Older Adults and High Cholesterol

Cholesterol is a waxy fat-like substance that is found in all the cells in your body.  Your body needs some cholesterol to make hormones, vitamin D and enzymes that help you digest foods.  Cholesterol comes from two sources.  Your liver makes all the cholesterol that you need.  The remainder of the cholesterol in your body comes from your diet, foods that derive from animals, eggs or dairy products.  These foods are high in saturated and trans fats.  These fats cause your liver to make more cholesterol than it otherwise would and could increase your cholesterol level to one that’s unhealthy.  The excess cholesterol can combine with other substances in the blood to form plaque.  Plaque sticks to the walls of your arteries.  This buildup is known as atherosclerosis and can lead to coronary artery disease, heart attacks or stroke. 

A variety of things can raise your risk for high cholesterol and atherosclerosis. 

  • Age – your cholesterol levels tend to rise as you get older.
  • Genetics – High blood cholesterol can run in families
  • Weight – Obesity or being overweight raises your cholesterol level
  • Race – African Americans typically have higher cholesterol levels than whites. 
  • Unhealthy eating habits – foods high in saturated or trans fats in your diet
  • Lack of physical activity
  • Smoking

I help my elderly mother with her medications and doctor’s appointments.  Decades earlier, to help lower her cholesterol, she changed her diet and obtained no results. Because of her genetics and her more sedentary life style, her provider prescribed a statin to help lower her high cholesterol.  A statin is a medication that blocks a substance your liver needs to make cholesterol.  This causes your liver to remove the cholesterol from your blood.  My mother was very happy that this medication helped her obtain a normal cholesterol level!

With any medications, there are side effects.  Now that she is older, I was wondering if the benefit of the statin medication still outweighed the risk of taking it.  The most common side effect is muscle pain.  Occasionally there might be liver inflammation, an increase in your blood glucose level, and some people have developed memory loss or confusion while taking statins.

Clinical trials of statins typically excluded very elderly subject or all elderly were grouped into age group of >65.  There is little data regarding statin usage among older elderly adults.  Statin prescribing practices are influenced by the provider’s and patient’s perception of safety concerns. Not everyone who takes a statin will have side effects, but some people may be at a greater risk than others.  They include:

  • Taking multiple medications, including ones to lower your cholesterol
  • Being female
  • Having a smaller body frame
  • Being age 80 or more
  • Having kidney or liver disease
  • Drinking too much alcohol

My mother and her provider are working together to provide her with the best care.  Every six months, she has lab tests done and discusses the results with him.  Along with her lipid panel, she gets tests that monitors her liver enzymes, muscle enzyme and glucose level.  She also discusses any changes that she notices, like aches and pains in her muscles. 

So for now, the benefit of the statin outweighs the risks of the side effects.  She is going to stay on the statin medication. Her cholesterol is normal and she still is happy that she does not need to watch her dietary input of saturated fats.  I guess we both can together enjoy an ice cream treat once in a while!

By Jill Liepold, MT

If you are concerned about high cholesterol, please contact your provider or contact Windom Area Health Laboratory Services at 507-831-0655 or 507-427-2700 to ask about Direct Access testing.

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