I am thin, I eat healthy and I exercise regularly. But my cholesterol has risen to 6.1 and my GP tells me I have a 14 per cent chance of having a stroke or heart attack in the next ten years. They are pressuring me to take statins. Since my risk is low, is it really necessary?
My husband took statins and they gave him muscle pain. I have fibromyalgia and I don’t want any more pain.
Sandra McKinnon, Watford, Herts.
It has clearly been evaluated using the QRisk3 calculator; This involves entering data about a patient (such as age, sex, ethnicity, blood pressure and weight) and then an algorithm calculates the chances of having a heart attack or stroke within the next ten years.
At 14 percent, your risk is moderate, and guidelines recommend that people with a score of ten or higher be offered cholesterol-lowering drugs, namely statins.
In my opinion, at your risk level, the decision to take a statin (which is usually continued for life) depends on balancing your opinion of the possible side effects with the well-established benefits.
Part of this decision may include thinking about other options that can help reduce your risk.
The guidelines recommend that people with a score of ten or more on the QRisk3 calculator be offered cholesterol-lowering medications.
For those who are overweight, for example, it helps them lose weight. Additionally, daily physical exercise; a Mediterranean-type diet (reducing the consumption of animal fats and eating plenty of legumes, fruits, vegetables, whole grains, nuts and olive oil); regular sleep pattern; give up smoking; and meditation has been shown to reduce cholesterol levels independently of medication.
Your letter prompted me to calculate my own risk percentage and I was surprised to find that it is 10.2, significantly higher than I expected.
You consider 14 percent to be low risk, but I think my 10.2 percent seems pretty high; In fact, if I went to sleep tonight with a 10.2 percent chance of winning EuroMillions in tonight’s draw, I would go to bed pretty excited!
I take a statin myself, but rest assured, they can’t force you to take one and you have other options.
Are my visual disturbances related to a 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 just above the front hairline. They sutured me in the emergency room with 13 sutures and did an examination. Everything extraordinary.
However, a year later, there still appears to be residual blood seeping into my eye sockets, appearing as dark circles under my eyes and a degree of “bumps” on my forehead. Recently, on two occasions I have had visual disturbances in my left eye. Could they be connected?
Jackie Godfrey, London.
A head injury like the one 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 protection) under the skin of the scalp, so although the impact did not fracture the skull, the blood vessels are less protected than in other parts of the body.
This means that a significant amount of blood has likely collected between the skin and the bone, which we call a hematoma.
These may be quite large, but over time, the body’s repair mechanisms will have reduced the mass of clotted blood; Months later, what’s left in your case is a scar-like lump under the stitches that will likely never fully resolve.
And as you may have guessed, the remains of the blood have been slowly coming out around each eye socket.
My feeling is that at this late stage, it is unlikely that his visual disturbances are related to the cut to his head.
I would advise you to see an optician and have your eyes tested.
It could be that you have a retraction of the vitreous gel in the back chamber of your eye, or there is some other cause of your symptoms.
Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email firstname.lastname@example.org. Dr. Scurr cannot correspond personally. Consult your GP if you have any health problems.
We need dietitians in general medicine.
One solution to the crisis in primary care would be to expand the role of support staff, such as physiotherapists, pharmacists, psychologists and nurses.
Surprisingly, there is actually money available for additional staff, following the introduction of primary care networks, which bring together GPs and other healthcare professionals to tackle chronic illnesses, using different professions under the Additional Functions Reimbursement Scheme .
Interestingly, dieticians do not appear to be involved, which is surprising given the increasing incidence of type 2 diabetes and obesity.
I declare my interest: I am married to a dietitian, but if we want to reduce the pressure on GPs and the number of patients struggling with chronic illnesses, employing a dietician in every consultation seems an obvious step.
Why hasn’t anyone thought about this?