Help: My doctor wants to put me on a statin drug

DEAR DR. mY OVERALL HEALTH IS EXCELLENT, AND MY LIFESTYLE IS EXTREMELY HEALTHY. IN SPITE OF THIS, AND WITH NO OTHER RISK FACTORS, EXCEPT A HIGH LDL MY DR. IS PRESSURING ME TO GO ON STATINS. I DISAGREE WITH THIS FOR MANY OF THE REASONS YOU MENTION IN YOUR BOOK. HE IS BECOMING INCREASINGLY ANNOYED WITHME, AND I AM AFRAID HE WILL REFUSE TO TREAT ME IF I DON'T COMPLY.I FEEL I AM BEING HELD HEALTH-HOSTAGE. WHAT CAN I SAY TO CONVINCE HIM THAT I,M NOT TRYING TO COMMIT SUICIDE,BY NOT GOING ALONG WITH THIS. HE PRACTICALLY LAUGHED IN MY FACE WHEN I SUGGESTED THAT HE READ YOUR BOOK- HELP !!!!!!- THANK YOU REGINA

Regina,

Your problem is not at all uncommon and highlights the bind that American patients and doctors are currently in.

First of all, it sounds to me like you might not even qualify for statin therapy under the current guidelines:
• 2 or more major risk factors (woman over 55, smoker, high blood pressure, HDL cholesterol < 40, or strong family history--first degree male relative < 55 years of age or female < 65 years of age)
• AND have a 10-20% risk of developing heart disease over the next 10 years according to the Framingham risk score
• AND have an LDL above 130

That said, even if you do qualify there is still absolutely no evidence from the gold standard of medical research, randomized controlled clinical trials, that lowering cholesterol with a statin is beneficial for women who don’t already have heart disease or diabetes.

Perhaps you can arrive at a compromise with your doctor: that because you are doing the things that reduce your risk of heart disease by 83% already (exercising regularly, eating a healthy diet, not smoking, drinking in moderation if at all and maintaining a health body weight) and because there is no evidence that a statin will help, you suggest that you wait one year to see how the medical thinking evolves on this issue. In the meantime you will continue with all the healthy lifestyle habits that are each more likely to protect you from heart disease than is taking a statin.

Hope this is helpful. Please let me know what happens.

Sincerely,

John Abramson MD

PS: I would encourage you to bring this letter to you next doctor visit to facilitate discussion about these important issues.