Pravochol

[lawrence]

I am 35 years old, 5'7", 160#, no real significant history of heart problems in my family, I eat very very well, and I am quite active.  With two kids, a large piece of property, and a job that keeps me running (not a desk job) I am surprised that my cholesterol is high.  I am taking 20mg Pravochol, and it had dropped my overall to about 170.  The good cholesterol is not very high, and the bad cholesterol is high (I can't recall exact numbers) At my most recent blood test, my overall was back over 200!!  So, I am back to eating like a bird, although my diet was never bad.  My tryglicerides (sp?) are very very low.  My question is this:  1) why is my cholesterol high?  2) what is the long term harm of pravochol? (besides my wallet)  3) I have always been the "sore in the morning" type - how do I know if the soreness is related to the pravochol, and therefore a problem?  4)am I really at risk for heart trouble?  BTW - I do not smoke, and I do not drink, except for the very rare cocktail (average 1 beer per 2 weeks, and one manhattan per week) - thank you for your time

[Cleveland Clinic, MD]

Dear Lawrence,
Unfortunately however well you are able to pick your food choices you can't pick your parents.  One of the most important determinants of cholesterol is genetics and your genetic code programs for a higher cholesterol level.  If you were living 10,000 years ago this may have had some survival benefits early in life (of course almost everyone was dead by the time they reached the ancient age of 35).  In the 21st century however your cholesterol level presents some problems.  It is very clear that there is a direct relationship between cholesterol levels and the risk of stroke and heart attacks. This risk is reduced with cholesterol lowering medication.  The side effects of the 'statin' drugs such as pravachol include elevated liver enzymes and rarely myositis (muscle inflammation).  There are no known long term side effects of these drugs after 12+ years of trials.  The muscle soreness associated with myositis is severe and does not go away as the day progresses. Smoking of course is one of the major risk factors for developing heart disease and moderate drinking may actually reduce the risk slightly.

[stevebu]

bad genes is probably the reason for your high cholesterol.  My cholesterol was 230, but I have been on a running program for the last 7 months.  I am now up to 40 miles per week.  My weight has dropped from 190 to 173.  I will check it again to see if it is still high, and if it is I will also start taking meds.  Someone told me that you can only decrease your cholesterol by 10% with exercise, but I hope they are wrong.  Good luck to you.

[Bill Serrahn]

In my opinion, having a low HDL is perhaps the most dangerous of the problems that you have mentioned.

I have a familial HDL deficiency.  Looking back, I can see that it was perhaps the most important predictor that I would develop coronary artery blockages and have a heart attack.  Both my brother and myself have had low HDL readings.  My mother had coronary artery disease, bypass surgery at 57, and died of heart failure at 64.

The statin drugs such as Pravachol can lower your LDL, which is important, but will do little to raise your HDL.  I take Lipitor, which has been much more effective than Pravachol was, in my case.  I would advise it as a precautionary drug for anyone at risk.

The best known way to raise your HDL is exercise.  Although you work hard, it is probably more stress than aerobic exercise.  I would advise daily walking or hiking of at least 3 miles.  Put as many hills in your route as possible.  I have raised my HDL about 10 points through walking, hiking, skiing, and mountain climbing.

If you have even moderately high blood pressure, start treating it.  ACE inhibitors such as Altace or Zestril are proven to improve the health of the heart and coronary arteries.

Knowing what I know now, after having a heart attack, I would have been on a low dose of Lipitor and Altace/Zestril 15 years ago(had they been available) as well as changed all of my eating, exercise, and work habits.

Good luck and don't end up plugged up!

[Buzz]

I also can't aford the cost of the drugs.  So my doctor checked into different drugs that I could take at a lower doze to help keep my cholesterol from going back up. (Total used to be 269 now total is 198) He looked mostly at the triglyceride, which I have gotten down to 117.  So he took me off the 10mg Pravochol and put me on 10mg Lipitor.  The Lipitor I then cut into half and take only 5mg a day.  That way the cost is  way down for the month.  My choleserol is still holding at the same level.  But with the decrease you have to be careful to watch your diet and to exercise.  Sounds like you could also ask about Lipitor.

[hktat]

It sounds like some of you know a lot about the different drugs.  I've been on Zocor for a year and at first it helped but then my numbers went up again so they increased the Zocor.  I don't know yet how it's worked or for how long.  But what is the real difference between the zocor - pravachol - lipitor?  Thanks