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I would tend to agree with Mark Joyce. Would need to know other risk factors (weight, hypertension, and presumably non-smoker). She has already tried diet without success, thus if she has a high LDL I'd certainly put her on a statin as I feel she has a high risk of a primary event in next 5 years, though I can't off hand give an EBM percentage. The risk is probably CVA >> MI, and the outcome for that is potentially worse with respect to rehabilitation. What about a Carotid doppler ? Nice low morbidity and useful investigation. Presumably she is now on ASA, which is probably even more important than the statin (IMHA) !! Jon Wilcox Auckland ---------- > From: Mark Joyce <[log in to unmask]> > To: [log in to unmask] > Subject: Re: Treating raised lipids > Date: Saturday, 5 October 1996 06:48 > > re: 72yr. old patient > headache > cholesterol came back as 9.6 and has not improved on dietary > treatment. > She has no history and one sister had an MI at age 65+ > > I would measure HDL, Trigs., and LDL and discuss her risk factors with > her. The headache may be related to cerebrovascular atherosclerosis. > If she is a vigorous 72 year old I would treat her with drugs if she was > interested in pursuing it, after offering her the options. Treatment at > this late age should be patient-led, and reflect your reaction to treating > her very significant hypercholesterolaemia, if it was your mother or you, > at her age. > > Mark Joyce > Calgary > %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%