Cholesterol

July 13, 2004 2:50 PM

What's the truth about cholesterol? I'm afraid to take statins, and don't know who to believe anymore.
posted by mecran01 to Health & Fitness (10 answers total)

1. Get your HDL (H)igh and keep your LDL (L)ow.
2. If heart disease doesn't kill you, it will most likely disable you for life.

Beyond that, you need to ask a more specific question.
posted by mischief at 3:23 PM on July 13, 2004

The NIH Cholesterol Education Project has released new recommendations and has some patient-focused material available, too.
posted by caitlinb at 3:31 PM on July 13, 2004

You need to know things like:
- your LDL/HDL levels
- your blood pressure
- your diabetes risk
- your history of heart disease in immediate family (sibs, parents are important; aunts/uncles less so).

You should know these things anyway, if you don't, get thee to a doctor.

The more of these that are high, the more you are at risk. But YMMV. I have very high combined LDL/HDL (top 5% or something, 400 in US measures), but normal bp, no diabetes, no cardiacs in immediate family. I also have pretty much a meat/dairy free diet and am average or probably slightly underweight. However I am considered high risk, so I am on 80mg Lipitor/day.

Statins are supposed to be good for all kinds of things, btw (too busy to do research now).
posted by carter at 3:37 PM on July 13, 2004

PS: 80 mg Lipitor and my diet reduced my combined count to about 220. Is Lipitor good for you? I think it has pretty low levels of contra-indications, so in the absence of evidence to the contrary, and not wanting to go through the rest of my life with super high cholesterol, I'm going to continue taking it, I think.
posted by carter at 3:44 PM on July 13, 2004

furthermore, I emphatically recommend that you begin with a fractionated lipid profile. The info provided is much more detailed.

In my case, I had 200+ total serum cholesterol and took comfort in also having quite high HDL, but it turned out this was not quite the case.

My doctor, an internist and lipidemiologist, quite conservative in general, feels that in 10-15 years, they will be selling statins over the counter. Many studies show that, for those who can tolerate them, statins are beneficial even for those who don't have high serum cholesterol.

(But I became a vegan instead, and cut my cholesterol by 45%)
posted by Fupped Duck at 4:31 PM on July 13, 2004

I was hoping mecran had stopped in, but since s/he hasn't, I will throw out this question:

Which are you more afraid of? Statins, or a quadruple bypass, two heart attacks, eight stents, ischemia, supraventricular tachycardia, and an implanted cardiac defibrillator?

The latter is my experience. All before the age of 45. Every time I lay in the cardiac ward, the children of my fellow patients are older than I am.
posted by mischief at 5:54 PM on July 13, 2004

I'd add this - I was listening to a discussion of current cholesterol risk factor assessments, for determining whether or not patients should go on statins. It underlined Fupped Duck's point and also noted that while obesity is not currently included in risk factor analysis, this is only so because researcher's haven't yet figured out how to include it. But it's widely accepted as a major risk factor.

Statins can cause muscle pains. High cholesterol levels can lead to mischief's experience. As the "Charmin" lady said, "weigh it for yourself, honey!"
posted by troutfishing at 6:55 AM on July 14, 2004

Also this - why not try the statins and also a parallel course of a dietary regimen and exercise (in consultation with your doctor, of course) ? Eating only a moderate quantity of high quality fats and oils, avoidance of animal fat, dietary sugar, refined carbohydrates, all processed foods, hydrogenated fats (the worst for your cardio system and body), and the consumption of lots of fresh greens and vegetables (rich in antioxidants, organic is preferable) - as well as a moderate daily exercise program - can all contribute towards cardiovascular health and lowered cholesterol.

[ My wife has followed this regimen for years, and doctors are routinely shocked at how low her cholesterol levels are. (She does, by the way, eat cheese and fish, and milk in her daily coffee.) They assure her, however, that these low cholesterol levels do not pose a health risk. ]

There's some evidence, I believe, which suggests that high levels of dietary sugar can contribute to raised cholesterol levels.
posted by troutfishing at 7:08 AM on July 14, 2004

Response by poster: I really asked a terribly vague question, and for that I apologize. I will repost with more explanation once I have built up my karma, but basically there are a lot of researchers out there, and not all of the nutball conspiracy theory variety, who claim that the emphasis on cholesterol is misguided, and that historically people eating non-industrial fats have had lower incidents of heart problems despite their cholesterol levels. They often refer to little known irregularities in the Framingham study, pointing out the large percentages of people with high cholesterol in that study who had no heart problems, then go on to suggest that there is something deeper at work other than just cholesterol.

Finally, there have been statistically small instances of statins causing muscle-wasting diseases that have resulted in death.

My bad, I didn't clarify any of this, but I do appreciate the good information that has been posted.
posted by mecran01 at 7:27 AM on July 14, 2004

mecran01 - maybe acidosis?

But, people who don't eat industrial fats (hydrogenated) would also tend to not eat processed food and to eat lots of greens and vegetables.

It could be that simple - it probably isn't, but I bet that's a factor.

Were you referring to the famous "Nurses' Heath Study"? - I helped process questionaires for that one.
posted by troutfishing at 7:44 PM on July 14, 2004