Hello doctor, My father is 77 years old. Just had quad bypass surgery. Too clogged for a stent. Not overweight (ever). Smoked 2 or 3 cheap cigars a day for 15 to 20 years. No regular exercise, but stayed busy in the yard, walked the dogs, etc. Generally ate what he wanted, including both a lot of good foods. But he certainly did not avoid red meat, bacon, etc. I am 50, male. I have never smoked. I am 6 feet, 185 lb. I am a teacher, so I am up and about all day. I do not regularly exercise, but I stay busy. My latest lipid is HDL 48, triglycerides 81, LDL 158. I eat pretty healthy, but probably more red meat than I should. My questions are as follows. 1. If my dad had been on a statin all those years, would he still likely be in the hospital recovering from this surgery? And I say likely, as I know you cannot guarantee that answer. 2. If you were forced to advise me at 50, given that I would remain at my current weight (and not start smoking at any point) would you tell me to eat an extremely healthy diet like fish, nuts, fruits, veggies, little or no bad fat, red meat, etc., or would you advise me to start playing tennis four days a week (or substitute any exercise similar to that like cycling, rowing, running, etc.). You have to advise me to do any of the above, not both, please.
Hi. There are three things you are asking, statin, diet, exercise, right? 1. Statin: Scientific evidence shows elevated lipid especially LDL is a major risk factor for coronary artery disease, peripheral vascular disease, and stroke. And guidelines tell us that everyone aged 40 or above, in familial cases even before 40, a lipid profile should be done. If LDL is above a certain threshold (different threshold in presence and absence of risk factors and family history), the statin should be started to prevent coronary events. If your father had started statins early, chances for the current condition was less likely. 2. Diet: Healthy diet is something like a prerequisite for preventing heart diseases, and it is must at all ages. 3. Exercise: Regular aerobic exercise of at least moderate intensity is must for all ages to prevent heart attack and stroke, etc. Two and three, both are must simultaneously, and both must be advised, if not enforced. If I have to advise only one, I would advise exercise. If still any concern, I will be happy to clarify.