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cholesterol drug Lipitor

cholesterol drug Lipitor

Would you recommend Lipitor for the following patient?

Female, age 66,No CVD risk factors[smoking, obesity, high blood pressure,etc.}
exercises regularly and eats a very healthy diet( Her husband is a retired college professor of Nutrition and fitness}
Her Lipid profile is:
Homocysteine: 9
HS-CRP: 1.94
Totral Cholesterol 250,HDL 69-77{last 2 years},LDL150, Trig 157

In my search about Statins I have become skeptical about its use. It seems the pharmacuetical companies are driving the low LDL craze. In an email from Dr. Antonio Gotto, he places much more emphasis of HDL and says when Pitzer's patent is up they plan to push HDL drugs(ijf they can). I also received an email from Dr. Kilmer McCulley, who discovered the connection between Homocystein and CVD.   He is much more skeptical than I and feels arterial inflamation (inflammation), not choesterol is the problem.  For older people , especially women, a high cholestereol is associated with lower mortality.
I obviously lean to focusing on a healthy lifestyle as opposed to statins.  Keeping an open mind I would very much appriciate your take on the situation as well as your second opinion on my wife.
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Avatar_n_tn
    I had this discussion with my cardiologist two days ago during my routine exam.  At his suggestion he doubled my lipitor three months ago to 40 mg/day.  Previously, overall cholesterol was 148, but the most recent test since the increased dose was 113, with LDL at 60.  He was pleased and said the goal is to see LDL's under 80.  
     He confirmed what I have been reading from other sources about statin drugs.  He said there is overwhelming evidence that statins work and do help people live longer and better.  I asked the same question about niacin, which I also take to supplement the Lipitor.  He said that niacin can have an effect in reducing cholesterol and/or raising good cholesterol, but studies do not show it affects long term outcomes.  He said some studies have shown a slight benefit, however, most do not.      
    After reading Arthur Agatston's book, "The South Beach Heart Program," and learning the components of "aggressive prevention" of heart disease, I have become a believer.  
   One caution:  There are people who post on these forums who I believe do an extreme disservice by trying to scare people away from statins.  True, some do not tolerate statins.  The overwhelming majority do.  We know statins are important in the prevention of heart disease, and Lipitor is one which the FDA allows it to be advertized as a drug that prevents heart disease.  
   My message is very simple:  Listen to your doctor.  If your physician is a family practice person, most are well up to speed on statin therapy.  Cardiologists are especially so.  When it comes to health care, and especially prevention of heart disease, be aggressive--and pay attention to the experts.    
    Now regarding my opinion--which please understand is not expert.  A 60 year old woman with cholesterol numbers that you present, is at risk for heart disease.  For many, a healthy lifestyle helps, but is not enough.  Postmenopausal women have the same risk for heart disease as men.  I would strongly suggest being aggressive at prevention.  And you might want to read Agatston's book.  
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68131_tn?1207970111
My mother in law had high cholesterol, and at age 70 it was discovered that both of her carotid arteries were severely blocked.  She had several small strokes because pieces of plaque broke off and traveled into her brain.  The plaque in her carotid arteries the docs said was from cholesterol.  She did not take cholesterol meds when she first found out that she had high cholesterol which was if I remember right in her late 50's or at age 60.

I've been taking 20mg of Zocor for the last four yrs and never had a problem, but was scared to death because of all the horror stories and refused to take it for over a year even though I knew that my cholesterol was 306 and LDL was 231.  Certain diet, stuff from the healthfood store and exercise I already been doing every day for decades only brought my cholesterol down 20 points in one year.  That was it I caved in and took the Zocor and wished I had taken it sooner.
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I can confirm to you that the 20mg Lipitor dose I have been taking has reversed to some extent the miniscule amount of plaque that I have near my LAD.Have had 2 64 ct angiograms,one in November last year,and one in June of this year,And I quote from the report."there has been a positive re-modelling of the calcified plaque in the vicinity of the LAD".My father and all his side of the family had heart attacks (in their sixties),and my cardiologist stated that there cholesterol and buildup in the arteries started at an early age.Of course ,they never took a statin.So even though my cholesterol initialy was 4.7,he thought I should be on a statin so as to avoid future events.With Lipitor and diet,my cholesterol is down to 3.2,with LDL of 1.7,and HDL of 3.I am convinced that statin therapy is extremely beneficial in saving lives.Of course every drug has a side effect profile but in my case the benefits outweigh the risks.
Regards,
Dimi.
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63984_tn?1333142839
Like Barbarella I refused cholesterol-reducing drugs and opted for a strict diet and exercise for about five years.  My wife hasn't eaten red meat for years so I adopted her diet of fish and vegetables, and worked out vigorously with both aerobic exercises and weights.  My cholesterol dropped, but not enough and I've had to have seven stents the last two years.  Vytorin works the best for me as it controls dietary and familial cholesterol.  I have blood tests every three months and I'm doing fine. I'm sure you know that the research leans heavily toward taking the statins.  The important question, of course, is how does your wife feel about the conflict?  
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Avatar_m_tn
I don't understand all the scare tactic stuff posted on here about statins either.

If your doctor prescribes them, either take them, or don't take them.

Personally I find the evidence to be for them overwhelmingly.

But, that's just me.

Give up on the damn scare campaign!
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216614_tn?1195668672
(Is it just me, or has anyone else noticed when these people come on with the cholesterol con stuff they have to yell.....?)

So anyway...I have had no probs with my Lipitor, which my cardio switched me to from a calcium blocker when I was diagnosed with CHF.  I have bloodwork every three months (not just for the cardio) and so far all my values have been normal.

However, I think that this decision should be made by your wife.  Hopefully she is getting all sides of the story and is making an informed decision.  She IS the one making the decision, isn't she?
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