Get your cholesterol even lower and start younger, new guideline says | The Seattle Times
- Should test starting at age 10; would identify 1 in 250 as needing treatment.
- Should test again at age 18-20.
- Should test every 5 years thereafter.
- You LDL level should be 100 or lower.
- Anyone with an estimated (model-based) risk of 10% or more to have a heart attack within 10 years should be medicated to get their LDL-C cholesterol below 70.
Previous studies found 50-75% of patients arriving at ERs with a heart attack had “normal range” cholesterol levels. Thus, they decided even lower would be better. It is also possible that there are many other risk factors that get neglected with so much focus on cholesterol. There are other factors including vitamin B deficiency and high homocysteine levels, diabetes, and chronic long term inflammation in the body, causing inflammation of the endothelial lining of the arteries.
Additionally, cholesterol lowering medications are not risk free. I was put on 80 mg of atorvastatin in the spring of 2025. Within 5 weeks my leg muscles and knee joints began aching terrible, making walking difficult. I was taken off atorvastatin, the pain went away. This was then restarted at 40 mg; the pain returned. I was again taken off the drug and restarted on rosuvastatin. In about 4 weeks, the pains returned but were initially milder. Then they got worse. On July 3rd, while merely walking I likely tore a tendon in my right gluteal muscle, diagnosed by a PT on July 7th. There is a rare and uncommon side effect of known tendon injuries but we have no way to know if this was the cause.
On July 14th, I had a ripping sensation on the left side of my left thigh muscle or perhaps the ITB. For several days I could not walk. I was told to discontinue the statin.
By end of August I was able to walk again. At the very end of September, I was put on a PCSK9 inhibitor named praluent (similar to repatha and leqvio). Within 3 weeks I developed outer hip pain, that over the next 6-8 weeks spread broadly to both thigh and glute muscles, developed mild swelling my lower legs, and in December, significant swelling in the tops of my feet. By early January, there were days I could not walk without preceding very slowly with the aide of hiking poles. I brought this up to my cardiologist and he said he had never had a patient with this problem from this drug.
The problems worsened from then on out. From late December to now mid-March as I write this, I have been housebound, usually in too much pain to be able to walk anywhere. In March I had an appointment with a new PA who is interested in working with me to resolve this and as I write this, I expect to discontinue praluent within a week. It is expected to take 3-4 months, minimum, for relief of these symptoms, if praluent is the cause.
As of May I still have to use 1 or 2 walking sticks to move.
There is not a lot information on this condition (there is some though) with praluent; however, there is a lot for the similar medication, repatha, which has about 72% market share. Hundreds of patients describe similar pain patterns that went away after a few months of being off the medication.
As this post goes live, I am now about 9-10 weeks off of praluent. The foot swelling is gone, the lower leg swelling is diminished, Pain in my knees has gone away – but glute/hip/thigh muscle pain persists although in the past week it seems to be diminishing.
It would seem to a brain injured idiot like me that being able to exercise and being able to stand to resume cooking healthy food in the kitchen, would have greater benefits to my heart than the extreme pain.
The point is: significant numbers of patients will experience pain, harm, and a reduced quality of life and health due to medications given to “treat a number”. Some practitioners take these problems seriously, but some tell patients the pain is “in your head”, or “tough it out” or “none of patients have these problems”. This is wrong.
I have no background in health care – just “experiences” and study from which I have learned much. Ignore everything I say or suggest regarding health care because I am a brain injured idiot, ok?
