Can statins be started in case of an abnormal lipid profile?

Question

Hello doctor,

I am a healthy, active, 70-year-old female with a lipid panel (cholesterol) within normal limits. I have no risk history, but the lipid-protein profile was done for the first time, and it is abnormal. LDL and HDL are in the high range. My doctor recommends a Statin, but my husband suggests Niacin ER would target the problem better. What is your opinion?

Kindly give me your suggestions.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Please share your lipid panel. If LDL (low-density lipoprotein) is more than 190 mg/dL (milligrams per deciliter), Statins should be started. If LDL is between 160 and 189 mg/dL and there are other risk factors such as a family history of ischemic heart disease, Statins (cholesterol-lowering medication) should be started. If no risk factors are present or the LDL level is less than 160 mg/dL, then ten years of ASCVD (atherosclerotic cardiovascular disease) risk should be calculated with the help of the American Heart Association's pooled cohort equation available online.

If the risk of ten years is more than 7.5 percent, statins should be started. Statins are the first line of drugs. They are contraindicated in pregnancy and breastfeeding. In that case, Niacin (a vitamin B3 supplement and lipid-lowering drug) can be started.

Please revert so I can assist you further.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Your lipid profile is normal. At this level, you do not need a statin, and advanced cholesterol testing is not indicated. Advanced cholesterol testing, like LDL (low-density lipoprotein) particle size, is indicated in cases when the lipid profile is normal, but individuals still have a heart attack or stroke or have a family history of a heart attack at a young age. You should only continue exercising, keep your BMI (body mass index) in the normal range, eat a healthy diet, and avoid stress and anxiety. Avoid smoking, drinking, and junk foods.

I hope this was helpful.

Thank you.

Answer 3

Hi,

Welcome back to icliniq.com.

Yes, it was not necessary. Lipoprotein subfractionation test is only done in case of a heart attack at a young age with no risk factors or in those with a family history of a heart attack at a young age. Lipoprotein subfraction testing is not diagnostic and is not endorsed by any medical societies such as the American Heart Association, American College of Cardiology, National Lipid Association, and National Academic of Clinical Biochemistry. and is not approved by the FDA (Food and Drug Administration). The guidelines cite insufficient evidence to support lipoprotein subfraction measurement for initial clinical assessment or on-treatment management decisions. Lipoprotein subfractionation is not used to guide Statin initiation or termination.

I hope this helped you out.

Thank you.