How much high cholesterol do I need to take “statins”?

How much high cholesterol do I need to take “statins”?  Different physical conditions have different standards for medication.

 Several friends asked Huazi the same question. They found that their blood lipids were high, but they were undecided about whether to take “statins”. The upper limit of normal for low-density lipoprotein cholesterol (LDL-C) given on the medical check-up sheet is 3.37mmol/L. Do I have to take medicine if it exceeds the limit? If you need to take medicine, how much should it be reduced? Why do some data say it should be reduced to 2.6mmol/L, and some data say it should be reduced to 1.8mmol/L, which one is right?

1. Losing weight does not lose blood fat

Hypertension, hyperglycemia, and hyperlipidemia are collectively referred to as the “three highs”. Everyone knows a lot about blood pressure and blood sugar, they also understand the dangers, and they need medication for treatment. However, many people don’t understand high blood lipids. Some people think that blood lipids are fat in the blood, which is similar to body fat, and can be reduced by dieting, exercise and other methods of weight loss.

These people are wrong, because although blood lipids are also fat, the method of weight loss cannot effectively reduce blood lipids. Because of the cholesterol in the human body, dietary intake only accounts for 20-30%, and 70-80% is synthesized by the body itself. And when the cholesterol intake in the diet is reduced, the body’s synthesis will increase accordingly. Blood lipids are regulated by the human lipid metabolism system, and humans have not fully understood this metabolic regulation system.

In other words, through diet control and exercise methods, the impact on blood lipids is very limited. Many people with normal weight or thin people may also have high blood lipids.

2. The effect of hyperlipidemia on the body

Hyperlipidemia is very harmful to the human body. The level of cholesterol in blood lipids is closely related to the formation and progression of atherosclerosis. The most important indicator is low-density lipoprotein cholesterol (LDL-C), because LDL-C is the main “raw material” for the formation of atherosclerotic plaques.

When the level of LDL-C in the blood rises, LDL-C will enter the arterial intima to form plaques; when the level of LDL-C in the blood drops, LDL-C can flow back into the blood from the arterial intima. However, most of the LDL-C that enters the arterial intima will be swallowed by macrophages, and eventually foam cells will be deposited in the arterial intima. The LDL-C that forms foam cells can no longer flow back into the blood, so once the atherosclerotic plaque is formed, it cannot be completely removed.

Atherosclerosis is the main cause of cardiovascular and cerebrovascular diseases such as coronary heart disease, myocardial infarction, and cerebral infarction. It threatens people’s lives. Therefore, the elevated LDL-C level must be controlled.

3. To what extent should the cholesterol be high?

The reference standard given by LDL-C for blood lipid examination on the physical examination sheet is lower than 3.37mmol/L. It should be noted that this is only a reference standard for healthy people without other diseases. People in good health do not need to rush to medication if their blood lipids are not excessive. Generally speaking, the standard of medication for healthy people is that LDL-C is higher than 4.9mmol/L.

For people with chronic diseases, the reference standard for healthy people is no longer applicable. For people with high blood pressure, diabetes, and smoking, if atherosclerosis has occurred, but people with cardiovascular and cerebrovascular diseases have not yet occurred, the control standard of LDL-C is below 2.6mmol/L.

If you already have coronary heart disease, or have had cerebral infarction, myocardial infarction and other diseases, you need to prevent the disease from recurring. The control standard of LDL-C is 1.8mmol/L or less. For people with a high degree of disease risk, LDL-C can be further controlled below 1.4mmol/L.

It is now medically believed that the lower the level of LDL-C, the stronger the protective effect on the cardiovascular and cerebrovascular. In related trials, some subjects reduced LDL-C to about 0.7mmol/L, and no adverse effects occurred. There is a saying that if your plaques are not reversed, it means that your LDL-C is not low enough.

The control of LDL-C is mainly based on statins, because statins can not only reduce LDL-C, but also stabilize plaques and prevent plaques from rupturing. When using statins alone cannot make LDL-C reach the target, it can be considered in combination with cholesterol absorption inhibitors and PCSK9 inhibitors.

Conclusion:

Different physical conditions have different requirements for LDL-C and different medication standards. For healthy people without chronic diseases, if LDL-C is slightly exceeded, there is no need to rush to take medicine. Although diet control and exercise have a limited impact on blood lipids, a healthy lifestyle has a positive preventive effect on all chronic diseases of the “three highs” and should be adhered to for a long time.

If the blood lipids are high, or people with other chronic diseases, you need to choose drugs to control blood lipids under the guidance of a doctor. I am a pharmacist Huazi, welcome to follow me and share more health knowledge.

(source:internet, reference only)

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