Roger Blumenthal: Should I Take a Statin?

My cholesterol is a little high, and my doctor says I might benefit from a cholesterol-lowering statin. What else should I look at to help make this decision?

Roger Blumenthal: There's no black or white answer about whether to take a statin if your "bad" LDL cholesterol level is moderately high—between 160 mg/dL and 190 mg/dL—and you've got no other heart-attack risk factors like diabetes or established heart disease. The first step is to work harder on improving your dietary and exercise habits. If you are over age 50, most doctors such as myself would favor treatment to reduce your risk of developing progressive hardening of the arteries. Ask your doctor to calculate your Framingham risk score to estimate your risk of heart attack over the next 10 years.

There are a few additional tests you might want to consider having if you're on the fence.

A routine blood test called high-sensitivity C-reactive protein can help determine whether you've got inflammation, which promotes plaque formation in your arteries. Statins can be additionally helpful if you have elevated hsCRP since they lower inflammation along with LDL.

Assessing your body weight, dietary habits, and physical fitness levels is also important. If you know you aren't maintaining good health habits, taking that statin can give you some extra protection. The recent JupiterJUPITER clinical trial showed that men at least 50 or women at least 60 with an elevated hsCRP benefited from a statin even with normal LDL levels.

Your doctor can also refer you to a cardiologist for a coronary calcium scan. If you have a high score for your age, this would be another reason to start a statin medication. It is best to discuss your questions and concerns with your own doctor. Also, remember that better dietary and exercise habits are important to lower your cholesterol levels even if medication is eventually prescribed.

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