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I am against statins as I have a liver abnormality. Should I be concerned if I have high level cholesterol.

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The Answer

Raised cholesterol is always a cause for concern, but how worried you should be depends very much on your other risk factors. Your overall likelihood of having a heart attack or stroke in the next 10 years is calculated on the basis of one of several ‘cardiovascular risk calculators’ which take into account factors such as your gender, age, smoking status, blood pressure, family history of heart attack and the relative amounts of total and ‘good’ HDL cholesterol in your blood. As a rule of thumb, statins are recommended if this overall 10 year risk is above 20%.

If you have had a heart attack or stroke, taking a statin is routinely recommended, and statins are recommended for the majority of people with type 2 diabetes, regardless of these other risk factors. Statins can cause an increase in some of the enzymes in your liver known as the transaminases. A minor rise is rarely of concern and is usually simply monitored. If they are very high (say, more than 2 ½-3 times the upper limit of normal) statins are usually not recommended. If you have active liver disease (cirrhosis or hepatitis) statins are usually contraindicated. However, it is important to bear in mind that some of the factors which cause liver abnormalities, such as fatty liver, are closely linked with a higher risk of heart disease.

Therefore, if you have some liver abnormalities you may have even more to gain from taking a low dose of statin. I would strongly suggest that you speak to your GP about how high your overall cardiovascular risk is, and about the relative risks and benefits of statins.

Answered by Dr Sarah Jarvis.  

 

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