Should I take a statin to lower cholesterol if I’m only 45 years old and I feel fine?

Dr. Wy, why should I take a statin to lower cholesterol if I’m only 45 years old and I feel fine?

You are correct that most young and middle-aged adults have no need to take a statin. Age is a strong risk factor, and we see more MACEs (strokes and heart attacks) in older adults. It IS important, though, that at EVERY adult age we get enough sleep (about 7-8 hours nightly), exercise enough (moderate exercise for at least 30 minutes at least 5 times a week) and eat a healthy diet (such as the Mediterranean diet). Those are the cornerstones of good cardiovascular health for both the present and the future.

A younger adult with enough risk, though, WOULD benefit from a statin. A person with diabetes OR an LDL (“bad” cholesterol) over 190 mg/dL SHOULD be on a statin drug because those conditions have a high MACE risk. You can estimate risk using an evidence-based tool developed by the American College of Cardiology. For example, a 45-year-old healthy AA man has less than a 5% risk of developing a MACE during the next decade and wouldn’t benefit from a statin. If that same man smokes and has hypertension, the risk is over 10% and he WOULD benefit from a statin to reduce his risk. (And he should stop smoking!)

The bottom line on who should take a statin is “it depends,” and is all based upon the risk of a stroke or heart attack. Your doctor can help you estimate yours and develop a prevention plan that works best for you.

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