Should I be on cholesterol lowering medication?

Cardiovascular disease is the leading cause of death in both men and women. In fact, more women than men die every year from cardiovascular disease. Five times the number of women will die from stroke or heart disease as compared to breast cancer. The Framingham study over over 50 years ago identified the risks for developing heart disease including age, sex, family history, hypertension, tobacco, diabetes, obesity, sedentary lifestyle and high cholesterol.

Today the focus is on cholesterol, which is necessary for the production of hormones and the structure of cells. The body can manufacture all the cholesterol it needs. The level of our cholesterol is influenced by the amount of food we eat that has saturated fats (animal fats and diary products), processed foods that contain trans fats (read the food label), foods high in cholesterol (eggs) and the quantity of food we eat. Obesity is of epidemic proportion and significantly increases the risk of diabetes, high blood pressure and high cholesterol. Lifestyle is the foundation for cardiovascular risk reduction. The first step is to walk 45 minutes daily, attain an ideal weight by focusing on your portion size, and limit calorie dense food high in sugar and fat.

This year the American Heart Association and the American College of Cardiology published the latest recommendations for cholesterol management in adults. All people over the age of 21 should have their lipids (cholesterol) checked and if normal repeated every 5 years. The first step, if you are between 40-79 years, is to calculate your 10-year risk for having a heart attack, stroke or peripheral vascular disease. You should be treated with statins – cholesterol lowering medication – if you have established cardiovascular disease, LDL cholesterol greater than 190, diabetes or a 10-year risk that is greater than 7.5 percent of developing atherosclerotic cardiovascular disease treated. If you are between 21 and 40 years of age, you can calculate your lifetime risk for developing cardiovascular disease.

You should review your risk with your primary care doctor to determine whether you might benefit from the use of statins to lower your cholesterol and decrease your risk for developing cardiovascular disease.

The intensity of statin therapy will depend upon your risk for developing cardiovascular disease. Follow up blood tests will be required to see if you have achieved the expected cholesterol lowering.