Dr. Keith Roach
Dear Dr. Roach: I’m64 and thin, on no medications and hadmy bloodwork done. Cholesterol showed 226 total, HDL 77, triglycerides 79, LDL
131, glucose 94. My blood pressure is usually about 90/60, and I have never smoked.
My doctor wantsme to go on a statin, which I know is not good. 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 powerful way to reduce the risk of heart attack and stroke; however, 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. For people without a history of cardiovascular disease or cerebrovascular disease, a good tool is a risk calculator.
Using the AmericanHeart 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 result, a statin would generally not be recommended, although there are conditions that increase risk of heart disease that are not considered in the calculator.
Almost everyone can reduce their risk of many diseases, not just vascular disease, by eating more plants and less meat, reducing simple sugars and starches, and having a diverse diet.
I recommend thinking of statins as a way to decrease heart disease risk. Blood cholesterol is just one part of risk. Your age and sex, and low blood pressure are helping to protect you, but youmay 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.
Dear Dr. Roach: I tested positive for COVID about six weeks ago. I had very mild symptoms for about 24 hours. I lost my sense of taste and smell. My senses are slowly returning, but now I constantly have a strange taste in my mouth. I can’t tell if it’s a metallic taste or not. Eating, drinking, chewing gum, brushing, etc., make it go away for 10 minutes. Is this COVID-related or something else? Will it go away?— M.R.
Dear M.R.: While I can’t answer with certainty, many people with COVID-19 have disturbances in taste and smell that take weeks or months to resolve. Based onmy experience with these patients, I would guess your disturbance is most likely COVID-19 related, and is likely to go away in time.