Ask Dr. Mark: A Primer on Cholesterol Management | Health & Fitness

Let me just summarize by advising the following: If you are a fourth group member, please have a fasting lipid profile and have your healthcare expert use the PCE to calculate your individual risk. If your 10-year risk of a cardiovascular event calculates to over 20%, it means that in the next 10 years, you have more than a one in five chance of a stroke or heart attack.

Physicians know that lowering your LDL with statins can effectively improve this outcome.* If one’s PCE calculates to under 5% “10 year risk,” then the risk is low and generally statins will be of no benefit. Between 5% and 20% “risk,” in a primary prevention cohort, there are more nuances, and the amplifiers mentioned above can play an important role in the decision to initiate statins. Again, in partnership with your healthcare expert, have a lengthy discussion of the risks (small) and benefits (“dialed-in” to your specific risk) of statin therapy.

Lastly, two important honorable mentions. First, women of child-bearing age prescribed a statin need to have in place an effective form of contraception. If pregnancy is being planned, statins should be stopped 6 to 8 weeks prior to attempts at conception, and if, by accident, one becomes pregnant on a statin, the statins should be stopped immediately and your obstetrician contacted. Rarely, but possibly, statins can cause birth defects.

Second, lifestyle modifications, which I briefly touched on in children discovered to have FH, have been shown to have benefits to cholesterol levels, decreasing diabetes and obesity, and are a general boon to overall health. Only positive effects have been shown in eating properly, exercising regularly, maintaining ideal body weight, and refraining from tobacco and illicit drug use. With this strategy, one is also more likely to have a normal blood pressure, a normal cholesterol, more focus and concentration, less depression and anxiety and greater self-esteem.