Statins are important heart treatment, but so is change in diet
BY KEITH ROACH, M.D.
DEAR DR. ROACH: I’m 64 and thin, on no medications and had my bloodwork done. Cholesterol showed 226 total, HDL 77, triglycerides 79, LDL 131, glucose 94. My blood pressure is usually about 90/60, and I have never smoked.
My doctor wants me to go on a statin, which I know is not good. I want to try adjusting my diet. Are these levels so high that they warrant a statin? Should his first course of action be to suggest changing diet? Your opinion is important. Thank you. — J.F.
ANSWER: Statin drugs are a powerful way to reduce the risk of heart attack and stroke in people at higher risk for developing them; however, like all drugs, they have the potential for adverse effects. They should be used only when the benefit of taking them is expected to be greater than the risks. Nearly everyone with known heart disease or history of stroke due to blockages in the arteries should take a statin if they can tolerate it. For people without a history of cardiovascular disease or cerebrovascular disease, a good tool is a risk calculator.
These are not perfect, but they give a good starting place to estimate risk. Using the American Heart Association calculator at cvdrisk.com, the best guess of you developing heart disease or stroke in the next 10 years is 2.3%. Based on this result, a statin would generally not be recommended, although there are conditions that increase risk of heart disease that are not considered in the calculator. Other medical conditions and a patient’s preferences need to be considered before recommending medication therapy.
Almost everyone can reduce their risk of many diseases, not just vascular disease, by eating more plants and less meat, reducing simple sugars and starches, and having a diverse diet.
I recommend thinking of statins as a way to decrease heart disease risk. Blood cholesterol is just one part of risk. Your age and sex, and low blood pressure are helping to protect you, but you may someday still benefit from a statin. If your cholesterol and blood pressure numbers stay the same as they are now, a statin may be in your future in 10 years.
DEAR DR. ROACH: I tested positive for COVID about six weeks ago. I had very mild symptoms for about 24 hours. I lost my sense of taste and smell. My senses are slowly returning, but now I constantly have a strange taste in my mouth. I can’t tell if it’s a metallic taste or not. Eating, drinking, chewing gum, brushing, etc., make it go away for 10 minutes. Is this COVID-related or something else? Will it go away? — M.R.
ANSWER: While I can’t answer with certainty, many people with COVID-19 have disturbances in taste and smell that take weeks or months to resolve. Based on my experience with these patients, I would guess your disturbance is most likely COVID-19 related, and is likely to go away in time.