When is Cholesterol Medication needed?

My husband (who is 54 yrs. old, eats a very healthy diet & and is not over weight) had his cholesterol checked the other day and got back his results today. His total cholesterol is 233 and LDL is 157. They told him that he is borderline high and that if he wants, he can have a prescription to lower it. Since they have left the decision up to him, it would be nice to now exactly when medication is warranted. Do you think that he should take cholesterol medication at this time? Or should he just keep an eye on it? We want to make the right decision.

[kenkeith]

The ACC/AHA guidelines are the following:

The goal for lipid management is low-density lipoprotein cholesterol (LDL-C) level less than 100 mg/dL. If triglyceride levels are 200 mg/dL or higher, the goal for non–high-density lipoprotein cholesterol (HDL-C) levels are less than 130 mg/dL. All patients should start dietary therapy, reducing intake of saturated fats (to  10 g/day) to further lower LDL-C; daily physical activity and weight management; and increased consumption of omega-3 fatty acids from fish or in capsule form (1 g/day), with higher doses for treatment of elevated triglyceride levels.

The above may be somewhat aggressive if your husband is not a heart patients.  My cardiologist has me on medication  that has reduced my chol 115 and LDL 58.  Chol was 168, LDL 98 prior to a lipid med regimen.

[Flycaster305]

Does your husband do cardio exercise daily?  That would help lower his cholesterol level.  That being said, I put off taking a statin drug when I had similar and higher numbers, and paid a huge price for my decision, I experienced multiple heart attacks and stent applications.  When my son had high readings like your husband, I strongly urged him to go on statin therapy.  Be sure and have frequent blood tests at first to be sure the side effects aren't there.  

[madjlp]

I'd try the "natural" route for a month or two to see if it does the trick and then re-evaluate - soluble fiber through daily oat bran (oatmeal or another route) and exercise are both well documented but you can research other options (phytosterols etc).  If you want to get more aggressive you could try extended release niacin which has a great profile for cholesterol reduction and is generally considered less invasive than statins (the sig risk is that it beats up your liver a little so if your husband has liver disease then naicin is out).  The book the "8 week cholesterol cure" offers a good practical plan if you want some specific guidance.  Best of luck.

[erijon]

I would start with exercise and diet, but if I did not see any change soon, like 30 - 60 days I would not hesitate taking meds. If he has other risk factors, especially family history, smoking, diabetes or weight issues I would be on meds now. I went on meds several years ago when I had a TC of only 220, but nothing I did helped lower it so I went on meds, I was not willing to wait until my arteries got blocked. Also, he should be exercising as well, it will help his numbers. The AHA reccommends 30 mins of moderate exercise most days of the week. I do as much as an hour a day on a treadmill and it has made a huge difference in my life. With meds and exercise, I was finally able to move my cholesterol down to 151 with an LDL of 58 and HDL of 40, all with NO side effects.

Hope some of this helps!

Jon