Cholesterol-lowering medication: Yes or No?

[macro]

My most-recent annual blood test showed that I have a total cholesterol level of 272, with triglycerides at 187 and HDL at 47. This is the third annual test in a row where my total cholesterol has been above 250.

Family members are insisting that I let the doctor put me on statin drugs (Lipitor, Crestor, etc), but I find some online opinions (and one given to me by a chiropractor friend) that counter that the meds do as much harm as good, and that the whole cholesterol fear-thing is propaganda from drug companies.

I am 6'1", 205, with 33" waist, and although I could stand to lose 20 pounds, my doctor says that probably won't do the trick for me. The only physical activity I get is occasional home maintenance and lawn work, but I've read that exercise alone, even if done right (8-12 miles walking per week is the baseline), will only reduce cholesterol by 10-20% or so, which won't be enough for me.

According the the doctor, my problem is genetic. So while the standard "diet and exercise" advice will help "some", it appears that drugs are the only way to reduce my cholesterol as much as it needs to be reduced.

I'm not sure what to do. I don't want to be on a medication every day for the rest of my life, but I don't want to have a heart attack, either.

Opinions?

[BoydsOfSummer]

Doc put me on Lipitor after heart surgery last year. It keeps mine in check pretty well. He told me, "This is going to save your life".

[Rojo]

I'm 41 and it seems that every male friend of mine of similar age has been put on some sort of statin. I'm overdue for a physical and I fear I'm going to have to make this decision.

I'm skeptical. How can it be that we all need these drugs now? How did our fathers and grandfathers live 70+ years without them?

[SMcGavin]

I'm 41 and it seems that every male friend of mine of similar age has been put on some sort of statin. I'm overdue for a physical and I fear I'm going to have to make this decision.

I'm skeptical. How can it be that we all need these drugs now? How did our fathers and grandfathers live 70+ years without them?

The obesity rate in 1980 was around 10-15%, today it's close to 30%. Obesity and high cholesterol go hand in hand, so there's one big reason why more people need cholesterol lowering meds. And despite less healthy lifestyles now, people are living longer than ever before. Preventative meds like statins play a big role in that.

I suppose nobody technically "needs" a statin, it's not something as clear cut as a guy with a ruptured appendix who will live with surgery and die without it. But going on a statin makes you less likely to have a coronary event. Unless there are major undesirable side effects (and with statins there typically aren't), that seems like a plenty good reason to take the drug.

[15fan]

18 months ago, I was your height & weight. I'm now your height less 20 lbs.

Drop the 20 and you'll be amazed at how much better you will feel.

Ratchet up the cardio-vascular exercise, and make a few life-style changes. You'll be amazed at how the weight will come off once you get going.

[Rojo]

The obesity rate in 1980 was around 10-15%, today it's close to 30%. Obesity and high cholesterol go hand in hand, so there's one big reason why more people need cholesterol lowering meds. And despite less healthy lifestyles now, people are living longer than ever before. Preventative meds like statins play a big role in that.

None of my three friends is obsese. And I don't know about people living less healthy lifestyles. They're certainly fatter but my grandfathers's generation polished off two packs a day and drank scotch like iced tea.

[gm]

I'm taking gemfibrozil (sp?) to keep the triglyceride level under control, but I would refuse the statins if prescribed. I got a free exercise bike off of craigslist and I can ride that and watch TV or listen to podcasts. The goal is get your heart rate up around 120-130 bpm for at least 20+ minutes per day. That's really not too tough and it'll bring your bp down

And more fiber intake will help with the chloresterol, that's a lot healthier/cheaper than medication. I've rediscovered grape nuts with a sliced banana after 35 years...and Subway has replaced junk food

Good luck, it sucks to get old when you've got to work to "stay even"

[BoxingRed]

Pharmacy student (again, this is not professional advice, I am only a student) says take the drug. The side effects are extremely rare and you really only stand to benefit.
Now, if you can really make the lifestyle change i.e. cut saturated fat and SUGAR from your diet, eat healthy portions while increasing your fiber and fruit and veggie intake, and get regular exercise, you should try it. Just know that doing all these things may not lower your LDL. Sometimes it's genetic and the body just produces a lot of cholesterol.
Please, do not take what you read on the internet to be, necessarily, true. Doctors and pharmacist really do have specialized training and knowledge and, usually have your interests and not the drug company's interest in mind when prescribing a medicine.

