High Cholesterol

Good morning, I’m curious about pros and cons of taking Statins for high cholesterol, it is now 6.7 (Canadian measurement) . I have had high cholesterol since the age of 18, with no changes with any dietary changes. My other stats are: ekg is normal , BP is 131/79 and HR is 58. I’m a 47 year old female. I have been involved with numerous activities since I was 18, bodybuilding, endurance running, strength training and now power lifting. I’m 5feet 6inchs tall and weighed 185lbs. I also work with a one on one coach with RP for nutrition. I have a new dr who feels that I could have a heart attack at any point now if I don’t start taking medication to lower my cholesterol. Are statins safe? What about the side effects? I’m concerned about the side effects of them and just really want to make an informed decision. Thanks for your help and input. Michelle

Hi Michelle,

These are good questions. Could you provide the full lab panel?

Do you have any medical problems, or any family history of cardiovascular disease?

I will have my lab information tomorrow when I see my dr. again. I have no medical problems myself, just the high Cholesterol, on my mothers side my grandfather had a heart attack in his 50’s and died. my mother has cholesterol and is on medication her sister also has high cholesterol and BP and diabetic - she is on medication for all of it. both are obese. my sister is pre diabetic, overweight and high cholesterol. not the best family history. I don’t know much about my fathers health. my grandparents on that side no health issues at all. grandmother is alive at 94 and my grandfather passed away around 89 or so.

Here are the labs:
hemoglobin a1c 5.5
Thyroid stimulating 2.72
B12 398
Estimated GFR 65
glucose Fasting 5.7
cholesterol 8.64 mmol/L
HDL 1.12 mmol/L
ldl 6.00 (high)
Triglycerides 3.36 (high)
non hdl cholesterol 7.52 (high)
iron 14
tibc 58
transferrin saturation 0.24
Gamma glutamyl 42
creatinine 91
ferritin 55
alanine transaminase 34
sodium 142
potassium 4.4

todays BP was 121/ 79

i have 20mg ao-atorvastatin once a day prescribed.

thanks Michellle.

I’ll have to convert your cholesterol numbers to units I’m more familiar with (mg/dL):

TC 334
HDL-C 43
LDL-C 232
TG 297
non-HDL-C 290

Yes, these numbers are quite elevated (especially if you were fasted for this test.)

If your waist circumference is elevated, I’d aim to get that down as soon as possible (see our YouTube video on the topic for more details) and increase your intake of dietary fiber. However, since the remainder of your numbers appear to be fairly good, and you have an extensive family history of cardiovascular disease, I suspect there may be some genetic issues at play here.

Based on current prediction models, it seems that all your other health factors are doing you a lot of favors here, as your estimated 10-year risk of a cardiovascular event is around 2% or less. Some folks would use this as justification to not use the medications. On the other hand, you non-HDL-C level (perhaps the best marker on this basic lipid panel) is in a very high risk range, and if we look beyond 10 years and consider your lifetime risk with these numbers, it is substantially higher. From this perspective, I could make a case to lower these values sooner rather than later. Obviously this is not a straightforward issue and comes down to patient preferences and informed decision making.

The overall benefits from statin medicines appears to be an approximately 20-30% reduction in the risk of cardiovascular events. These benefits tend to outweigh the risks, as the medicines are generally safe – though there are many histrionic information sources on the internet that will argue otherwise. I don’t know your level of education and scientific background, but more information can be found here: 2014 Statin Safety Update | National Lipid Association Online

Thank you for all this feedback. My waist measurement at narrowest part is 33.5 inches and at the belly button is 36.5. I am currently maintaining my weight after a 3 month diet and will be doing another diet maintaining phase until I get to a healthier weight. It does feel that the medication is safe vs the risk. Thank you again.