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152159 tn?1200082454

Cholesterol Survey

Dear board members...I am currently reading "The South Beach Heart Program" and I am curious what others have observed with their own cholesterol and heart disease...namely:

Are there any folks out there with "bad cholesterol numbers" and no heart disease?

Are there any folks out there with "good cholesterol numbers" that DO have heart disease?

I am enjoying the book and actually doing the diet...but I feel like in one breath he says, "getting your cholesterol numbers right will prevent heart disease" and then at other times he talks about people with "normal cholesterol numbers" who have all kinds of plaque/heart disease.

I understand his point that the density numbers and calcium scores are the real indicators...but I'm wondering if there has to be another factor that causes bad numbers to lead to heart disease...namely genetics.
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Avatar universal
My total cholesterol is 134 (has always been under 150), HDL 76, LDL 48, tg 48, my bp is (average) 120/75, and my family history is negative for early CAD. But a mild perfusion defect showed up on a nuclear stress test last month. They can't say whether it was an artifact or whether I have true CAD, and my doctor won't authorise any further tests for now. I know how my body feels though and I am quite worried that I'm headed for a heart attack soon.
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Avatar universal
My LDL  is 211  and HDL is 33 and tryglycerides is 33.  


So my doctor is puting me on Niaspin I am 30 yrs old .  I work out evryday  45 minutes of cardio.  I guess I do not eat a lot of junk food, some.   I eat a lot fruit just need to eat more vegitables.  

I asked my doctor if I am in danger of a heart attack, he said if I was 45 he would be concerned.    Hopefully just changing my eating and niaspin will help. My dad has high cholesteral and is on lipitore, he said its probaly hereditary, but  does anyone have any  thoughts.

I just worry some times and I do not want to be a statistic one of the young ones that die of a heart attack at young age.
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Avatar universal
Ywa, I do have severe white coat syndrome for the last 30 yrs.  My BP shot up to 255/160 at one time when I was in extreme suspense about an outcome of a very serious and important medical test.  There are tons of articles about white coat syndrome, and tons of chat rooms on the Internet with people suffering from this condition.

When I was a very young Teenager my BP used to be 140/90 when going to the doctor, when I was in my early twenties it went up to 150/90, every ten years it got higher and higher at the doctor's office/hospital even though it was 115/75 at home.  Tranquelizers, different brands, and doubled up before going to the doctor did not help no matter how soon before my appointment I took them.  Once it was over and I was on my way home they kicked in and I slept for the next 20 hrs.

Therapy did not help because they and doctors either do not understand or brush it off.  
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152159 tn?1200082454
Well I had my appointment. I liked the nurse practitioner very much. She is a "prevention specialist" at a major research hospital and I was very impressed with her knowledge and ability/willingness to answer ALL my questions.

She agrees I should keep trying the SB heart program diet and because I am young and have only one risk factor, we are going to start with the OTC niacin in a very strict regimine that she provided for me. If that doesn't work after 4-5 months we will look at the Niaspan. I will keep everyone updated...thanks for the great advice and I will keep everyone posted.

Side Note: My blood pressure since I have been running again has consistantly been in the 118/60 area. Today it was 140/80 and the other nurse refused to use the large cuff (I have about a 14-15 inch arm). They blamed it on nerves....aka "white coat syndrome". Anyone have experience with this?
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Avatar universal
I know people who got a big jump in their HDL from Niaspin as in prescription Niacin, not over the counter niacin.  Everybody reacts different.  Some people get a big jump, some do not, some people get side effects, some do not.  If you need the meds, start out slow as I did, every other day, and see what it does to you as in side effects, if you get side effects then stop taking the meds and tell your doctor.  If you don't get side effects continue to take the meds, have your liver checked every 3-4 months as well as your cholesterol.

Exercise also is very good to boost your HDL, but again, different people react differently.
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152159 tn?1200082454
Yes...these are all things I've been reading and that Agatston talks about at length in his book. It's also more complicated than that...if you have bigger LDL density and bigger HDL density that is also considered protective. I will be curious to see what my cholesterol density is and what other suggestions they have.

What does the doctor say about your husband's HDL still being only 26...doesn't seem like much of a jump? Nor have i heard of many people having a big jump from Niaspan...are they suggesting other things?
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61536 tn?1340698163
The thing to remember about HDL is that, in quantity, it is protective. It bonds to the LDL and carries it out of the arteries where it would otherwise collect.  This is why low HDL is such a risk factor.  You can have low numbers of LDL, but if the HDL isn't helping your body process the LDL, your low cholesterol doesn't mean much.

