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Heart Disease (Expert Forum)
Cardiac risk factors
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
Cardiac risk factors
by runnertom, Jan 22, 2005 12:00AM
I have posted before but am still uncertain as to whether I am doing all I can for my health.
I am a 56 yo male who had double bypass of LAD and first diagonal about two years ago. My only symtoms were transient sob at the very beginning of my running and arrythmia during exercise that got my GP excited when he was evaluating me for the wheezing I sometimes experienced while running. I never experienced any angina, probably due to extensive collateralization.
These blockages were a complete suprise in view of a very benign family history and my background of serious running and cycling since I was 25. I never smoked. LDL was about 130, HDL 60. BP normal although elevated during exercise. It was found that my homocysteiene was high but is now down to 13 with folic acid and B vitamins. Taking 20mg Lipitor, my LDL is now 71 with 73 HDL, TG 60. Lp(a), CRP, and fibrinigin are good. I do take 12.5 mg Paxil for anxiety because my lipid specialist says I am obsessing over this heart thing. My GP says I have every right to since I should not have heart disease.
I was evaluated for the apolipoproteine E4 allele since I have had these little yellow deposits under the skin of my upper lip for many years. I suspected they could be xanthomas, but I came back E3/E3. The yellow deposits were said to be cholesterol deposits (!).
My GP still thinks I should perhaps be evaluated by the Cleveland Clinic to eliminate any more subtle risk factors. Do you think a more thorough workup is indicated for me? I do think I am in the care of one of the better cardiologists in the area.
I am a 56 yo male who had double bypass of LAD and first diagonal about two years ago. My only symtoms were transient sob at the very beginning of my running and arrythmia during exercise that got my GP excited when he was evaluating me for the wheezing I sometimes experienced while running. I never experienced any angina, probably due to extensive collateralization.
These blockages were a complete suprise in view of a very benign family history and my background of serious running and cycling since I was 25. I never smoked. LDL was about 130, HDL 60. BP normal although elevated during exercise. It was found that my homocysteiene was high but is now down to 13 with folic acid and B vitamins. Taking 20mg Lipitor, my LDL is now 71 with 73 HDL, TG 60. Lp(a), CRP, and fibrinigin are good. I do take 12.5 mg Paxil for anxiety because my lipid specialist says I am obsessing over this heart thing. My GP says I have every right to since I should not have heart disease.
I was evaluated for the apolipoproteine E4 allele since I have had these little yellow deposits under the skin of my upper lip for many years. I suspected they could be xanthomas, but I came back E3/E3. The yellow deposits were said to be cholesterol deposits (!).
My GP still thinks I should perhaps be evaluated by the Cleveland Clinic to eliminate any more subtle risk factors. Do you think a more thorough workup is indicated for me? I do think I am in the care of one of the better cardiologists in the area.
Doctor's Answer
by CCF-M.D.-MJM, Jan 22, 2005 12:00AM
Hi Tom,
I agree it is very important to pay close attention to your diet and exercise. It sounds like you have had a pretty thorough evaluation for the known treatable causes of coronary heart disease. I higher dose of lipator may not hurt. I use a lot of higher dose atorvastatin (Lipator) to bring down the LDL and feel very comfortable with an LDL in the high 50's to 60 range. There are not studies to suggest that low very high dose lipator works any better--it is what I do though.
We would certainly love to see you at the Cleveland Clinic and could offer a second opinion, but am not sure we would change anything.
I hope this helps and keep up the good work.
I agree it is very important to pay close attention to your diet and exercise. It sounds like you have had a pretty thorough evaluation for the known treatable causes of coronary heart disease. I higher dose of lipator may not hurt. I use a lot of higher dose atorvastatin (Lipator) to bring down the LDL and feel very comfortable with an LDL in the high 50's to 60 range. There are not studies to suggest that low very high dose lipator works any better--it is what I do though.
We would certainly love to see you at the Cleveland Clinic and could offer a second opinion, but am not sure we would change anything.
I hope this helps and keep up the good work.
The result were almost fruitless.
I decided to use the tread-mill, walking 3 miles every other day and remove all fatty foods. replaced with high fiber foods.
My cholesterol drop withen six month from 220 to 170.
I'm 73+