STATIN USE IN PATIENTS WITH NORMAL LIPID LEVELS

  I AM A 46 YO WM WHO HAS RECENTLY COMPLETED A CARDIAC WORK UP DUE TO IRRITATING PALPITATIONS.  AFTER A TREADMILL, LIPID PROFILE, AND 24 HR CARDIAC MONITOR, I WAS GIVEN A CLEAN BILL OF HEALTH. I MENTIONED THAT MY HDL LEVELS WERE BELOW NORMAL DURING MY LAST APPT. AND QUESTIONED THE DR CONCERNING INTERVENTIONAL TREATMENT WITH CHOLESTEROL LOWERING MEDS.  I EAT A VERY LOW FAT DIET, EXERCISE 60 MIN / 5 X WEEK (AEROBIC) AND STILL CANNOT GET MY HDL DOWN. MY FAMILY HISTORY IS NOT REMARKABLE EXCEPT MY FATHER HAD TRIPLE BYPASS AT AGE 65, WITH NO PRIOR HISTORY OF HEART DISEASE.  MY TOTAL CHOLES IS 194, HDL 29, VLDL 38, LDL 127, AND TRIGLYCERIDES 190. THESE NUMBERS HAVE REMAINED THE SAME FOR YEARS.  THE CARDIOLOGIST STATED HE WOULD TAKE A STATIN IF HE HAD THESE LAB RESULTS AND HX.  HE PRESCRIBED LIPITOR 10MG.  
  SHOULD I TRY MORE EXERCISE OR NIACIN ETC TO TRY TO REDUCE MY CHOLESTEROL AND RAISE MY HDL???
  AT 46 I MAY BE ON LIPITOR FOR 30 YRS OR MORE....IS THE RISK OF LIVER DAMAGE SIGNIFICANT FOR SUCH LONG PERIODS????
  DO I HAVE ANY ALTERNATIVES TO REDUCE MY RISK OF HEART DISEASE????    

[Cleveland Clinic, MD]

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Dear Robert,
Thank you for your question. We can not make specific recommendations on individual drug therapy.  I would comment however that a LDL of 129 and a HDL of 29 is not normal.  Specific treatment be it exercise and diet, niacin, or a statin such as lipitor is up to your doctor and you.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.