Heart Disease Risk :: Cholesterol - Good Vs Bad Cholesterol


Jun 18, 2014

I had a general health check at doctors yesterday. Am a 41 year old male and am taking co-codamol painkillers and amitriptyline on regular basis for back/nerve pain. Try to be physically active when I can but have real issues with my back and legs that limits anything too physical or for any length of time, but in general I manage at least 30 mins of some kind of physical activity each day. My diet isn't brilliant but it isn't terrible either (can be improved I'm sure).

6ft tall, waist measured yesterday at 38" and I'm just under 80 kg in weight.

My health check said my blood pressure was good, and that my pulse was nice and steady but also that my good cholesterol was above average (over 1.5) but that my bad cholesterol was not where it needs to be at 7.2.

The bad reading has freaked me out a bit. I've never had a cholesterol test before so cannot compare reading to a historic level but nurse has requested me to have a further blood test and probably a chat with doctor.

So, question is does having an above average level of good cholesterol and good blood pressure help manage the higher levels of bad cholesterol? My overall risk of having some kind of cardiac issue in next ten years came out at 1.49% which seems fairly low, but I forgot to ask how low you can get this % ie a risk of 0.01%?

I can try to up my physical activity a little bit but how dramatic would you change your diet based on above? I have lost two relatives to heart disease on my father's side of family (his sister and his father) but both parents appear to be fine although not aware they have ever had their own cholesterol tested.

I'm going to try and lose a few kg in weight which I'm sure will help but any advice in how to better manage my bad cholesterol appreciated.

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For several years I took Simvastatin lowest dose (cut in HALF) and had good cholesterol numbers that satisfied the internist. That doc retired and new internist did a CPK test last year (my first one ever) and found it elevated to 243 so stopped the statin due to fears of muscle damage.

A year later (last week) the retested CPK, after taking NO statin for a year, was 303 and chol. numbers were back up (see below)!! So, doc says go ahead and take atorvastatin because there is a percentage of people who have high CPK with no other apparent problem. He said atorvastatin is more effective re chol. lowering than simvastatin which I'd had years ago. Is that so?

I am female, 64 years old and at age 55 had a calcium scan of the heart which showed ZERO calcium score. This was because I had similar TC numbers to current numbers and one doc (a cardiologist!) said 'have the scan' -- "find out if you need a statin." When he saw the ZERO calcium score for someone 55 he laughed and said I did not need a statin.

Years later, however, this new internist/gerontologist says that's fine but that is just the hardened cholesterol seen in the zero score, not the 'soft,' which is what travels and causes heart attacks and stroke. Great! Money spent for nothing on the test! Guess I need to educate the cardiologist?

My current chol. numbers before re-starting a statin last week were: Total Chol: 251; HDL: 77; LDL: 157; and Trigs: 87. Ratio is 3.26 -- Doc says he does 'not like' the 157 LDL.

So... a week ago I started on atorvastatin at a super low dose (I cut the 10 mg. pills into quarters so 2.5 per day. I have read in multiple places that it's stronger than simvastatin so wanted to start LOW and research shows that 2.5 is often enough to bring numbers to reasonable levels. I am not aiming to have the world's lowest cholesterol.

Last night and today I developed sharp pains in upper mid section and read the 'side effects' -- sure enough -- it's a possibility. Have also experienced increase in heartburn since taking these pills for a week. Started almost immediately. Is there a connection?

NOTE: Gallbladder removed in '04, before ever starting on any statin at all -- I'm one of the many who still has occasional GB related pains, likely from sphincter of oddi problems (sludge or stones formed by liver). It is called SOD III and it's not uncommon and since it's not a frequent occurrence, there is nothing to do about it per gastro doc. I have not had an episode in three+ years until last night/today, though this was mild.

Any relation to start-up of atorvastatin and these pains? Who knows? I would prefer taking NO statins since they are known to raise glucose a little and can bring on Diabetes type 2. My fasting glucose is high normal already at 98 and type II runs in my family at older ages. Swell.

What do YOU experts think of this? Would you be concerned about taking atorvastatin (or switching to simvastatin, which I took with no obvious problems for a few years?) Or would you just say forget the statins and live your life and don't worry about it? There is NO history of heart attack in anyone on either side of my family before age 80 and no 'strokes' at all.

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However, after I went home, and I did a lot of research and found that it would be a bad idea because having my ovaries removed increase my risk of heart disease and osteoporosis, and my family has a strong history of both, but not of cancer (which I didn't think to mention at the consultation - finding out that there was a slight chance I might have cancer in my uterus put other thoughts out of my mind.) So I sent a very long, detailed email to the gyn/onc, explaining why I thought removing my ovaries would be a bad idea but never got a response. So I called the gynaecological nurse, who was present at my consultation, and she reassured me that I didn't have to have my ovaries out; I have to consent to the surgery.

Well, I was all relieved until I had my pre surgical assessment on Wednesday, when I was given the paperwork to fill out and on the top of the first page it said TAH/BSO (The BSO part means removal of Fallopian tubes and ovaries.) I wrote on the page that I did not consent to BSO and told the assessment nurse, who said she just go that from the doctor and it had nothing to do with her.

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What do you think? Isn't the HDL a bit low?

I am male aged 68.

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I have cut out salt and brought all low fat alternatives and started to do 30 mins exercise 4 times a week.

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