My husband's HDL started out at 28 and is now 36.  Our cardiologist started him on 500mg Niaspan, and after three months he increased it to 1000mg.  He gets the flushes with it occasionally, but aspirin takes care of that rather quickly.  For men, HDL below 40 is a risk factor, and for women, below 50 is a risk factor.  For both, over 60 is considered protective.
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152159 tn?1200082454
Thanks for the heads up...I did not realize until reading the warnings on line tonight that Niaspan had liver risk factors...I though the only risk factor was flushing. I am taking OTC niacin right now that is marketed as slow release. The good thing is I have my appointment tomorrow and will discuss all this with my medical folks.

MC...did you start taking the Niaspan simply because your HDL was low or because you have CAD?
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Avatar universal
I see that you are now taking niacin. Did your doctor give you advice on how to take it? I am a little concern that you are going from 500 to 1000 mg so quickly.  Niaspan is not the same thing as the niacin you are taking. However, my doctor started me Niaspan at 500 mg for about 2 months, then boosted to 1000 mg for 1 month, and then increase it to 1500 mg.  Several months later, he boosted it to 2000 mg  He did the lipids/liver enzyme test at each step before raising it.

FWIW, my HDL did not increase until I got to 1500 mg of Niaspan.

Is your doctor running lipid/liver enzyme tests on you?
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Avatar universal
If you go to Google and type in "stress and cholesterol" you get tons of links.  I'm sure the article might be in there somewhere.
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152159 tn?1200082454
Thanks...great points. I was never a very high stress person until I got married and had kids and went back to law school. Before law school when I wasn't eating well and not exercising for about 12 months my HDL was 42...now its 27...who knows. I am hoping that the Niacin, the diet changes, etc. will help bring it up. I'm meeting with a specialist tomorrow.

But I would love to read that study...because it would make sense in my case for sure. Because right now I can't tie it to anything...

Thanks again.
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Avatar universal
A Specialist in that field told me one time that it takes decades for the high cholesterol to do damage to your arteries, don't know how long for low HDL to do harm to the heart.  I didn't ask about that because I have no problem with low HDL.  But have very high total cholesterol and very high LDL if I am not taking statins.  In my case its not from eating the wrong food.  I always have eaten/eat very healthy and do exercise every day.  In my case its inherited.  I do know that most doctors out there immediately blame the "eating the wrong foods" on your cholesterol problem.  In lots of cases it is indeed from eating the wrong foods and certain diets can bring it down, but not always.  Your cholesterol can also shoot up if you are under severe emotional stress or from a side effect of a certain medication you are taking including over the counter meds.  Everybody reacts different.  Some people get other stuff from being under high emotional stress, some people do get other side effects from certain meds, but their cholesterol is not effected.

The Specialist told me that there was a survey a Teaching Hospital did at one time about "Stress and Cholesterol" and they did the survey on Medical Students and Law Students, they started two weeks before their big final tests which decided if they will graduate.  Two weeks before that test their cholesterol was normal or even low.  The day before the test some of their cholesterol shot up as much as 200 points.  It took several weeks before their cholesterol came back down to normal.

High Cholesterol is not always from eating the wrong food, if you eat healthy and your cholesterol is still very high you need to make inventory of your life i.e. stress and family history, and what meds you are taking.
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Avatar universal
I am 25 and my cholesterol is about 253 with my tri's in the 400-500 range. November 1st i was put on tricor so i dont know if it has helped yet but I have had high cholesterol since i was like 19 (thats when i was checked first time) and according to my cardio there is nothing wrong with me as of yet.
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Avatar universal
I think I heard of that apo-a1 thing a couple years ago.  If I remember right, they were developing a drug that would specifically raise HDL  But, they have since given up on that.

I may have my studies mixed together.  Seems like the whole deal had something to do with the meditterranean diet.

I don't know........
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Avatar universal
    I found this feature on National Public Radio especially interesting and addresses your issue.  According to the author of the book who was interviewed on NPR, high LDL is only part of the story. There does seem to be some evidence that LDL is not the same for everyone who has high numbers.
You can click on the "Listen now" and hear the entire interview.

    http://www.npr.org/templates/story/story.php?storyId=15886898
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152159 tn?1200082454
Thanks excellent advice...and I am trying to do that. What bothers me is the idea that low HDL is like some genetic predisposition that will inevitably take its toll no matter I do. I am still hopeful that the Niacin and the diet stuff will have a strong positive effect. I'm meeting with a specialist Weds.

I also read tonight about some type of experimental study with a gene called Apo-A1 Milano. Not sure if anyone else has heard of this...but the reports were interestng.

