK9 inhibitors came along invent. Are PCSK9 inhibitors for LDL cholesterol safe and effective? I am exploring this issue in my country video Of the same name. PCSK9 is a gene that mutates to give people lower LDL cholesterol, and that’s what big pharmaceutical companies do belief To try to paralyze PCSK9 with drugs. After an intense heart attack cut Lowering an individual’s low-density lipoprotein (LDL) cholesterol level beyond the target of 70 mg/dL appears to work better than a more moderate reduction. there He was Fewer deaths from cardiovascular disease, heart attacks, or strokes when your low-density lipoprotein (LDL) level is less than 30 mg/dL comparison With 70 mg/dL or higher, and even compared to less than 70 mg/dL. There is a consistent reduction in risk even when starting at an average of 63 mg/dL, and pushing LDL to 21 mg/dL has, remarkably, shown “no noticeable offset” of adverse side effects.

Maybe it shouldn’t He is It’s very surprising, because this is about the level at which we start our lives. There is another type of genetic mutation papers People who have LDL levels of around 30 mg/dL throughout their lives are known to have exceptionally long life expectancy. So where did we get this idea that cholesterol could be lowered so much?

The common claim is that it can lower cholesterol He is Dangerous due to cholesterol depletion in cells is not supported by evidence and does not take into account the wonderful homeostasis mechanisms used by our body. After all, this is how we evolved. Until recently, most of us were used to it He owns LDL levels are around 50 mg/dL, which is very normal for the human race. There is no evidence that low or low cholesterol levels are somehow bad for us Contradictions With overwhelming evidence that lowering cholesterol reduces the risk of coronary artery disease, our number one killer.

But what about hormone production? Since the body needs Cholesterol for the synthesis of steroid hormones – such as adrenal hormones and sex hormones – there is a concern that there is not enough of it. But you don’t know that until you put it to the test. For decades, we’ve known that women who take cholesterol-lowering drugs don’t He owns A problem with the production of estrogen and failure to lower cholesterol affects Adrenal function. Well, it doesn’t happen weakens Testicular function in terms of causing testosterone levels to fall below normal. If anything, statin drugs can do that It improves Erectile function in men, which is what you would expect from lowering cholesterol. But you’ll notice that these studies focused only on lowering low-density lipoprotein (LDL) to 70 mg/dL or less. What about really low LDL?

On PCSK9 inhibitors, you can It happens Most people have less than 40 mg/dL of low-density lipoprotein (LDL) and some have less than 15 mg/dL! And there He is There is no evidence of impaired adrenal, ovarian, or testicular hormone production, even in patients with LDL levels less than 15 mg/dL. Risk of heart attacks falls In a straight line where the low-density lipoprotein (LDL) level gets lower and lower, even below 10 mg/dL, for example, without obvious safety concerns, but that is over the duration of exposure to these drugs. Longest follow-up to date for those whose LDL level, through the use of multiple medications, remained below 30 mg/dL He is Six years.

Now, we can takes Comfort in the fact that those who have severe mutations in PCSK9, which result in a lifelong drop in LDL levels to less than 20 mg/dL throughout their lives, remain healthy and have healthy children. Mutations that affect cholesterol are what a reason These are called “longevity syndromes”, but this does not necessarily mean that the drugs are safe. The bottom line is that we should He tries To lower our LDL cholesterol as low as possible, but much longer follow-up data is necessary any time a new class of drugs is introduced. So far, so good, but we were just that the next Data for approximately 10 years. For example, we didn’t know that statins increase the risk of diabetes until decades after they were approved and millions were exposed to them. Also worth noting: PCSK9 inhibitors It costs About $14,000 a year.

Doctor’s note

How can we lower cholesterol with diet? See Trans fat, saturated fat, and cholesterol: The tolerable upper intake is zero.

To learn more about statin drugs, see the related posts below.