No one argues the beneficial effect of fluorides in the water supply. I am the first to concede that testimonials are one of the lower forms of evidence. On the other hand, six years ago I found out that I had asymptomatic left main coronary disease requiring an immediate cardiac bypass. True, I had mild hypertension but also a total cholesterol in the range of 225. I was placed on a statin and now (with minimal dietary changes) my LDL is less than my age. I cannot help but wonder if I had been placed on a statin 25 years ago if my heart surgery (and vessel damage ) could have been avoided.

We all know that classic risk factors do not predict almost 50% of acute coronary syndromes. We also know that simply lowering cholesterol by a drug does not necessarily tie to decreased heart disease. We are also just starting to understand how the inflammatory process is playing a role  in ACS.

The studies on statins are overall favorable, but they are not compelling.

Yet when I speak at medical meetings I love to ask cardiologists whether they are on statins. To my informal analysis it seems like at least 90% of cardiologists I ask are taking the drug.

So what do we do?

Statins do have side effects. Musculoskeletal symptoms can be a nuisance and liver disease can be fatal.

Let’s face it. Cardiovascular disease remains a leading cause of death for Americans. To this date we do not completely understand the pathophysiology of ACS.

Well for me, I will stay on a statin. I will check the cholesterol of my 23 year old son, and, if it is elevated, put him on a statin now and not wait until he is diagnosed with heart disease 25 years later. We need to intervene now, not later.

Maybe putting a statin in the water supply is a bit extreme.

Maybe just in bottled water?