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Question:

Do high cholesterol levels increase my chances for heart disease?

Cholesterol 253, triglycerides 317, dhdl 36, ldl cal 154.  On simvastatin for over a year, these are a little better than a year ago. At this level are the chances of ischemic heart disease higher? Or do I already have it? Stress test showed heart within normal limits.  

submitted by Walter from Indiana on 12/14/2012

Answer:

Michael J. Mihalick, MDby Texas Heart Institute cardiologist, Michael J. Mihalick, MD  

Dear Walter: Your elevated LDL is the most pressing issue. I suggest you ask your doctor to switch you to a stronger statin such as lipitor (80 mg) which is now generic. Alternatively, you could take Crestor, (not available in a generic form) probably at a starting dose of 20 mg which could be increased if you are not at goal (LDL <100 or, if you have evidence of arteriosclerosis, as low as possible). This may require a maximum dose of 40 mg daily. Other commonly prescribed drugs such as the fenofibrate family, niacin, and other lipid lowering drugs may increase the risk of a serious side effect known as rhabdomyolysis which is fortunately quite rare. The intensity of the treatment depends on your individual risk of heart disease and stroke and needs to be discussed with your cardiologist. 

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Updated December 2012
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