Thanks for the advice...I'm just trying to do the best I can. It would be nice to hear from SOMEONE who has low HDL and no heart disease...surely there are people like this.
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Avatar universal
   When it comes to the human body, it is amazing how little we really know.   What seems especially confusing is what works for one does not work for another, and often there is no reasonable explanation other than people are different.  You may find an answer, but to compare the experience of others with your own can be a mistake.  
   You have taken an important first step with "The South Beach Heart Program."  Stay aggressive in your cardiovascular management and you will benefit.  While information is generally a good thing, too much information leads to confusion and uncertainty.
   Age 30 is a good time to develop lifetime health habits.  Just do it, don't dwell on it, and get out there and enjoy yourself.   Does that make sense?

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152159 tn?1200082454
I guess what I'm trying to get at is that I haven't seen any report that says you can have very low HDL and NOT get CAD...just feels like I have to get this under control somehow. Part of me thinks this can't be 100% accurate....I guess that's why I'm searching for anecdotal evidence of someone with low HDL and no CAD. Goodness knows, for a 30 yo I can't do much more to try to prevent it.
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Avatar universal
My HDL is 33 and I do take 500mg of niacin.  This may be giving me a bit of a boost on my HDL, but not much.  LDL is 66.   Diet and exercise don't seem to change my numbers much.  I think it is genetic.  
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Avatar universal
My LDL is 53 and HDL is 40 now.  I don't know what the breakdown was waaay back there.  Maybe they didn't even test it back then.  The LDL varies a little-maybe  +/- 5 points, but the HDL stays on 40.  They used to think the key was low LDL, then they thought high HDL was it.  I figure about now, probably both is the secret.  Every time I ask about increasing the HDL, they say 'more exercise'.  Well, I hate to break it to them, but there is a limit to how much exercise we can do, and the time we have to do it.

Que sera, sera .......
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152159 tn?1200082454
Have either of you guys been told you have Lipoprotein A or low HDL? I guess my concern is that overall cholesterol and high LDL are not the big factor...but rather low HDL. I'm not sure if there is a study showing this. I know docs say it's "A" factor...I'm wondering if it is actually "THE" factor.

Sweetwater...I believe you said you had low HDL and are taking Niacin? I am trying the OTC niacin...the 500mg was no big deal...took 1000mg last night and definitely had some tingling for about an hour...no big deal, but weird.

Thanks guys.
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Avatar universal
     I agree getting heart disease is a **** shoot.  Winston Churchill did everything wrong and lived past ninty.  Distance runners have died in their 30's and 40's from clogged arteries.   Even knowing that, the scientific evidence of the link between cholesterol and heart disease is powerful.  Dozens and perhaps hundreds of studies show that.  
     Regarding anecdotal evidence, which scientifically is the weakest kind, I have managed my own cholesterol for 10 years with lipitor, recently doubling the dose to 40mg/day.  There are two things noteworthy here:  My overall cholesterol last time checked was 113.  The second thing is both my brothers, younger than I, had heart attacks before age 50.  They are now on statins.  My only heart problem at age 64 is a-fib now under control following ablation, and a couple of narrowing arteries that so far have not affected my relatively vigorous outdoor lifestyle.  
     Again, I agree life is a **** shoot and there are no guarantees.  I prefer to load the dice in my favor by doing the things we are told helps:  statins, managing blood pressure, diet, and weight control.  
Too many people who lose do so because of self inflicted problems.   I am determined not to be one of them.  
  
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Avatar universal
I had stents and then bypass surgery.  The only explanation the doctors have come up with is, "heredity has to start somewhere".  Very comforting.

I've been told that the problems we face may be the result of something we did or didn't do, or  our lifestyle 40 or 50 years back.  That being the case, it seems like anything we do now will likely not come into play until we're dead.

I'm just skeptical of risk factors, I suppose, because of all the inconsistency I've seen involving heart trouble.  Of all the folks I know that have had heart problems, I'd say there are at least as many that have never smoked, were not obese, had no high blood pressure, had no high cholesterol, and exercised regularly, etc., as there are who did EVERYTHING wrong.  Of course, this is not a particularly scientific study--just my observations of my fellow sufferers.
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152159 tn?1200082454
Thanks for the great feedback...these are the types of anecdotal stories I am so interested in.

Do you really think there are no risk factors that can point to anything? Have doctors pretty much told you the same thing?

Kind of makes heart disease sound a lot more like cancer than the way it is traditionally advertised.

Do you think taking the drugs helps at all? Sorry for not remembering...but did you have bypass or a heart attack?

Thanks again for your candor Jim.
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