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How much cholesterol reduction on lipitor
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How much cholesterol reduction on lipitor

I had an MI on Sept 13th.  2 stents in RCA.  Am on Efflient 10mg, coreg 3.25 2x/d, aspirin 325, and lisinopril 5mg, and lipitor  5mg.

I immediately went on a plant based diet.  no animal products at all.

lipids used to be about

Total Chol - 200
Triglycerides - 220
LDL - 120
HDL - 36
was on no drugs.  had similar numbers for many years
BP was typically about 120/80 with a HR of about 65
BP and heart rate now slightly lower.

lipids are now

Total Chol - 110
Triglycerides - 107
LDL - 55
HDL - 37

blood drawn 8 weeks after MI

Questions:  
how much of this drop is likely due to the small dose (5mg per day) of lipitor versus the radical change in diet?
would it make sense to come off  lipitor if I maintain this strict vegan diet and/or total chol stays below 150?

My diet wasn't that bad before, but I was obviously doing something wrong.  

thanks,

peter
Avatar_n_tn
We would expect your LDL would likely be lowered by approx 25-35% with this dose of lipitor (though is variable between patients), so the reduction you describe is likely a combination of both interventions. While aggressive diet modification as your are doing will go a long way to prevent further events and progression of coronary artery disease, I would not recommend stopping the lipitor. We have good data that statin therapy improves outcomes in patients with CAD with improvement seen at even lower dose of cholesterol then you have. We also know that statins seem to have beneficial effects independent of cholesterol reduction including anti-inflammatory effect and possible improvement of the health of the inner lining of the blood vessels.
7 Comments
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Avatar_m_tn
Thank you.    next Sept 13 (2013) will be a year after my MI.   Given what you say about the other benefits of taking lipitor, are you implying that I should stay on liptior indefinitely?   Or is there an optimum period of time?  again, assuming I can keep cholesterol under control by diet alone.
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Avatar_n_tn
We generally recommend you stay on it indefinitely as long as you are tolerating the medication without issues. It is important to say that it is important for you to maintain the diet changes you discussed above. It sounds like you are very motivated to make these changes. Congratulations on what you have done so far and good luck in the future.  
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Avatar_m_tn
I am also on a plant based diet, and although I cannot comment on my cholesterol reduction as I did not have high cholesterol prior to the diet, I can attest to it's BP lowering effects.  Here are my results before and after a year later:

October 2011

Blood Pressure 159/110 (Before medication)
Total cholesterol 104
HDL 47
LDL 37
Triglycerides 104
Glucose 130

October 2012

Blood Pressure 118/63 (No medication)
Total cholesterol 94
HDL 47
LDL 34
Triglycerides 64
Glucose 96

I discontinued BP meds 2 months after starting as BP plummeted quickly.
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Avatar_m_tn
I've read several reviews from folks who have had substantial cholesterol reduction via the plant based nutrition, so my best guess is you should be able to go on "autopilot" with just the diet alone without the statin and get TC<150, but be sure to mention to your doctor what you are doing with the diet.  This plant based diet, if follwed rigorously, will acutally accomplish the same thing as the Lipitor in that it heals the arteries and prevents inflammation from developing without the side effects of medication.
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Avatar_m_tn
I stopped Crestor for 33 days. my lipids were:
TC             139
HDL             35
TRG           126
LDL/HDL         2.3
GLU              88

Now they are:
TC              211
HDL              29  
TRG            164
LDL/HDL         5  
GLU              96  

I did not relax my strict Mediterrean diet nor hard daily exercise.  Now I  take the side of statins in the on-going controversy  on whether they do any good or not.
(I dropped Crestor to see if i twas the cause of my two-year bout of night sweats. I still have them.)        
      
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Avatar_m_tn
let me add: I'm 84, one stent RCA, May 2010
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