General responses to selected questions from Joel Braunstein, MD, of Johns Hopkins University and Joseph Toscano, MD.
Question:
If the results from a catheterization test are all clear, is it necessary to take medication to prevent cholesterol buildup?
Answer:
Whether someone would benefit from a cholesterol-lowering medication depends on that individual's blood cholesterol level, whether efforts at diet and exercise have been successful, and whether that individual already has heart disease or has other risk factors for heart disease. These risk factors include high blood pressure, diabetes, cigarette smoking, and a strong family history of heart disease. Because your angiogram showed that you have no coronary disease, your need to lower your blood cholesterol level is not as strong as that for someone who does have heart disease.
There are several systems for determining what would be an optimum cholesterol level, but an easy and effective one involves setting a goal based on the level of the LDL (low density lipoprotein) form of cholesterol in your blood. Anyone who already has heart disease or has had a heart attack should probably shoot for an LDL below 100. Those without heart disease but with 2 or more of the risk factors (high blood pressure, diabetes, cigarette smoking, strong family history of heart disease) should try to keep the LDL level below 130. The goal for those with no heart disease and with fewer than two risk factors is an LDL less than 160.
In each case, you should try to achieve your goal LDL through diet and exercise. An appropriate diet is one that is low in cholesterol and saturated fat. An exercise program includes some type of aerobic activity (walking, running, biking, swimming) for 30 minutes or more, 3 or more days per week. If diet and exercise are not successful in lowering the LDL to the goal level, that's when medication can help. Diet and exercise should be continued, however, because they have their own health advantages and work together with medication to keep the LDL level low.
