I’ll give the facts and basics first. 47 year old male, father of two. Run about 40-45 miles per week.
Recent physical indications:
BP: 110/70
Weight: 160 / Height: 5’10”
RR: 48
HDL: 76 LDL: 129 TOTAL: 205
2 years ago had a Calcium Test (coronary artery scan) with a score of 61.
Some history of heart problems in my family. Father triple bypass in his late 50s (poor diet little exercise). His father heart disease (smoker, drinker).
Doctor wants to put me on 5 mg of Statin. I’m a little resistant. Hoping there are other ways to make adjustments. In the meantime, looking for any experience with taking statins and the impact on exercise, running and general life. Any comments welcome.
Take them for 3 months every day and during that 3 months, eat really healthily, preferably vegetarian and low dairy with small portions. Test again at the end of this period. If not down significantly then repeat for another 3 months. Hopefully by this time, you will see a significant reduction in bad cholesterol and then just take every time you eat unhealthily or the day before running days. No MD will advise this course of action but I found that statins kind of built up in me and anyway my cholesterol went from very high to a healthy level after 3 months and so thats what I do as otherwise the statins make my legs hurt so much I can't actually run properly. My race performance has improved from this time last year on this regime too.
I’ll give the facts and basics first. 47 year old male, father of two. Run about 40-45 miles per week.
Recent physical indications:
BP: 110/70
Weight: 160 / Height: 5’10”
RR: 48
HDL: 76 LDL: 129 TOTAL: 205
2 years ago had a Calcium Test (coronary artery scan) with a score of 61.
Some history of heart problems in my family. Father triple bypass in his late 50s (poor diet little exercise). His father heart disease (smoker, drinker).
Doctor wants to put me on 5 mg of Statin. I’m a little resistant. Hoping there are other ways to make adjustments. In the meantime, looking for any experience with taking statins and the impact on exercise, running and general life. Any comments welcome.
Your total cholesterol is LDL + HDL + triglycerides/5, not just the sum of the first two. Your LDL is borderline, not “high”, and your comfortably above average HDL may be in your favor (though more recent studies suggest HDL may be irrelevant), but a family history of heart disease increases risk in your case.
FYI, I’m very similar, bit taller and lighter and similar RHR with HDL of 68 and LDL of 113 that I brought down from 130 a few months back with just dietary modifications. I’m choosing to not worry about the still borderline high LDL as I don’t have any other risk increasing factors. The single most effective dietary change is to reduce saturated fats to under 6% of total calories, which is not easy but works.
I know the medical community has shifted toward being 'concerned' at I think 185? cholesterol?
I am not going to tell you what to do.
I know what I would do.
You are a healthy person with possible iffy family medical history.
Alan
Agree OP’s cholesterol is not worrisome high. It’s actually close to the average of folks in their forties. But people even with low LDL get CVD all the way down to an LDL of 55, so risk is never 0 just because your LDL is below 100, and conversely, some folks with 180+ LDL don’t get any CVD, so accounting for other factors like family history is important as they do increase risk.
Family history is very, very important. Don't risk it, start on the statins. I take 40 mg of Atorvastatin daily and don't notice any of the muscle soreness others report. You may have the same experience, especially at the low dosage they are recommending.
I have been on statins because of family history and my cholesterol levels were not proving susceptible to improvement through diet alone. Some statins can have side effects, such as body aches, but the right one for you can avoid that. Jim Fixx, the famous writer/runner, died at 46 when he went out for a run one day, because unknown to him he had massive blockage of his arteries. Statins will prevent that.
Jim Fixx, the famous writer/runner, died at 46 when he went out for a run one day, because unknown to him he had massive blockage of his arteries. Statins will prevent that.
Fixx was 52 when he died. He smoked until age 36. His father died of a heart attack at 43. You don't know if statins would have helped him at all.
Jim Fixx, the famous writer/runner, died at 46 when he went out for a run one day, because unknown to him he had massive blockage of his arteries. Statins will prevent that.
Fixx was 52 when he died. He smoked until age 36. His father died of a heart attack at 43. You don't know if statins would have helped him at all.
You just listed two major risk factors that, today, would have led to him being prescribed statins in his 40s. And obviously you can’t know for sure but it’s highly probably they would have prevented his death.
I know the medical community has shifted toward being 'concerned' at I think 185? cholesterol?
I am not going to tell you what to do.
I know what I would do.
You are a healthy person with possible iffy family medical history.
