A 39-Year-Old Woman With Hypercholesterolemia
- Murray A. Mittleman, MD, DrPH, Discussant
- Author Affiliation: Dr Mittleman is Associate Professor of Medicine, Harvard Medical School, and Associate Professor of Epidemiology, Harvard School of Public Health, Boston, Mass.
- Corresponding Author: Murray A. Mittleman, MD, DrPH, Beth Israel Deaconess Medical Center, 185 Pilgrim Rd, Deac-301, Boston, MA 02215 (mmittlem{at}bidmc.harvard.edu).
Abstract
Ms T, a 39-year-old woman, has a total cholesterol level of 277 mg/dL (7.17 mmol/L) and well-controlled hypertension; her brother had a stroke in his 30s. She is primarily concerned with her mother’s history of breast cancer, but she would like to know if she can take a dietary supplement or if she needs to take cholesterol-lowering medication, and if so, whether she will need to continue it as well as adhere to her diet for the rest of her life. Her estimated 10-year risk of developing coronary heart disease (CHD) is 1% to 2% using the Framingham Risk Score, but that may underestimate her true risk as an African American woman with a family history of CHD. Recommendations for her, her longer-term risk for CHD, and evidence for lipid-lowering therapies are discussed.
- KEYWORDS:
- BLACKS
- CORONARY DISEASE
- HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS
- HYPERCHOLESTEROLEMIA
- LIPOPROTEINS, LDL CHOLESTEROL
- WOMEN'S HEALTH
This conference took place at the Medicine Grand Rounds held at Beth Israel Deaconess Medical Center on April 8, 2004.
Clinical Crossroads at Beth Israel Deaconess Medical Center is produced and edited by Risa B. Burns, MD, Eileen E. Reynolds, MD, and Amy N. Ship, MD. Tom Delbanco, MD, is series editor.
