I am slim, eat healthy and exercise regularly. But my cholesterol has risen to 6.1 and the doctor says I have a 14 percent chance of having a stroke or heart attack within ten years. They force me to take statins. Is this really necessary, since my risk is low?
My husband was taking statins and they were giving him muscle pain. I have fibromyalgia and I don’t want any more pain.
Sandra McKinnon, Watford, Herts.
You have been clearly assessed with the QRisk3 calculator; This involves entering data about a patient – such as age, gender, ethnicity, blood pressure and weight – and then an alogorrhythm calculates the chance of a heart attack or stroke within the next ten years.
At 14 percent, your risk is moderate, and the guidelines recommend that people with a score of ten or more be offered cholesterol-lowering medications, i.e. statins.
In my opinion, the decision about whether or not to take a statin (which is usually lifelong) at your risk level depends on balancing your views on the potential side effects against the established benefits.
Part of this decision may include thinking about the other options that can help you reduce your risk.
The guidelines recommend that people with a score of ten or more on the QRisk3 calculator are offered cholesterol-lowering drugs
For example, it helps people who are overweight to lose weight. In addition, daily exercise; a Mediterranean diet (reducing animal fat intake and eating plenty of legumes, fruits, vegetables, whole grains, nuts and olive oil); regular sleep pattern; quit smoking; and meditation have all been shown to lower cholesterol levels independently of taking medications.
Your letter prompted me to calculate my own risk percentage and I was surprised to find that it is 10.2, which is higher than I expected.
You consider 14 percent to be low risk, but I still feel like my 10.2 percent seems quite high; Indeed, if I went to sleep tonight with a 10.2 percent chance of winning EuroMillions in tonight’s draw, I’d go to bed pretty excited!
I do take a statin myself, but rest assured, you cannot be forced to take one, and you do have other options.
Are my vision problems related to the fall I had almost a year ago?
Almost a year ago I fell and cut my head on a metal mailbox. The wound site was located just above the anterior hairline. I was stitched up in A&E with 13 stitches and given a scan. All remarkable.
However, a year later, residual blood still seems to seep into the eye sockets, appearing as dark circles under my eyes and some degree of ‘lumpiness’ on my forehead. Recently I have had visual disturbances in my left eye twice. Could these be connected?
Jackie Godfrey, London.
A head injury like you describe can cause a lot of bleeding and can split one of the veins just under the skin.
There is very little fat – which means very little cushioning – under the skin of the scalp, and although the impact didn’t fracture your skull, the blood vessels are less protected than elsewhere in the body.
This means that it is likely that a significant amount of blood has collected between the skin and the bone – what we call a hematoma.
These can be quite large, but over time the body’s repair mechanisms will have reduced the amount of clotted blood; Months later, what remains in your case is a scar-like lump under the stitches that will probably never go away completely.
And as you suspected, the remnants of blood have slowly come out from around each eye socket.
I feel that your visual disturbances at this late stage are probably not related to the cut on the head.
I recommend that you consult an optician and have your eyes examined.
You may have a withdrawal of the vitreous gel into the posterior chamber of the eye, or there may be another cause for the symptoms.
Write to Dr. Scurr from Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: drmartin@dailymail.co.uk. Dr. Scurr cannot enter into personal correspondence. If you have health problems, consult your own doctor.
We need dieticians in general practice
One solution to the crisis in primary care would be to expand the role of support staff, such as physiotherapists, pharmacists, psychologists and nurse practitioners.
Amazingly, there is actually money available for additional staff, following the introduction of primary care networks, which bring together GPs and other health professionals to tackle chronic diseases, using different professions under the Additional Roles Compensation Scheme.
Strangely, dietitians don’t seem to be involved, which is surprising given the escalating incidence of type 2 diabetes and obesity.
I indicate that I am interested: I am married to a dietitian, but if we want to reduce the pressure on general practitioners and the number of patients with chronic diseases, hiring a dietitian in every practice seems an obvious step.
Why hasn’t anyone thought of this?