Alan
FYI, that is a super low dose if it makes you feel better. You are getting a statin not because of your cholesterol #s. Its mildly elevated numbers + a high calcium score + family history. No number cut offs these days, has to do with pre test risk. There are online calculators. 61 means you already have heart disease albeit "low" (higher than "minimal"). A calcium score of 1 is abnormal. But it can go up to 1000, Its a weird scale.
This is not medical advice, but your scores put into the calculator give a 5.6% 10 yr risk of heart attack without statin. If you take away your Ca score, its 3.6%. I do not recall what percent they trigger a statin (see below). But your fam history and Ca score is weighing on the decision.
Im startin' one too. Ill let ya know.
From ACC/AHA guidelines:
Statin Treatment Recommendations The following are guideline recommendations for statin treatment:
-Patients ages 20-75 years and LDL-C ≥190 mg/dl, use high-intensity statin without risk assessment. -T2DM and age 40-75 years, use moderate-intensity statin and risk estimate to consider high-intensity statins. Risk-enhancers in diabetics include ≥10 years for T2DM and 20 years for type 1 DM, ≥30 mcg albumin/mg creatinine, eGFR <60 ml/min/1.73 m2, retinopathy, neuropathy, ABI <0.9. In those with multiple ASCVD risk factors, consider high-intensity statin with aim of lowering LDL-C by 50% or more. -Age >75 years, clinical assessment and risk discussion. -Age 40-75 years and LDL-C ≥70 mg/dl and <190 mg/dl without diabetes, use the risk estimator that best fits the patient and risk-enhancing factors to decide intensity of statin.Risk 5% to <7.5% (borderline risk). Risk discussion: if risk-enhancing factors are present, discuss moderate-intensity statin and consider coronary CACs in select cases. Risk ≥7.5-20% (intermediate risk). Risk discussion: use moderate-intensity statins and increase to high-intensity with risk enhancers. Option of CACs to risk stratify if there is uncertainty about risk. If CAC = 0, can avoid statins and repeat CAC in the future (5-10 years), the exceptions being high-risk conditions such as diabetes, family history of premature CHD, and smoking. If CACs 1-100, it is reasonable to initiate moderate-intensity statin for persons ≥55 years. If CAC >100 or 75th percentile or higher, use statin at any age. Risk ≥20% (high risk). Risk discussion to initiate high-intensity statin to reduce LDL-C by ≥50%.
Family history is very, very important. Don't risk it, start on the statins. I take 40 mg of Atorvastatin daily and don't notice any of the muscle soreness others report. You may have the same experience, especially at the low dosage they are recommending.
This.
I'm about 15 years older than you, but about the same height/weight/BP/cholesterol numbers. My father and older brother had bypasses when just a bit older than I. Father was otherwise in very good health, brother is overweight maybe 30 lbs and more sedentary. Grandfathers both had heart issues.
Doctor put me on low dose statin (5 mg) for these reasons with no notable side effect. My spouse has similar (slightly higher) cholesterol numbers but same doctor is not concerned because of more favorable family history.
Family history trumps your perceived health and fitness. I left statins way too late and now post-MI I have fairly bad CHF and get out of breath pretty easily. I have never experienced muscle probs in my legs and even if I did, it sure beats HF. Also I now have to take 8 heart pills a day.
btw there are tons of genetic studies on CHD and lots of markers (SNPs) to test, in one test I did after a genome sequencing run I got scored in the 99th percentile for risk. Sadly this info was about a decade too late.
Jim Fixx, the famous writer/runner, died at 46 when he went out for a run one day, because unknown to him he had massive blockage of his arteries. Statins will prevent that.
Fixx was 52 when he died. He smoked until age 36. His father died of a heart attack at 43. You don't know if statins would have helped him at all.
I read that it was found that he had arterial blockages of 80-90% that had been undetected. Statins would have prevented those blockages.
Family history/genetics is about 90% of the risk. Everything else with diet and exercise is the other 10%. We (especially in the US) want to believe we have the power to make lifestyle changes and change the 90%. We can't. Take the statins. They can change the other 90%.
You are young. Your CA score while low is high percentile for your age - in a not good way. If you look it up, you are about 80th percentile meaning only 20 percent of adults have a worse score than you. It’s good to get in front of this. Your LDL is what matters and it is high at 129. You have risk factors, and therefore the ideal goal may be <55! I am vegan for 15 years and have a similar CA score to you and I am on meds. Also, endurance athletes may increase CAD risk. You can see this in studies. Moderate vs vigorous may be better. See if the low dose statin helps.
On crestor couple times a week for 12 years as preventative. Ldl in the 50,60s with it. 0 calcium score 3 months ago. Could not believe it. Very happy, no side effects.
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