My ldl has jumped from 105 (2009) to 155 (2 recent tests over a 3 mo. period). hdl is 90. how important is it that i take pravastatin (20 mg.)?

It depends: It depends on other risk factors. If u have no or 1 risk factors, your LDL should b <160. If u have 2 or more risk factors LDL should b <130. If u have heart disease or an equivalent, it should b <100. Risk factors include: smoking, hypertension, HDL <40, family history of premature heart disease (male 1st degree relative <55, female 1st degree relative <65), age > 45 if male or 55 if female.

Not very: Your HDL is so high that you, most likely, do not need statin therapy. With an HDL of 90, your LDL could be 220 and your risk would still be relatively low - much lower that a person with an LDL of 100 and an HDL of 25. Now if you have a significant family history of heart disease or if you have diabetes or high blood pressure, then a very low dose statin is recommended. See www.Lipid.Org.

Must Maintain Goal: Talk with your physician. The longer high LDL levels exist, the more damage occurs in the artery wall. Once on therapy it is important to maintain goal LDL levels (ldl-c < 100 if high risk, otherwise < 130). Ldl particle number (ldl-p) should be checked once at ldl-c goal to judge adequacy of therapy (ldl-p < 1000 nmol/l for high risk, < 1300 nmol/l otherwise). If not at goal treatment is needed.