From the Guidelines
Lowering cholesterol levels is crucial for reducing the risk of cardiovascular disease, but there is no direct evidence that it affects cancer risk, as stated in the American Cancer Society guidelines 1. When considering the relationship between C15 and cholesterol, it's essential to understand that C15 is a synthetic compound that inhibits cholesterol synthesis. The most recent and highest quality study 1 suggests that lowering blood cholesterol levels, particularly LDL-C, is critical for reducing the risk of atherosclerotic cardiovascular disease (ASCVD). Key points to consider include:
- Elevated LDL-C is a significant risk factor for ASCVD, and reducing it can lower the risk of cardiovascular events 1.
- The relationship between cholesterol levels and ASCVD risk is continuous, with lower levels associated with reduced risk 1.
- There is no evidence to suggest that lowering blood cholesterol has a direct effect on cancer risk 1.
- C15, as a potential cholesterol-lowering agent, may offer benefits in reducing cardiovascular risk, but its impact on cancer risk is unclear and not directly related to its cholesterol-lowering effects 1. Therefore, the primary focus should be on managing cholesterol levels to reduce cardiovascular risk, rather than specifically targeting cancer risk 1. In clinical practice, this means prioritizing evidence-based cholesterol-lowering therapies, such as statins, and lifestyle modifications, including dietary changes and increased physical activity, to reduce the risk of ASCVD 1.
From the Research
C15 and Cholesterol Relationship
- There is no direct mention of C15 in the provided studies, however, we can discuss the relationship between cholesterol and various treatments.
- Cholesterol levels are regulated by its synthesis, absorption, and elimination 2.
- Plasma levels of phytosterols and ratios of these sterols to total cholesterol correlate with efficiency of intestinal cholesterol absorption, whereas levels of certain cholesterol precursor sterols correlate with cholesterol biosynthesis 2.
Effects of Treatments on Cholesterol Levels
- Statins have been proven to effectively reduce the risk of atherosclerotic cardiovascular disease (ASCVD) and are recommended as a first-line therapy for the primary and secondary prevention of ASCVD 3.
- Ezetimibe, a cholesterol absorption inhibitor, leads to additional LDL cholesterol reduction and decreased ASCVD risk when added to statin therapy 3, 4.
- PCSK9 inhibitors, such as alirocumab and evolocumab, have been approved to lower LDL cholesterol levels and reduce ASCVD risks when added to maximally tolerated statin therapy 3, 5.
Dietary Treatment to Lower Cholesterol
- Dietary measures to lower levels of LDL-C and triglyceride and reduce cardiovascular risk include minimizing saturated fats and refined carbohydrates, eliminating trans-fat, and increasing fruits, vegetables, whole grains, low-fat dairy, and fish or other omega-3 fatty acids 6.
- Adhering to a Mediterranean diet is strongly recommended because of lowering CVD and total mortality 6.