Cardia Risk Questions

Hi, I've written to you before and apprecate you respose.
Female - 42yrs- 45pds Overwieght - Mother died 67-smoking related issues - father died 46yrs in fire.  Don't really know any history of father's family.  Little about mothers.

My problem is that I have had bad HDL/RATIO for about 7-9yrs.
I had blood test in Feb Chole was 243.  don't have the other number on hand.
Blood test:          May            Aug
                     Chol  201       184
                     HDL    34        28  
                     LDL    143       122
I have been excersing 3-4 times a week for 30 minutes and although my LDL has gone done so has my HDL how much should I be concered, does one offset the other.  I have read that exercise is the best was to raise the HDL and I am trying, are there any other suggestions.  I also had a blood test for Homosestic, this is suppose to tell if you have a cardic risk, I was told that mine was 11.3 and it should be under 9, therefore I am at increased risk, they put me on folic acid tablets and are going to repeat the test in 4 months.  I am trying to lose weight, but it comes off very slowly.

My question (Sorry so long winded.) Is how much at risk am I for cardic issues.  When I wrote to you before I was experienceing left sholder pain, and heart flutters, you suggested a stress-echo, which I had and it said I could get up to 92%.  I also wore a King of Hearts Monitor which showed my h/r jump from 70 to
130 said I had sinus arrithma - what is this.  Should I be worried, doctor don't really want to take the time to explain things to you, so you people are a god-sent.  I am very concered,
should I be,  Am I at moderate risk, low risk, or high risk,
ANy suggestions to help this HDL would help and should I worry
about this sinus arrithma and heart flutters.  Heart does seem to
race alot, could this just be stress?  Any answer would be greatly appreciated.  Thank You

[CCF CARDIO MD - DLB]

Dear Nancy

Low HDL, such as yours, is a risk factor for heart disease. It is less of a risk factor if the LDL level is also low. Exercise of an aerobic nature is useful to raise the HDL. Certain medications, such as niacin, can also raise the HDL.

Sinus arrhythmia is a variation in the heart rate in response to different things such as breathing. It is usually not abnormal.

I hope this has been useful. I wish you the best of luck. Feel free to write back.

Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.