I am 67 years old and have been taking simvastatin for 10 years. I started when a cardiologist put me on simvastatin and crestor for a cholesterol level of 225. She advised I would have to take them for the rest of my life. I thought that was kind of aggressive at the time. My level was brought down to 160.
My internist who I have been seeing for three years questioned me about my family history.
My dad had angina at 57 but had low cholesterol, while my mom had over 300 cholesterol but never developed any heart problems. Neither died from heart problems.
He told me that cholesterol causes calcification of your arteries but that is not true with many individuals. He recommended that I get a calcium score study to measure the calcification in my aorta and carotid artery, My calcium score test was low for my age and he believed that if I have a low calcium score I should stop taking meds for cholesterol. He further stated I should take the calcium score study every two years to insure the calcium score remains low. After stopping simvastatin for 6 months my cholesterol is back up to 229
Is my doctor's belief that cholesterol is only a number and that if you are not prone to calcification of your arteries you shouldn't take meds sound and in line with current medical knowledge??
This is an interesting and somewhat complex question without an easy answer. It is true that cholesterol plaques in the coronary arteries are often associated with significant calcification and that higher calcium scores are associated with presence of coronary disease. With that said, some people have significant cholesterol plaque in the absence of significant calcification (with low calcium scores). While low calcium score is a very good thing, it is not the only factor in determining need for treatment of high cholesterol. Other factors like family history or coronary disease, age, h/o high bp, smoking, and diabetes should also factor into this equation. Also current guidelines of cholesterol management do not factor in calcium score into the determination of whether treatment is needed for high cholesterol. While having a low calcium score suggests lower risk of having significant plaque accumulation, it is not the only factor and we do not generally use this as the sole factor to determine need for cholesterol treatment. In regards to need for repeat calcium scoring, there is no current guidelines that I know of that would recommend biannual calcium scoring. Calcium scoring is a fairly new thing and different doctors use it in different ways. I would recommend having a discussion with your doctor about what other risk factors you may have for coronary disease. I hope this helps.
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