Lastly, see if your MD will try you on Zocor or pravastatin first. They come in generic and may do as good a job at a much cheaper price. While they may have good reason, I think MDs skip the drugs with generics too quickly. I think they fail to realize that you are more likely to take a med that costs you 5 bucks vs $30. (And that's if you have insurance.)

[Will M]

statins have been proven to lower the risk of myocardial infarction (heart attack), stroke & death. they are generally very safe unless you have something wrong with your liver or are a heavy user of alcohol. they are not drug company propaganda but rather one of the greatest medical discoveries of the late 20th century.

Rojo: our fathers and grandfathers did not live 70+ years without them. they clogged up their arteries and died young. the reduction of death in middle age from heart disease is a major reason we are living longer.

macro - your LDL is ~188. very high. if you have other risk factors for heart disease (genetics, diabetes & smoking are the big ones) your goal LDL should be under 100 (maybe under 70). even if you have no other risks for heart disease your goal LDL should be under 130 (maybe under 100)

[Roy Tucker]

I've bee taking Lipitor for 7-8 years. My chloresterol level had been steadilty climbing over the years and my doc had been saying its a just a matter of time for a while. Its a hereditary thing with me, even when I was in the best of shape, my levels were high.

As far as how people lived without it, both of my grandfathers died of heart attacks in their mid-50's. And if it hadn't been for bypass surgery, my dad ould have been dead about then too.

[Rojo]

Rojo: our fathers and grandfathers did not live 70+ years without them. they clogged up their arteries and died young. the reduction of death in middle age from heart disease is a major reason we are living longer.

Not all of them did, yet it seems that every man over 35 is put on a statin. Am I the only one who finds that odd?

[BoxingRed]

Not all of them did, yet it seems that every man over 35 is put on a statin. Am I the only one who finds that odd?

I see where you are going with that, but what is the conspiracy and who is in on it?
As has been pointed out, they can dramatically lower the risk for heart problems and they have very few side effects. As an explanation to your question, it's preventative medicine. Sometimes it's better to take a small risk with a med if it will keep something dramatic from happening later on. The cool thing about modern medicine is that we don't always have to wait till your clutching your chest with a no feeling in your arm to try and solve a problem.

[Will M]

Not all of them did, yet it seems that every man over 35 is put on a statin. Am I the only one who finds that odd?

lets say you have 100 men age 40 with cholesterol levels that doctors feel are too high. 20 out of 100 will live to old age and never have a cardiovascular event. but 80 out of 100 will clog their arteries prematurely.
some will die very young ( 1 out of 4 people don't survive their first heart attack). so far medicine has not been able to determine if you are one of the 20 or one of the 80. so the recommendation to all 100 men is to take a statin.

[Rojo]

I see where you are going with that, but what is the conspiracy and who is in on it?

Although I don't think the relationship of doctors and pharmaceutical companies is the healthiest thing in the world, I don't see a conspiracy.

I was thinking something closer to Will's explanation. Its a shotgun approach. That has its merits. And what's the harm? But I'm always leary of pharmaceuticals. In my experience, one pill leads to another.

I'm also not satsified with the cholesterol-heart disease correlation. Not saying there is no link but I want to know whats different in those men with high cholesterol who don't have a heart attack.

[BoxingRed]

I'm also not satsified with the cholesterol-heart disease correlation. Not saying there is no link but I want to know whats different in those men with high cholesterol who don't have a heart attack.

To answer that question, I think one would need to go into the explanation of how high levels of cholesterol can contribute to various diseases. If you want, I can do that.
Before I got into school, I often wondered about that relationship.
Without getting into the technical aspects here is what a medical professional said to me once, "Have you ever heard of anyone dying from taking a statin or even having a serious complication? No? Well have you ever heard of some one with high cholesterol having a heart attack? Yes? Well then you tell me, what is the smart choice?"
Now that is a gross simplification of the facts and science, but it summed things up pretty nicely for me.