Problem:
Age 45, is an editor-in-chief of a metropolitan newspaper and typically works 10-12 hours a day, 6 days a week. His position is demanding, but he enjoys his work. M.G. is married and the father of 3 sons (12,14, and 16 years old). The family are close and enjoy eating out and attending sporting events. One day while working in the yard, M.G. experienced a heavy, dull, aching in the sub-sternal area. After resting a few minutes later, the chest pain disappeared. He first attributed the discomfort to indigestion as he had just eaten a large meal. But, he remembered earlier in the week he had experienced the same sensation after climbing two flights of stairs. M.G. has become anxious about the cause of this chest pain. Two close friends have had heart attacks within the past year. His concern prompted him to go to the ER and he was hospitalized for a complete cardiovascular evaluation. Upon admission to the hospital, M.G.'s blood pressure was 170/100. The electro-cardiogram was normal. Laboratory findings after a 12-hour fast included: Serum Cholesterol 250 mg/dL (< 200 mg/dL) LDL-Cholesterol 180 mg/dL [< 130 mg/dL (<100 - optimal)] Triglycerides 450 mg/dL (<150 mg/dL) BUN