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Question
Posted by: Linus | 2011/05/18

Cholesterol drugs

Dear Dr - I am a 54 year old male and the only meds I am on is Purbloka for arrhythmia. However my cholesterol level is a concern and is improving due to diet changes. I have tried taking cholesterol lowering drugs that contain statins and without fail they all leave feeling exhausted as if I have had no sleep and aching legs etc. The side effects are so bad I have no choice but to stop taking them or I would be to work. Are there any new drugs on the market that you think might help for me?

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Our expert says:
Expert ImageCardiologist

Hi Linus.

Cholesterol lowering drugs have most potential benefit for those at highest risk, so the first thing to do is establish how high your overall risk (of coronary and other vascular disease) actually is - bearing in mind that your risk depends not just on your cholesterol level but also on a number of other "risk factors" such as blood pressure, etc, etc.

So a decision about treatment should depend on the answers to questions such as: How high is your cholesterol actually? What are the LDL ("bad") and HDL ("good") levels? Do you have a family history of coronary disease? Do you smoke? Are you diabetic? etc etc

A good way to estimate your risk even more accurately would be to have a "coronary calcium score" done, (a simple CT scan without conrast) which will tell you how much actual "hardening of the arteries", if any, you have at age 54.

If very little, or none at all, your risk is low, and depending on the answers to the other questions I mentioned you could argue that you do not need tablets to reduce a risk which is already low.

If on the other hand your calcium score is high, and your risk therefore also high, you would potentially benefit from a cholesterol lowering drug. Alternatives to statins include fibrates, nicotinic acid, and ezetimibe, but I would suggest you see a cardiologist or physician interested in the primary prevention of coronary disease to help you make an informed decision about whether you need drug treatment, and if so which drug. What you do now may have an impact on the condition of your arteries 10 or 20 years from now.

Best wishes

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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Our users say:
Posted by: Cardiologist | 2011/05/31

Hi Linus.

Cholesterol lowering drugs have most potential benefit for those at highest risk, so the first thing to do is establish how high your overall risk (of coronary and other vascular disease) actually is - bearing in mind that your risk depends not just on your cholesterol level but also on a number of other "risk factors" such as blood pressure, etc, etc.

So a decision about treatment should depend on the answers to questions such as: How high is your cholesterol actually? What are the LDL ("bad") and HDL ("good") levels? Do you have a family history of coronary disease? Do you smoke? Are you diabetic? etc etc

A good way to estimate your risk even more accurately would be to have a "coronary calcium score" done, (a simple CT scan without conrast) which will tell you how much actual "hardening of the arteries", if any, you have at age 54.

If very little, or none at all, your risk is low, and depending on the answers to the other questions I mentioned you could argue that you do not need tablets to reduce a risk which is already low.

If on the other hand your calcium score is high, and your risk therefore also high, you would potentially benefit from a cholesterol lowering drug. Alternatives to statins include fibrates, nicotinic acid, and ezetimibe, but I would suggest you see a cardiologist or physician interested in the primary prevention of coronary disease to help you make an informed decision about whether you need drug treatment, and if so which drug. What you do now may have an impact on the condition of your arteries 10 or 20 years from now.

Best wishes

Reply to Cardiologist

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