DEAR DR. ROACH: You have written many times about elevated cholesterol, but I have never seen anything about low cholesterol. I am an 86-year-old man with Type 2 diabetes that has been treated with moderate success using oral medication. I am 5 feet, 10 inches tall and weigh 160 pounds. I exercise regularly. My total cholesterol has always been low (under 125). Recently it was 103 — with HDL 41 (it also has always been low), LDL 38, triglycerides 112 and total/HDL ratio of 2.4. I have high blood pressure under control on lisinopril and HCTZ. My physician has suggested using a statin to raise the HDL. — S.J.Z.

ANSWER: Statin drugs reduce the risk of having a first heart attack in people at moderate to high risk for heart disease. I think of statins not just as drugs that lower cholesterol or raise HDL (although they do), but also as drugs that reduce heart risk when used appropriately. This includes not only people with very high total or LDL cholesterol levels, but also those with low HDL cholesterol levels.

One major risk for developing heart disease is age. Despite your low cholesterol and blood pressure, which I assume is under control, your age alone puts you at high risk for heart disease.

On the one hand, a statin is likely to decrease your risk of a heart attack. On the other hand, you have gone 86 years without developing heart disease.