A friend asked after the physical examination with the report of the four blood lipids, his low-density lipoprotein cholesterol (LDL-C) is 4.2, whether he needs to take statins, this question is really difficult to answer, this is a very professional question, because whether LDL-C is high or not, whether to take medicine, does not depend entirely on the LDL-C level to decide
LDL cholesterol is the most eye-catching indicator of the four blood lipid items, because the elevated LDL cholesterol is most closely related to atherosclerotic cardiovascular diseases such as coronary heart disease and ischemic stroke, but whether you need to take statins if you need to take statins if you have elevated LDL cholesterol, you need to look at various factors, not only to look at the value of LDL-C, but also to integrate other factors, such as age, blood pressure, The number and level of these risk factors for cardiovascular diseases such as smoking history, as well as whether there are underlying diseases such as diabetes, are clinically classified according to the value of LDL-C, combined with the above risk factors, and the risk degree of cardiovascular disease is divided into high-risk, intermediate-risk and low-risk groups, and high-risk people need to take statins.
This is a classic cardiovascular disease risk grading table, the table is first divided into two types according to the incidence of cardiovascular diseases, namely primary prevention and secondary prevention, the so-called primary prevention, that is, has not suffered from myocardial infarction, cerebral infarction and other cardiovascular diseases, in the stage of prevention of the above diseases, the so-called secondary prevention, is already suffering from the above diseases, to prevent the progression and recurrence of these diseases.
As can be seen from the table, the population belonging to the secondary prevention needs to strictly control the LDL-C level, and the minimum should be controlled below 1.4, such people basically need to take statins to make the LDL-C standard, and for the people who belong to the primary prevention, it is necessary to combine the LDL-C level, and then according to the age, family history, smoking history and other factors comprehensive evaluation, high-risk people need to take statins.
Specific to this female friend, 42 years old, in addition to a little high blood lipids, no hypertension, diabetes, coronary heart disease and other underlying diseases, no smoking, according to the risk factor classification of this table, belongs to the low-risk group, there is no need to take statins, lifestyle intervention is enough, but if her LDL-C exceeds 4.9mmol/L, or she has type 2 diabetes, it is directly listed as a high-risk group for cardiovascular disease, and she needs to take statins.
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Guidelines for Lipid Tubes in China (2023)