Cholesterol - any experts out there?

[ArtichokeTagine]

DH is 35. A year ago he was diagnosed with high cholesterol (8.2). The consultant thought it might be genetic as DH was only slightly overweight.

Over the last year DH has cut out a lot of saturated fat in his diet. He has exercised more and lost 20lbs. His cholesterol is now 6.8. Despite this improvement the Consultant wants DH to start medication and stay on it for life. He says that life style changes alone will never get his levels down to normal.

DH is depressed about this. He thought he was doing really well. He hates the idea of medication for life and is worried about side effects.

Does anyone know whether it would be possible for him to get down to safe levels from lifestyle changes alone? He has got his levels down by 1.4 in a year - could this trend not continue indefinitely? We would be interested in views on the risks of being on drugs for the rest of his life versus the risks of leaving his cholestrerol levels as they are and hoping that continued life style changes will improve them.

We want DH to see DD's graduation without popping pills every day .

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OK, I might be able to help. I've worked in the health industry for the last decade.

Your DH has done really well to lower his cholesterol from 8.2 to 6.8 with lifestyle changes alone. If he is now at a normal weight/ BMI then it may just be that high cholesterol IS genetic for him.

The thing to understand is that GPs/ consultants in the UK have 'targets' for populations for things like blood pressure/ high cholesterol/ obesity / vaccinations etc. They receive money if they meet their targets.

Whilst this may be OK on 'average' for most of the population, it causes issues for people such as your DH.

The reason GPs need to target high cholesterol is because this is often an indicator for other risk factors e.g. people with high cholesterol are more likely to suffer from heart attacks, or diabetes etc - all of which are expensive for the NHS to treat, so it's easier and cheaper for them to prescribe medicines such as statins.

But the targets for cholesterol levels are complex and contraversial. Im Scotland a few years ago the target was 6, but 5 in England ? Now it is 5 mostly everywhere. However there are moves to lower it to 4! If this happened, suddenly lots of 'healthy people' today would suddenly need medicines. Some heart experts say that 4 is 'too aggressive' and many people ould not reach it.

I think the key thing for you DH and you is to ask lots of questions:

• What are his relative risk factor levels with/ without medication?
• Can he be monitored for risks, rather than take medicines

At the end of the day, no doctor can MAKE you take a medicine -it is the patient's ultimate decision.

Thanks Norma. It is quite likely that there is a gentic component for DH as his gran has very high cholesterol and his grandad died of a heart attack aged 61. DH is nearly at a normal BMI and yet his cholesterol is still high. If there is a genetic link does that mean no amount of lifestyle changes will get him to normal?

Do you know what the side effects of statins are? The doctor mentioned muscular pain which is worrying DH.

Hi Artichoke
I'm not medically qualified, so can't and shouldn't comment on your DH's specific situation, he really needs to make a list of questions like these and take them to his GP/ doctor.

I think the big question to consider is "what is normal" ? If he is otherwise healthy, fit and at the correct weight, 6.8 may well be 'normal' for your DH.

Statins are the medicines used for treating high cholesterol. They affect different people in different ways. Some people don't seem to notice/ experience any side effects, other people have complained of muscle pain/ muscle weakness and amnesia!

Perhaps a compromise might be for your DH to agree with his doctor that he will continue with lifestyle changes for another period of time (a year?) and see what effect that has. In that time he could fully research any other alternatives to medication?

He should definitely contact these people for more information:
www.heartuk.org.uk/