High cholesterol in a very healthy male

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Submitted by Dr T on July 13, 2011 – 8:51am

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Question: 
I am a healthy 55 year old man, who does not smoke, who exercises, and eats a low fat diet with lots of fruits and vegetables (I have been a vegan for 14 years.)  Nonetheless, probably due to genetics, I have struggled (sometimes unsuccessfully) keeping my cholesterol within normal range. 
About a month ago, I received my highest results to date:  Total=274; Triglycerides=151; LDL=191.  My HDL was 53.  Because I was troubled by these results, I underwent a CIMT ultrasound.  My CIMT results were good, indicating an arterial age of 43 years old. Given high cholesterol mixed with a good CIMT result, what would you advise?  Would you still recommend statins for a person in my circumstances?  Thanks!

I suppose you can go either way: healthy 55 yo male, healthy diet, exercise, no evidence of cardiovascular disease, but with a high total cholesterol, HDL almost perfect. Statins are used primarily to reduce your LDL, increase HDL and reduce triglycerides, which in your case means your doctor would treat only the high T.cholesterol. Assuming you wouldn’t have side effects, it might be OK to try a generic statin and see what happens.

Assuming your BP is normal, your risk for developing CV disease is about 11% in 10 years, lower than the average male but almost double the risk of an average male your age, meanwhile exposing you to the potential side effects:
https://www.cardiachealth.org/app/risk-assessment.php
https://www.cardiachealth.org/heart-disease-treatment/heart-disease-med
People without heart disease should question the use of statins:
https://www.cardiachealth.org/patients/news/statin-benefits-questioned

About CIMT ultrasound, I have some concerns about the accuracy of this test:
https://www.cardiachealth.org/ca-blog/comments-on-the-niacin-ezitimiber

Hope this helps,
Dr T
https://www.cardiachealth.org/

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