Cholesterol and heart disease

[myheart2014]

Hello, I was hoping to get some advice please from anyone knowledgeable in the areas of cholesterol and cardiovascular disease.

I am a 34 year old male, I am 5’10 and I weigh approximately 100kg(220lb). My entire life I have been overweight and my weight has fluctuated between 80kg – 100kg. I did smoke for approximately 8 years, however I quit about 5 years ago. I would consider myself a light drinker, however there have been periods throughout my life where I either haven’t drunk for months or where I have drank heavily for short periods. I have always been fairly active, although I have never had good cardiovascular fitness, and I used to go to the gym and lift weights for a number of years. My parents have slightly high cholesterol levels, however they are in their 60’s and they have never had any heart problems and are not diabetic. I had one grandma who was diabetic and had angina and she died from a heart in her late 60’s. Everyone else in my family appears to be healthy and I have never had any health complications.

Approximately a year ago I was going through a particularly stressful time in my life and I started having panic attacks for the first time out of nowhere. Sometimes when I was at the gym I felt spells of dizziness, so I stopped training altogether in fear that there was something wrong with me and that I might be having a heart attack. On one occasion I had a really bad panic attack and I went to the hospital as I was convinced I was having a heart attack. Everything turned out fine and they recommended I consult a doctor and have some blood tests done.  

For the first time ever in my life I had my cholesterol and blood pressure checked and I found out I had very high cholesterol and normal blood pressure. My total cholesterol was 8.4mm (approximately 325mg), triglycerides were 6.1mm, and HDL was 1.75mm. There was no LDL measurement taken due the high triglyceride level. After these findings my doctor recommended I take medication to lower my cholesterol, however I didn’t want to accept that this was my only option and I said I would try and make some dietary changes and try and exercise more. After this consultation I researched different diets and I immediately cut out carbs and sugars from my diet in hope that this may help lower my numbers. Since switching to a low carb high fat diet I have lost about 5kgs and I do feel a lot better. The problem I was having is that I was afraid to exercise because I thought that I would have a heart attack or stroke since I didn’t know how long my cholesterol had been that high for.  About 6 months after my first test, with minor dietary changes and no exercise, I had a re-test done and I found that my total cholesterol had increased to 8.6mm and my triglycerides decreased to 2.0mm.

Should try a different diet such as a vegan or ketogenic diet to try and decrease my numbers along with some exercise, or should I start medication immediately?

If my cholesterol has been this high my entire life is it possible I already have advanced atherosclerosis and could I be on the brink of having a cardiac event? If so, should I see a specialist?

Is it safe for someone in my position to exercise? I am worried if I exert myself too much I could suffer a cardiac event. I used to enjoy lifting weights but will this be dangerous for me?

I am really scared right now and don’t know what to do next.

[Jerry_NJ]

I take 10 mg of a generic simvastatin to control my cholesterol.  Before this medication my total ran around 240, and I was a regular exerciser and ran for cardiovascular and physical endurance   So my good HDL was also high and contributed to the high total.  In any case, with the simvastatin my total is normally under 150.  I now suffer from heart disease and am senior aged so I have to keep my cholesterol low.

I have no blockages and have low/normal blood pressure, but I also take medications for atrial fibrillation which lower my blood pressure.

[ed34]

I would say watch your blood pressure, you don't want it high.

[erijon]

You need to ask your doctor about an exercise routine to be safe. At your age, you have probably not developed CAD yet, however since it seems diet is not the underlying cause of your high cholesterol, you should consider meds. The sooner you get it down the better off you'll be over the next few years.

I would image your doctor will give you and OK to exercise as long as there are no other issues. High cholesterol alone will not kill you and chances are you are still fine but your doctor can do a nuclear stress test to look for areas of your heart that may be damaged or not getting enough oxygen due to blockages.