Karen Swanson has been researching and writing about cholesterol for several years on GoLowCholoesterol.com
Who or what was your inspiration for becoming knowledgeable and expert in the realm of cholesterol?
In August 2010, my total cholesterol and LDL (bad) cholesterol inexplicably skyrocketed. I'd been trying for years to eat a low-fat diet (operative word: trying) and faithfully had my cholesterol measured annually, as I have a family history of high cholesterol. But suddenly, as I neared 50, my doctor said what I was doing was no longer working and she wanted to put me on Lipitor. When I balked, she said I could try - for six months - to reduce my too-high numbers with a (more serious) low-fat diet and daily exercise. So I did a lot of food research, starting taking Metamucil, broke my daily ice-cream habit and began running in addition to playing tennis. It was "easy" at first - like the first week of a diet - and then I faltered. It wasn't until I launched my blog to keep me honest and keep track of what I was learning, that I really got motivated. In six months, my cholesterol did fall back down to my still-too-high-but-OK-no-statins-YET levels. And I've been trying to keep it there ever since.
What's the most challenging aspect of cholesterol that you wish you could make easier?
That there are conflicting reports as to whether cholesterol medications are indicated for those whose only cardiovascular risk is high cholesterol is frustrating. Some studies and cardiologists (and internists) say yes, others say no. The "if your cholesterol is over 200 you need a statin no matter what" school of thought has been prevalent for years, but there are studies that refute this belief. It's difficult to understand how such an important question - who should take statins and who should not and why - is so murky. This needs to change.
How do you think cholesterol affects or could affect people every day?
Heart disease is the leading cause of death in the United States(1), and cholesterol is clearly linked with heart disease. Currently, there are an estimated 30 million(2) Americans age 45 and over who take statins to lower their cholesterol. That's about 25% of the adult population being medicated.
Statins can have serious side effects including liver damage, myositis (inflammation of the muscles) and, rarely, life-threating muscle damage called rhabdomyolysis(3). That 25% of the US population is taking statins and risking side effects - and some perhaps need not take statins as they have no other cardiovascular risk other than high cholesterol - is concerning.
In what ways do you see cholesterol impacting people around you, or even the world?
Every single one of my blood relatives my age or older takes statins. Every single one. And not one of them ever questioned their doctor's recommendation. This is the case even though none of my relatives taking a statin are overweight, none have other cardiovascular risks (that I'm aware of), and we do not have a family history of death by cardiac disease.
This is astonishing to me. I wish there was a clear answer to the question: "if you have no cardiac risk other than high cholesterol, do you need a statin?" An answer convincing enough to give courage to my relatives (and others, of course) to discuss their statin use with their doctors. And perhaps decide to go off the statin, if their doctor agrees.
How have developments in treating high cholesterol impacted people in recent years?
Since the first statins were launched in 1987, the number of Americans taking them has increased dramatically - especially in recent years. The "Health, United States, 2010" Report from the National Center for Health Statistics(4) shows that in 1988-94 just 3% of men and 2% of women aged 45-64 took statins. Those figures grew to 18% of men and 16% of women in 2005-2008. Looking more broadly, it's estimated that 30 million Americans aged 45 and over now take statins - that is an astonishing 25% of the adult population. Nearly a quarter of American adults deserve more clarity about that statin they are taking, potential side effects, and whether it is truly necessary for their personal situation.
1. (1)According to the CDC.
2. (2)"Health, United States, 2010," as reported by the Harvard Health Blog.
3. (3)Mayo Clinic and WebMD.
4. (4)"Health, United States, 2010," as reported by the Harvard Health Blog.