Statins are important, but so is change in diet

Dear Dr. Roach: I’m 64 and thin, on no medications and had my bloodwork done. Cholesterol showed 226 total, HDL 77, triglycerides 79, LDL 131, glucose 94. My blood pressure is usually about 90⁄60.

My doctor wants me to go on a statin. I want to try adjusting my diet. Are these levels so high that they warrant a statin? Should his first course of action be to suggest changing diet? — J.F.

Dear J.F.: Statin drugs are a way to reduce the risk of heart attack and stroke in people at higher risk for developing them; however, they have the potential for adverse effects. They should be used only when the benefit of taking them is expected to be greater than the risks. Nearly everyone with known heart disease or history of stroke due to blockages in the arteries should take a statin if they can tolerate it.

Using the American Heart Association calculator at cvdrisk.com, the best guess of you developing heart disease or stroke in the next 10 years is 2.3%. Based on this, a statin would generally not be recommended, although there are conditions that increase risk of heart disease that are not considered. Other medical conditions and preferences need to be considered.

Almost everyone can reduce risk of diseases by eating more plants and less meat, reducing simple sugars and starches, and having a diverse diet.

Blood cholesterol is just one part of risk. Your age and sex, and low blood pressure are helping to protect you, but you may someday still benefit from a statin. If your cholesterol and blood pressure numbers stay the same as they are now, a statin may be in your future in 10 years.