Red yeast rice

Red yeast rice is being hailed as a natural cholesterol-lowering agent. Perhaps more significant is its apparent anti-inflammatory action.

Hyperlipidemia — not just the numbers

For several years, I have geared my treatment of hyperlipidemia (Item 126-8) to a goal of 70 mg/dL LDL and 70 mg/dL triglycerides. In my treatment goals, I have placed great importance on the use of statins to (1) reduce endothelial dysfunction as manifest by reduction of cardiac-specific C-reactive protein and (2) enhance plaque regression.…

When to treat high LDL with high HDL

What is the best therapeutic approach for asymptomatic patients with zero to two cardiac risk factors, elevated LDL (>130-160 mg/dL), and high HDL (>60 mg/dL)? At what LDL would you treat the hyperlipidemia despite the high HDL?—David Y. Kawashiri, MD, Beverly Hills, Calif.  This is the question cardiologists are hearing more and more often: When…

Statins for premenopausal women?

A physically active 47-year-old woman who has no true risk factors for coronary artery disease (CAD) has a total cholesterol of 235 mg/dL, LDL 160 mg/dL, and HDL 53 mg/dL. She has done most of what she can with diet and exercise. While I would start a statin in a man, the literature is confusing…

In MS, the myelin sheaths around the brain’s axon nerve fibers (purple) are destroyed.

Comorbidities slow MS diagnosis

Chronic conditions, such as obesity, diabetes, high BP, or high cholesterol, seem to delay multiple sclerosis (MS) diagnoses.

Shortness of breath on a statin

A 53-year-old man who has a history of hypercholesterolemia with elevated triglycerides and LDL has been tried on different statins to bring down his LDL. He developed musculoskeletal pain even though his creatine kinase was normal. While on pravastatin, he developed shortness of breath, which resolved when the medication was stopped. Has shortness of breath…

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