Do I need a statin?

[menomom54]

I am recently post menopausal. My Cholesterol is 275 , rose up 25 points since last year,. Other numbers about the same although HDL went up 10 poiints since last year. So now- LDL 150, TG 89, HDL107, ratio 2.57. I am not overweight and watch my diet.

I exercise 4 days a week. My primary care MD said I am not ready for a statin. I went for a cardiology consult and he saw minimal plaque on my right carotid artery. How do I know it has not been there forever and has not changed?
I was put on lipitor 10mg and started to get headaches. I have been cutting the pill in half now so taking 5mg daily.
Still getting headaches but better. Have only been on it a few days.
I guess my question is, is it possible to stay off statins and just monitor the carotid artery for more plaque accumulation.

[CCFCardio MD2]

Thanks for the question, this is an important one and comes up a lot.  Your cholesterol is high, as is your LDL.  But an LDL of 150 is not terrible in someone with no risk factors for coronary artery disease.  Your HDL (good cholesterol) is very high which is good.  Don't worry about the carotid plaque, it sounds less than concerning.  If you already exercise rigorously and have a good diet, a low dose statin might not be a horrible idea to get your LDL lower.  In general, the lower the LDL the better (to a point), but we don't aggressively push meds on patients unless they have coronary artery disease or significant risk factors such as diabetes and hypertension.  If the statin you are taking is not sitting well with you, try switching to a different brand.  The side effect profile is often different.  Best of luck to you!

[menomom54]

Thank you both very much for your replies. I will talk to my caridologist about switching the statin. I was curious if you could reply regarding your experiences with Crestor. I have heard good things regarding this medication. I am guessing they work differently in your body.

[wh2399]

I think you made the right decision starting on the statin.  275 is too high irregardless of the HDL, LDL, ratio, etc.  A study was done on 2 groups of patients one with high HDL, the other low HDL and they had the same degree of coronary disease.  The current metric seems to be getting  the total <150 and the LDL < 80-100.  Don't worry about the HDL, just focus on the total and LDL.  Yuo might also consider a plant based diet as it has been proven very effective at lowering cholesterol.  I've been on this for one year and saw remarkeable changes in my BP.