cholesterol meds

  I have a family history of CAD and am considered a high risk, right now my cholesterol levels are within normal range but because of my history my DR has recommended a statin I cant take NSAIDs because i have active crohns disease and thats the other problem I bleed internally. What are my options? No aspirin and no blood thinners?

[Lee Kirksey, MD]

First, the issue of family history requires some explanation. The current recommendations are for the treatment of high risk patients with LDL>130. High risk is defined as a first degree (mother, father, brother, sister) male with heart disease at age <55 or female <65 with heart disease.  The goad is to treat the LDL down to 100. The recommendations are that this may be attempted with lifestyle changes before medication is initiated to treat cholesterol. So the breakdown of your cholesterol is more important than your total cholesterol in this particular case.

Depending upon the exact level of your LDL and any other risk factors ie diabetes, claudication, smoking, weight....diet/nutritional manipulation to decrease your fat intake and increase fruits vegetables might be an options

given your Crohns disease, diet may be a feasible alternative since Im sure that you are conscious to control that problem. The other question I would have is if you're on any medication for IBD which might increase your cholesterol like a steroid.

Although aspirin has been shown to decrease your risk of heart attack or stroke, it does not affect your cholesterol level.  My impression is that a mediterranean diet is your best option. Good luck