From low blood pressure to high cholesterol, your problems solved

As part of a series on ‘the 100 most questions GPs are most often asked’, the Daily Mail spoke to consultant cardiologist at Royal Brompton Dr Sanjay Prasad about statins.


Why do I need a statin?

STATINS are a group of medicines that can help lower the level of low-density lipoprotein (LDL) or ‘bad’ cholesterol. Cholesterol can build up in the artery walls, causing them to become narrowed and hardened, leading to coronary heart disease.

For people who have already had a heart attack or stroke, statins could be important to prevent a recurrence, says Dr Sanjay Prasad, a consultant cardiologist at the Royal Brompton Hospital in London.

‘For other people whether you need a statin will ultimately depend on your doctor’s assessment of your risk of heart disease — it’s important to look at the overall picture.

‘Your GP will make an assessment using the QRISK2 cardiovascular risk calculator: this online questionnaire calculates your risk of developing cardiovascular disease over the next ten years.’

Statins have become a controversial area, with some experts questioning their increasing use in otherwise healthy people, not least as they carry the risk of side-effects, although just how serious and how common these are is also contested. But Dr Prasad is emphatic: ‘The overwhelming evidence is they are beneficial in the right patient.’


Can I cut my cholesterol without statins?

‘IF YOU eat a healthy diet and exercise then that can sometimes improve your cholesterol numbers — unless you have a genetic high cholesterol, or familial hypercholesterolemia,’ says Dr Glyn Thomas, a consultant cardiologist at the Bristol Heart Institute.

A plant-based diet can help: a major review of 50 studies published last year in the journal Nutrition Reviews found that vegetarian diets were associated with significantly lower levels of total cholesterol.

Some high-fibre foods, such as oats, are known to actively lower cholesterol. ‘When it comes to diet, the most important things which influence cholesterol are sugar and refined carbohydrates,’ says Dr Thomas.

‘You should stop snacking on processed foods, reduce refined carbohydrates and increase fibre and then go back three weeks later for a blood test. If there is no change your GP may then have to consider medication.’


My wife says I need my bloodpressure checked. Is there any point— I feel fine?

‘SHE is absolutely right to nag — especially if you’re over the age of 40,’ says consultant cardiologist Dr Sanjay Prasad. High blood pressure or hypertension is known as the silent killer because you can have it but otherwise appear completely well, and all the while over time it’s causing the arteries and blood vessels in your body to narrow. This can lead to damage to the brain or heart, such as a stroke or heart attack.

Heart attacks tend to occur more commonly in the over 40s — the average age for a first heart attack is 66 for men and 70 for women. Dr Prasad explains: ‘ If you treat borderline high blood pressure in your 40s it can help prevent a heart attack in your 60s and 70s.’

High blood pressure is also a risk factor for kidney disease, dementia and some eye conditions.

‘ It doesn’t necessarily mean having to take medication,’ he says. ‘It might just require a change of lifestyle such as cutting back on salt. I would suggest anyone over 45 should have their blood pressure checked a couple of times a year.’

Source: Daily Mail