Always trust the medical advice given by an anonymous forum member citing sketchy “health” websites with no scientific backing, typically citing anecdotal cases, poorly conducted studies, and “professional” opinions not based on the concepts of evidence based medicine.
It’s worth noting between @Huntn’s post in 2014 the American Heart Association has changed its guidelines for cholesterol. In fact 2013 had a massive change in guidelines- and
the reality is many prescribers are slow to adopt new protocols.
As it stands now, LDL/HDL/TG levels and goals aren’t the exactly the focus of treating cholesterol. The current (2018) guidelines largely determine treatment based on the patients calculate ASVCD (atherosclerotic cardiovascular disease) risk. The ASVCD algorithm considers LDL and HDL, but also other factors like age, sex, race, blood pressure, diabetes, smoking status, etc to estimate (based on statistics from decades of research) the patient’s percent risk of a stroke or heart attack within the next 10 years.
Medication therapy (mainly Statins, ie Lipitor) and dose are largely determined by this risk score. For those with lower risk scores (generally <5% + in good health), proper diet and exercise may be sufficient to reduce their ASVCD risk score and avoid the recommendation for medications. (...however, many patients scoring borderline who attempt lifestyle changes first often fail and eventually are recommended meds)
Some conditions guarantee or nearly guarantee statin treatment- such as heart failure, kidney disease, and most diabetics. Also it’s strongly suggested to consider with people age 75+.
Years ago a correlation was made between high cholesterol and risk of cardiovascular events (ie stroke, heart attack). Over decades a number of drug classes were discovered and marked to lower lipids/cholesterol (about 8-9 total, with 1-10 individual medications in each class).
In the 90’s statins were discovered (ie simvastain/Zocor, atorvastatin/Lipitor, rouvastatin/Crestor, etc. After years of research and meta-analysis it was realized that the pre-Statin drugs, while effective at lowering lipids to varying degrees, were not really effective at reducing CV events and mortality.
Statins however actually so reduce risk of CV events and mortality, in addition to lipid levels. Statins were designed to inhibit cholesterol synthesis, but were found to also increase LDL uptake by the liver (a favorable effect). Years later, it research suggests statins has effects that ultimately stabilize plaque formations, improve blood vessel function/health, prevent clots, and help modulate vessel inflammation— which explains why these seem to be more effective than the previous drugs.
As a clinical PharmD I can say statins are one of my favorite classes of drugs. They’re highly effective, generally well tolerated, and low relative risk. CV disease (and resulting CV events- stroke, heart attack) is a serious issue in the US. Too often surviving victims suffer (and their families) with permanent cognitive and physical impairment- which frankly I think can be worse than death.
It’s crazy... in the process writing this rant I just received a text from my mother that a family friend (late 60’s male) just had a stroke and is in the ICU.
