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By the way, doctor: Should I take a statin?

By the way, doctor

Should I take a statin?

Q. My cholesterol numbers are as follows: Total — 220; HDL — 82 (it’s been anywhere from 75 to 85 for the last 20 years); LDL — 130; total-to-HDL ratio — 2.7. I’m 85, and the heart doctor wants to put me on a statin. I feel great; I’m not overweight, and I don’t have any heart problems. I don’t take any medications except a daily 81-mg baby aspirin. Do I need to take a statin?

A. If you’ve reached the age of 85 without any evidence of disease from atherosclerosis, I can’t say I would be pushing a statin on you.

Just to be clear, I would recommend a prescription if you’d had a stroke or near-stroke, any evidence of coronary artery disease, or blockages in the arteries in your legs. But if you haven’t, I’d urge restraint — and tell you to keep on doing what you’ve been doing. If you’re 85, feeling great, and free of cardiovascular disease, you’re way ahead of the game.

At 130 mg/dL, your “bad” LDL cholesterol isn’t all that high, and your “good” HDL is remarkably good — and it offers protection against heart disease. Statins do carry a small risk of complications and, so far, there aren’t any terrific studies showing that they help people your age live longer or feel better. And they’re certainly not free. Even with drug coverage, a prescription may run you several hundred dollars a year in copayments.

Thomas H. Lee, M.D. Partners Healthcare System, Boston Harvard Health Letter Editorial Board

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Last updated:	August 21, 2006