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I am 55 years old, my cholesterol is 6.5 mmol/l and I do not want statin


Authors: Jan Piťha 1;  Michal Vrablík 2
Authors‘ workplace: Laboratoř pro výzkum aterosklerózy, Centrum experimentální medicíny, Klinika kardiologie, Kardiocentrum, IKEM 1;  Centrum preventivní kardiologie, III. interní klinika – endokrinologie a metabolismu 1. LF UK a VFN v Praze 2
Published in: AtheroRev 2024; 9(1): 42-46
Category: Reviews

Overview

In this article, we present a systematic approach to a person who has had a lipidogram measured for the first time at the age of 55 and has moderately elevated LDL cholesterol concentrations and who has significant concerns about the use of 3-methyl 3-glutaryl CoA reductase inhibitors (statins). In addition to the traditional options available in a routine outpatient examination, we also briefly mention other options including genetic testing and imaging methods and discuss their possible contribution to solving this situation. In additon, we present an overview of the available non-statin therapy.

Keywords:

statins – dyslipidemia – detection of cardiovascular risk


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Labels
Angiology Diabetology Internal medicine Cardiology General practitioner for adults
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