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Plano, TX
A 55-year-old male asked:

Which statins offer cardiac help when there is cad with normal cholesterol that you recommend to ur patients: pravastatin, simvastatin or atorvastatin?

3 doctor answers6 doctors weighed in
Dr. Elden Rand
Cardiology 21 years experience
Various: If a patient has documented coronary artery disease and the total cholesterol and the LDL cholesterol are in therapeutuic range numbers, the options are open, and i may typically recommend Simvastatin or atorvastatin. Overall, pravastatin would have a lower expected efficacy, and so would tend to prefer agents which would have an increased expected effect.
Dr. Milton Alvis, jr
Preventive Medicine 41 years experience
Rosuvastatin1st;then: Simva, atorva, prav, in this order of efficacy for both measured LDL nmo/l particle conc. (not cholesterol: made by every cell ; wrong issue) ; measured large-hdl μmol/l. See NMR particle test. Normal does not mean healthy; only common; i.E within central 96% of usual, nothing to do with excellence of health. Cost-wize: splitting Rosuvastatin 40+1/2 tab ezetimibe usually most bang for buck ; safest.
Dr. Milton Alvis, jr
Preventive Medicine 41 years experience
Provided original answer
Food choices, as always, are the 1st issue. The long recommended Low-Fat diet drives atherosclerosis. Thus go Hi-Fat (of nat origin, NOT processed, not high polyunsat plant fats, BOGUS), mod. protein & very low carb. Study: Big Fat Lies, McGovern's Report, Mary Enig, The Men Who Made Us Fat, FatChance.html, Peter Attia, Gary Taubes, NuSI.org, Paleo, Loren Cordain, my answers on healthtap, etc.
Feb 20, 2014
Dr. Joseph Woods
Pathology 28 years experience
Diet, wt. loss 1st,,: You've got a normal cholesterol and a condition of being overweight. Depending on the extent of your cad, it would be smart to talk to your doctor about a reasonable exercise program first. This and diet would help control the CAD without statins which have many side effects and seem to just lower cholesterol. If diet and exercise fail, then drug therapy should be carefully considered.
Dr. Andrew Zadeh
Cardiology 16 years experience
'Normal' cholesterol is relative, and targets for your cholesterol change based off your risk factors. These included Diabetes, known CAD, and prior heart attack. Each of these may set a lower ideal goal for your cholesterol. The choice of medication depends on how much lowering of your cholesterol is required. Atorvastatin is higher-intensity and can lower your cholesterol more than the others.
Feb 20, 2014

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Last updated Oct 16, 2016

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