Your Weekly Checkup: Learning from Nature to Reduce Cholesterol

“Your Weekly Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive. 

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Nature has much to teach us if we are smart enough to listen.

For example, in 1928 an English doctor named Alexander Fleming returned to his messy hospital lab after a long vacation. He noted that a mold growing in the dish containing Staphylococcus bacteria had inhibited growth of the bacteria. The name of the mold? Penicillium. Louis Pasteur said, “Fortune favors the prepared mind.” Fleming’s mind was prepared and nature led him to the birth of antibiotics, revolutionizing the treatment of infections.

In modern times, statin drugs that reduce cholesterol, especially the “bad” LDL cholesterol, have revolutionized treatment of atherosclerosis, the fatty cholesterol build up in arteries that leads to heart attacks and strokes. But what if the cholesterol buildup is so great, it overpowers the statin effect? Are there other choices?

Yes, because nature opened another door likely to precipitate another revolution.

In 2005, a study found that a specific group of African Americans had very low cholesterol levels and virtually no heart disease. Researchers sought the reason and established that these people were born with a specific gene that was underperforming and was responsible for their low cholesterol. Scientists set about creating a drug that could block that gene, to reproduce nature’s experiment.

They created a new medicine, evolocumab, that opposed the gene’s function. In a recent study of over 27,000 individuals with preexisting atherosclerotic cardiovascular disease, almost all of whom were already taking a statin, those treated with evolocumab had a major drop in cholesterol—particularly the bad LDL cholesterol—to low levels never seen before, with a significant reduction in heart attacks and strokes. The downside is that the medicine is expensive and must be administered by injection. Nevertheless, nature has opened the door to an approach potentially more powerful than statins in preventing heart attacks and strokes.