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    Cholesterol for Seniors

    Numbers + meds + food = manageable.

    Understand your numbers

    • Total — under 200.
    • LDL (bad) — under 100. Under 70 if heart disease.
    • HDL (good) — over 60.
    • Triglycerides — under 150.
    • Lp(a) — important, often skipped. Ask doctor.
    • Get free copy of your bloodwork.

    Statins explained

    • Most prescribed med after 65 (Lipitor, Crestor, simvastatin).
    • Lower LDL 30-50%.
    • Reduce heart attack + stroke risk.
    • Generic = $4-15/mo.
    • Side effects: muscle aches (10-20%), liver enzyme rise (rare).
    • Try different statin if side effects.
    • Take at night (cholesterol made overnight).

    Newer alternatives

    • Ezetimibe (Zetia) — pill, often added to statin.
    • PCSK9 inhibitors — Repatha, Praluent. Injection. Expensive.
    • Bempedoic acid (Nexletol) — pill alternative for statin-intolerant.
    • Inclisiran (Leqvio) — twice-yearly injection.
    • Statins still first-line for most.

    Food approach

    • Soluble fiber — oats, beans, apples. Lowers LDL.
    • Omega-3 — salmon, sardines 2x/week.
    • Nuts — walnuts, almonds. Daily handful.
    • Olive oil — replace butter.
    • Limit — red meat, fried, butter, full-fat dairy.
    • Plant sterols — Benecol, Promise margarine.
    • See /tools/anti-inflammatory-eating.

    Senior-specific considerations

    • After 75 — debate over statins for primary prevention.
    • If history of heart attack/stroke — keep taking statin.
    • Cognitive decline + statins NOT linked (despite myths).
    • Talk to doctor about CAC (calcium) score — guides decisions.
    • Lp(a) genetic — runs in families.

    Heart age calculator

    CDC has free "Heart Age" calculator — cdc.gov. American College of Cardiology has ASCVD Risk Calculator — predicts 10-year heart attack/stroke risk. Both free + senior-friendly. Discuss with doctor at next visit.