Aug 10, 2009
I have been on Atripla for 14 months now with great success. undetectable, CD4 723, CD4% 36. I am 48 yo, 6-1, 190lbs and I run or use an elliptical 6 days per week for at least 45 min (30 miles per week). I have no family history of heart disease and my blood pressure is 122/68. However my doc is concerned about my cholesterol. My overall is 189, triglycerides 60, HDL 56, LDL 121. He says my LDL is high and would like to start me on lipitor. , (should be under 100). I really don't want to take another drug. Considering my weight, level of exercize and family history I can't see how I'm at risk for a heart attack. Am I being unreasonable? Would love some advice.
Response from Dr. Henry
You should ask your doctor to calculate your Framingham risk score of heart disease with current current data and then assuming you are on Lipitor and have a LDL < 100. The decrease in risk will be very modest and for many patients often not worth use of a drug intervention. Your HDL level is excellent. For some patients adding a low dose aspriin and use of fish oil as well as continued attention to diet, exercise as you are doing), and avoiding smoking are the key life style interventions to minimize future cardiovascular risk. KH
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