Quote:
Originally Posted by blueash
What is your family history? Did your father have an elevated cholesterol and live to 85 with no cardiac issue? Don't treat numbers in isolation. If you have a high HDL that is "protective" against the influence of a high LDL. None of this is clear cut and the understanding is evolving. Recently the recommended healthy lipid level was lowered.
From Mayo
For predicting your risk of heart disease, many doctors now believe that determining your non-HDL cholesterol level may be more useful than calculating your cholesterol ratio. (that is the total cholesterol/HDL) And either option appears to be a better risk predictor than your total cholesterol level or even your low-density lipoprotein (LDL, or "bad") cholesterol level.
To calculate your cholesterol ratio, divide your high-density lipoprotein (HDL, or "good") cholesterol number into your total cholesterol number. An optimal ratio is less than 3.5-to-1. A higher ratio means a higher risk of heart disease.
Non-HDL cholesterol, as its name implies, simply subtracts your HDL cholesterol number from your total cholesterol number. So it contains all the "bad" types of cholesterol.
An optimal level of non-HDL cholesterol is less than 130 milligrams per deciliter. Higher numbers mean a higher risk of heart disease.
Here is an interesting read which may not answer your question
http://www.scientificamerican.com/ar...rol-conundrum/
There are two studies mentioned pending, one on niacin, results are here:
Niacin Causes Serious Unexpected Side-effects, but no Worthwhile Benefits, for Patients who... -- SAN FRANCISCO, March 9, 2013 /PRNewswire/ --
and one on zetia with a statin
Ezetimibe in Combination With a Statin Does Not Reduce All-Cause Mortality
As you will see while both niacin and zetia with statin produced better lab values they were both useless in improving patient outcome. |
My family history is horrible. Major cardiac problems on both sides. My HDL is very low, my LDL is very high and my triglycerides are off the chart. I have been diagnosed with familial hypertriglyceridemia. My triglycerides routinely run into over 400.
I have coronary artery disease and have six stents. I'll probably be getting more and I don't think that bypass surgery is out of the question in the future.
But as I stated, there are some doctors, (cardiologists) that have come out to say that cholesterol is not the problem.
The thing is that my LDL is so high that reducing it by 20% or 25% would still leave it ridiculously high. So the question becomes are the risks of side effects of statins worth it to reduce my LDL to 300?
And as you have pointed out, often times better lab results don't improve patient outcome. Some studies have shown that people taking statins and successfully reducing their LDL have the same rate of heart attacks and other coronary problems as people who take nothing.
The problem is that if you read as much as I have about the subject, you end up not knowing what to believe. I also believe that pharmaceutical companies influence decisions made by doctors and the AMA. Politics can also be involved.
Doctors, especially cardiologists are simply following a protocol that is established by the AMA and other organizations. They have to be careful because if the go outside the recommended protocols, the risk being sued for malpractice.
Like I said, I think that everyone has to do what they think is best for them.