Published Aug 15, 2004
I know a 34 year old male with total cholesterol of 215 and HDL of 50 that is being advised to start Lipitor 10mg daily by MD. Triglycerides are also elevated buy I don't know actual level. This person has been on a low fat/low cholesterol diet for 3 months and his level has only dropped from 227 to 215. This person has no male or female relative that has had an MI or angina or CABG. I know there are new quide lines based on new studies about starting this kind of drug at much lower total cholesterol levels. However, my understanding is that the studies were funded by drug companies. I am not faulting the MD if because she is following new guidelines. I advised person involved to go very, very cautiously. What have the members of this board heard, what do you advise?
gwenith, BSN, RN
We use different figures but we don't aim for really low cholesterols until after established cardiac incident, then we will aim for low cholesterols.
RNPATL, DNP, RN
I was 36 years old when I had my first cardiac event .... and 38 when I had my second one. My cholesterol and tri's were very high and I was advised to start a statin regime to reduce my cholesterol and overall cardiac risk. As a nurse, I thought it was not necessary ... I was young and decided to start an exercise program and reduce my fats and cholesterol. I worked out faithfully everyday and was very strict with my diet ..... at 36 years old, I was hospitalized with chest pain and had my first stent to my RCA r/t a 98% occulsion. At 38 I had my second RCA stent placed as well as an LAD stent placed.
I am now 40 .... doing fine, (my life has changed dramatically thought) but I faithfully take my statin drug (Crestor). It is unfortunate that many physicians wait to get their patients on statin therapy until their is a cardiac event. My opinion ... one that is tested and real to me, is to offer preventative care to people, especially young people, who may have a genetic pre-disposition to CAD and are showing signs of cardiac risk. I am now worried about my kids ... they are also predisposed to these risks.
Anyway ... just thought I would share my opinion and personal experience. I would recommend that your friend seek out a second opinion and then make a decision that works best for him.
Don't have any answers for you as I am not a nurse but coincidentally my doctor started me on Lipidor about a week or so ago.
I don't know if it's the medicine or what but ever since then, I find myself incredibly drowsy. I make it to work and get through the work day but when I get home, I want to lay down on the couch and I fall asleep for a couple hours and when I wake up I really don't feel woken up or refreshed.
I've had this weekend off and could not find it within myself to wake up and get some stuff done.
My eyes feel so heavy most of the time.
Has anyone else ever have side effects like these with Lipidor?
Otherwise I'm wondering if something else is working on me.
llg, PhD, RN
If you wait until you actually have a heart attack, then it is too late for prevention, isn't it? If I were your friend, I would be thanking my lucky stars that I had a health care provider who was interested in actually preventing the first heart attack and not waiting until my arteries were already clogged and my heart possibly damaged before taking any action.
One of my goals for my trip home in a couple of weeks is to ask my younger brother (age 40) about his levels and see if he is taking anything yet. Our father died of heart disease at the age of 67. My sister and I (late 40's) have both started on drugs within the last 2 years because our cholesterol was starting to creep up. Neither of us could tolerate statins, but we both tolerate Zetia well. My sister tried Lipidor (but had heart palpitations with it) and I tried Zocor (but had the bad muscle pain they warn you about). Fortunately the Zetia is working well for both of us. My total cholesterol had gotten as high as 250, but is now down to about 170, with normal trigycerides. My BP was also starting creeping up, but is well controlled with atenolol.
I, for one, did NOT want to wait to have an "incident" and risk permanent damage. In fact, I switched doctors because my old doctor was not taking my gradually, but steadily rising, numbers seriously enough. I'm all for prevention, whenever possible.
purplemania, BSN, RN
As a diabetic my physician wants my cholesterol to be
There is a website on federal guidelines for various diseases. Maybe this will give you the answer you seek. http://www.guideline.gov.
How very timely. My SO was just placed on Lipitor on Friday. This was his first test. Doctor did not recommend trying diet, exercise and lifestryle changes first. That made me a bit uncomfortable. Is this the new thinking? His total was 276 - tri's high as well. Don't know family history as he is adopted.
I know the "diet, exercise, and lifestyle changes first" strategy SOUNDS good, but very few people get more than a very small drop in their cholesterol levels through these strategies alone. And while they are postponing the initiation of pharmachologic strategies, their arteries are getting more clogged by the day.
At 275, your SO would be lucky to get much below 250 without pharmachologic help -- no where near the
While I don't like to jump on bandwagons and take drugs casaully either, it seems sensible to take high cholesterol levels seriously as there has been so much research on it (regardless of who funded it.) Heart disease is the #1 killer -- the most likely thing for us each to die from.
Many people try hard to eat right, exercise and do something healthy, however, sometimes it does not matter what you do, you are a product of your genes. Yes, there are modifable risk factors that we do control, but there are also things that are out of our control. Starting on statin therapy, while it may not be the most wonderful thing, does indeed lower your risk factors for a first cardiac event.
Thank you for the replies. It does make me feel better regarding the medication.
controlling ones health is a multi focal job...if you need drugs take them but do not rely on the drug alone...you MUST eat right and get up off your duff and walk or what ever as long as you do something....you are not losing control of your life is you take drugs...you may be saving your self from becomeing a cardic cripple...
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