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How Ray Zapped His Cholesterol
Ray’s Cholesterol-Lowering Plan
Ray tried diet and exercise to lower his numbers, but his total cholesterol failed to drop below 232 and his LDL stayed at 160. That’s when his doctor turned to statins. “We wanted to get his LDL below the magic number of 130, which seems to be important in prevention of heart disease in people who are at higher risk,” says Steven Kunkes, M.D., of Bridgeport Hospital in Connecticut. “Cholesterol, and particularly LDL cholesterol, has a great potential to damage the inside of blood vessels and is primarily responsible for the development of plaque and hardening of the arteries.”
Ray started out on a moderate dose of lovastatin (Mevacor), now available as a less-expensive generic drug. He was hesitant about the statin program at first because of potential side effects. “Certain people can have either liver problems or muscle problems with statin medications, but this occurs less than 2 percent of the time,” Kunkes says. “Doctors do surveillance to assure that patients aren’t affected by such problems. Precautions should be observed, such as avoiding excessive grapefruit juice or not combining statins with certain antibiotics and antifungal medications.”
Because Ray experienced muscle aches while taking the prescribed medication, his doctor prescribed a different statin, simvastatin (Zocor). In six weeks, Ray’s total cholesterol dropped to 198, and his LDL cholesterol to 124. There were no side effects, and he continued to lose weight. His doctor, however, thought Ray’s LDL cholesterol was still too high. “When a young person has a strong family history of heart disease and other potential problems like hypertension and high glucose levels, it is an advantage to keep the LDL closer to, or below, 100,” Kunkes says.
He advised Ray to try a combination therapy, adding a second medication, ezetimibe (Zetia), to prevent the absorption of cholesterol through the intestinal tract. The combination of simvastatin and ezetimibe is available as one medication, called Vytorin, allowing Ray to take just one pill daily.
The approach worked. Ray’s cholesterol—and his risk for heart disease—is now in check. “He was motivated and still healthy, so medicine’s preventive tools could be employed to help him live a longer and hopefully happier life,” Kunkes says. “Ray has an excellent outlook as a man willing to invest in the future by changing his lifestyle and taking medications proven to help prevent heart problems.”
Steven Kunkes, M.D., contributed to this story. He is a cardiologist with Cardiac Specialists in Fairfield, Connecticut, and medical director of the cardiac rehabilitation program at Bridgeport Hospital in Bridgeport, Connecticut.
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