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HDL Cholesterol Is Elevated. Taking Lovastatin. Suggest?
Question: My bad HDL cholesterol has risen from 115 to 150 over the past year even though I am eating better.
I am taking 20mg. of Lovastatin and have done so for the past decade. Would a change of drugs be advisable?
I am taking 20mg. of Lovastatin and have done so for the past decade. Would a change of drugs be advisable?
Brief Answer:
please provide details.
Detailed Answer:
Respected Sir/ Madam,
1. Bad cholesterol is LDL and not HDL. I would request you to post your complete lipid profile so that I can tell you in detail about this.
2. Please also tell the following things so that exact interpretation can be done:-
a. Your age and gender.
b. If you have diabetes/ stroke/ anginal heart disease/ kidney disease/ carotid artery stenosis/ peripheral arterial disease?
c. Do you smoke?
d. Do you have high blood pressure.
e. Do you have history of heart attack/ angina in blood related family member? If yes , at what age it started?
f. Please also share any other medical illness and all your current medicines.
Waiting for your mail.
Sincerely
Sukhvinder Singh
please provide details.
Detailed Answer:
Respected Sir/ Madam,
1. Bad cholesterol is LDL and not HDL. I would request you to post your complete lipid profile so that I can tell you in detail about this.
2. Please also tell the following things so that exact interpretation can be done:-
a. Your age and gender.
b. If you have diabetes/ stroke/ anginal heart disease/ kidney disease/ carotid artery stenosis/ peripheral arterial disease?
c. Do you smoke?
d. Do you have high blood pressure.
e. Do you have history of heart attack/ angina in blood related family member? If yes , at what age it started?
f. Please also share any other medical illness and all your current medicines.
Waiting for your mail.
Sincerely
Sukhvinder Singh
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The Lipid Panel is as follows:
Cholesterol 188
Triglycerides 90
HDL 43
LDL C 150
I am a 68 year old male
No diabetes/stroke/anginal heart disease/kidney disease/carotid artery stenosis/peripheral arterial disease
Never smoked
BP is under control with Lisinopril and Norvasc at about 125/70
Mother had heart surgury at about 72, but father died at 95
No other medical problems. In fact, I am quite healthy other than the high blood pressure. I am very active and work 12 hour days, play tennis, walk, etc.
The other current medications inclue 150mg. of Wellbutrin which I only started taking about two months ago and I also take 2.5mg. of Cialis for BHP.
Cholesterol 188
Triglycerides 90
HDL 43
LDL C 150
I am a 68 year old male
No diabetes/stroke/anginal heart disease/kidney disease/carotid artery stenosis/peripheral arterial disease
Never smoked
BP is under control with Lisinopril and Norvasc at about 125/70
Mother had heart surgury at about 72, but father died at 95
No other medical problems. In fact, I am quite healthy other than the high blood pressure. I am very active and work 12 hour days, play tennis, walk, etc.
The other current medications inclue 150mg. of Wellbutrin which I only started taking about two months ago and I also take 2.5mg. of Cialis for BHP.
Brief Answer:
You have more than one option.
Detailed Answer:
Respected Sir
1. The target LDL cholesterol level in your case is 130 mg%. Since you have levels 20mg% more than desired levels, it needs intervention. First intervention is life style modification. This includes Maintaining optimal weight (BMI~23), diet XXXXXXX in vegetables/ fruits/ cereals/ legumes/ nuts and low in saturated fats/ sweets/ processed foods & to do daily supervised exercise. This trial should go on for 6 weeks and levels reassessed. If they start improving wait for another 6 weeks and recheck. If the level is below 130 mg% continue same.
2. If you are already following life style modifications or your levels do not come to less than 130mg% after 12 weeks of life style changes, then you need to either change your drug or increase the dose of drug after obtaining a prescription from your local doctor.
Hope this clarifies the issue.
Feel free to discuss further if there is anything.
Sincerely
Sukhvinder Singh
You have more than one option.
Detailed Answer:
Respected Sir
1. The target LDL cholesterol level in your case is 130 mg%. Since you have levels 20mg% more than desired levels, it needs intervention. First intervention is life style modification. This includes Maintaining optimal weight (BMI~23), diet XXXXXXX in vegetables/ fruits/ cereals/ legumes/ nuts and low in saturated fats/ sweets/ processed foods & to do daily supervised exercise. This trial should go on for 6 weeks and levels reassessed. If they start improving wait for another 6 weeks and recheck. If the level is below 130 mg% continue same.
2. If you are already following life style modifications or your levels do not come to less than 130mg% after 12 weeks of life style changes, then you need to either change your drug or increase the dose of drug after obtaining a prescription from your local doctor.
Hope this clarifies the issue.
Feel free to discuss further if there is anything.
Sincerely
Sukhvinder Singh
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for informing me of the target LDL level. I had not been informed of that before. I know about diet and actually do XXXXXXX all of the suggestions that you made. I also exercise regularly. My BMI is at 26, so I am a bit heavy.
2. I have suggested changing the drug as I believe that in some cases, this is a way to lesson the problem. I have increased the intake of Lovastatin from 20mg. to 40mg., in the past, but became victim of muscle cramping and discomfort which disappeared when I reduced the dose to 20mg.
Do you believe that there is a statin that I might consider?
2. I have suggested changing the drug as I believe that in some cases, this is a way to lesson the problem. I have increased the intake of Lovastatin from 20mg. to 40mg., in the past, but became victim of muscle cramping and discomfort which disappeared when I reduced the dose to 20mg.
Do you believe that there is a statin that I might consider?
Brief Answer:
Yes there are other options.
Detailed Answer:
Respected Sir
1. You definitely need to work on your weight. You are right; muscle weakness/ cramps/ fatiguability are well known side effects of statins.
2. There are more statin drugs and to some extent better than lovastatin available in the market. I prefer using Atorvastatin or Rosuvastatin in my patients. Atorvastatin has robust data in its favor and Rosuvastatin was marginally better whenever compared to Atorvastatin. You can get a prescription of one of these two after discussing with your local physician.
Hope this helps.
Sincerely
Sukhvinder Singh
Yes there are other options.
Detailed Answer:
Respected Sir
1. You definitely need to work on your weight. You are right; muscle weakness/ cramps/ fatiguability are well known side effects of statins.
2. There are more statin drugs and to some extent better than lovastatin available in the market. I prefer using Atorvastatin or Rosuvastatin in my patients. Atorvastatin has robust data in its favor and Rosuvastatin was marginally better whenever compared to Atorvastatin. You can get a prescription of one of these two after discussing with your local physician.
Hope this helps.
Sincerely
Sukhvinder Singh
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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