Dr. Wy, why do I need to take cholesterol medication if my level is normal? And my good cholesterol is normal, too!

Ask Dr. Wy…

Richard Wyderski, MD, FACP

Dr. Wy, why do I need to take cholesterol medication if my level is normal? And my good cholesterol is normal, too!

In the old days we were taught that if you had a high HDL cholesterol that it counteracted the effects of LDL “bad” cholesterol. In modern times, though, we look at a person’s risk of heart attack and stroke to determine the benefit from cholesterol lowering treatment, especially a statin. The higher the risk, the more the benefit.

The best tool we have to estimate a person’s risk is on the American Heart Association’s PREVENT calculator. It considers many factors such as age, blood pressure, kidney function and more in addition to the cholesterol and HDL numbers. It was developed using the electronic medical records of hundreds of thousands of people that correlated risk factors with the chances of a stroke or heart attack. It was then applied to a different set of hundreds of thousands of people and was found to accurately predict the percentage of people that had either one during the following 10 years. Even if you have a “normal” cholesterol level, the higher your risk, the more you benefit from preventive treatment.

Still not convinced? Other factors that increase risk that aren’t part of the calculator, such as the lipoprotein(a) level, also increase risk that could sway your decision. Or you could get a CT scan that calculates your heart artery calcium score. The higher the score, the higher the risk of stroke and heart attack.

Just like controlling blood pressure, controlling cholesterol reduces our chances of strokes and heart attacks. So please check out your risk!

 

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