Cholesterol

[erijon]

There has been considerable discussion as of late as to the risk involved in having elevated cholesterol levels and whether or not having elevated cholesterol is still considered a risk for CAD. I am still one who believes in the conventional medical thinking that elevated levels of cholesterol help contribute to CAD. I seen many studies quoted that show how many people admitted with acute coronary events had what was considered normal levels of serum cholesterol and others that take the position that the real issue is inflammation of the arteries as the cause of CAD, not to mention the discussion concerning the use of statins. I have also read many of the pro-statin studies as well and still feel that there is more validity to the thought process that says lower cholesterol helps prevent CAD.

As a stain user, I was wondering if there has been a shift in the conventional thinking concerning cholesterol levels and statin use. I have used stains for many years and have had excellent results without any issues what so ever. and  have been very pleased with the results. With the use of statins and a major change in lifestyle including exercise and diet, I have lost weight (70 lbs) and reduced my cholesterol levels to a low of a TC of 155 with an LDL of 77, so I'm very happy. I still believe that I would not have had these results with lifestyle changes alone as I did that first for almost a year without any drastic results, that did not come until I added statins.

I just wondered what the current thinking is on this subject.

Thanks,

Jon

[Cleveland Clinic]

The recent change in thinking has to do with results from trials in which medications which lowered the cholesterol to acceptable lfailed to show improved cardiovascular outcomes. Hence I think what we should follow is what we have learned from all of the primary and secondary cardiovascular morbidity trials, which is generally that if you use a statin in low, medium and high risk groups for cardiovascular outcomes, then the risk is diminished by a rate that is proportional to their risk for CAD. This is not true in other classes of dyslipidemic medications in general. So I believe in the statins, and it likely has more to do with reverse cholesterol transport and decrease of endothelial cholesterol and inflammation than cholesterol levels per se.

[Healthyself2]

I do think that maintaining a recommended ldl profile is important, but HDL and the ratio of hdl to total cholesterol are also important.  I think that they have known this since the 50's, but not exactly why.

I just look at coronary plaques as scaring from zits that you get on the inside of your arteries that start out about the same as what you would get on your face.  We all know that cleaning the oils, which are basically cholesterol, from your face will prevent these from forming.  When they do, it's inflamation (inflammation), with a vicous liquid interior.  That interior is a mix of bacteria and cholesterol based oils.  Scratch them enough and you will get a scar.  These scars in you coronary arteries continue to get inflamed, infected, break and build up over time.  This is not based on any medical fact or research of my own.  I've just sort of divined this vision of my coronary plaques over time.

So the root cause of the inflamation (inflammation) is a combination of lipids sticking to the arterial walls and combining with bacteria in my vision of how my disease got started.  

I changed my lipid profile from 230 total with only 30 HDL to consistent to 139 TC / 65 HDL / 57 LDL / 83 TRI on my last checkup.  I've been in that ballpark for the last 9 years or so and am a believer that it's one of the 3 main reasons that I have had no further cardiac events and have lived a normal life during that time.  I take 3 drugs in combo: Lipitor, Niaspan, and Welchol.

Another thing that I did early on, to address what I thought was a root cause of my disease (and inflamation (inflammation)), was to take a strong round of a frontline antibiotic.  I planned 3 months of Zithromax, but had to quit after about 5 weeks as it evidently killed every bug in my body, including the good ones.  Did it work?  Don't know?  The studies on that were inconclusive.

In my book, your HDL level is the primary predictor of coronary artery disease and longevity in general.