Is Lipitor Indicated?

[jermartin]

My daughter has just been told by her doctor that she needs to go on Lipitor. She is 43, is 5ft 2in, weighs 120 lbs and exercises daily.  She has no current  health problems.   Her  total cholesterol was 226. The HDL is 55, LDL is 155 and the triglycerides are 76 Most of her life her total cholesterol has ranged between 196 and 226.  Her doctor has not recommended a low fat diet, or other changes other than Lipitor.  
What would you recommend?  Should she get a second opinion prior to beginning Lipitor?

Her family history is that I have high blood pressure and cardiovascular disease. My total  cholesterol was always below 150 without medication. Her mother’s total cholesterol has always been 220 – 240 without any adverse affects to date.
Thank you.
Jerry

[CCF-M.D.-RCJ]

Jerry,

Thanks for the post.

The decision to go on a statin drug, like lipitor, is not as simple a decision as it might seem.  I generally use a rule of thumb -- prescribing the drug when a person has high cholesterol plus one other risk factor.  You did not name a second risk factor, but that does not mean that one does not exist.

Several web sites have risk calculators that can help in the decision.  Check out http://www.nhlbi.nih.gov/about/ncep/ as a starter.

Good luck.

[HealThySelf]

From my personal experience, I would say that HDL is the most important predictor of future coronary artery disease.

Your daughter is in good shape with 55.

She seems to be normal weight and fit, but perhaps can get TC below 200 by taking as much meat and dairy out of her diet as possible.

If not, a low dose of a statin like Lipitor would definitely do the job.  She might also try an LDL absorbtion blocker like Zetia.  If there are no apparent side effects, either would probably be beneficial.

[heartbeat]

If I had your daughters numbers I would not go on Lipitor yet, I would first try a fat-free diet, cut down on dairy and red meat, do daily exercise and see what happens.  Her ratio is 4.1 (total divided by HDL) which is still good.  Ratio should not be above 4.5.