How much is enough?

[Clogged]

As a 29 year old male 5-way arterial bypass patient, I'm left with the age old question of "Am I doing enough?"
Here's a recap: 28 year old male, strong family history, no symptoms, had mutiple blockages.
Weight was 190 lbs.
TC was 505
LDL was 464
HDL was 40 something
Trig was normal

One year post bypass
Weight = 155 lbs.
TC = 173
LDL = 104
HDL = 58
Trig = 80
Current meds are Aspirin, 80 mg Lipitor (the king of all statins), and Zetia. I exercise daily, I don't "eat" anymore, I just "graze" (veggies and fish) and I have 1 glass of red wine daily.

My Cardiologist is very pleased with my results, but I'd just like your opinion. Should I see a lipid specialist? I guess the only other drug I know of would be Niacin = side effects.

Got any fancy formulas to tell me my odds of having a heart attack?

Ever read "The Cardiovascular Cure"? Intersting book on Endothelial Function. Opinions?

Thanks so much for your help..... Great Forum.

[Clogged]

JazzyJJ,

My father passed away at 34 from heart attack... lot of heart attacks on his side of the family, but most were later in life.
Although my mother has not had any "events", both her mother and father had heart attacks, but both were later in life also.
My brother and I both have had extremely high cholesterol for all of our lives. Never did anything about it other than watch diet.
About a year and a half ago my brother, who is 2 years older than me, had a light heart attack. One major blockage was found and fixed with stent. Naturally this was a wakeup call for myself to get checked out. One test lead to another and another and so forth. Turns out I was worse off than my brother with major blockages in all three main arteries... one of them 100%. I had grown a fair amount of collateral arteries which is why I wasn't having symptoms. Wasn't enough to pass a stress test though.
I never smoked, never been one to eat much fried food or red meat. I was getting a little over weight, but that has since been taken care of.

Konopka,

Thank you for your encouragement. It's nice to hear positive stories like yours.

[JazzyJJ]

Can anyone comment on how common or rare it is to have this at 29?

[JazzyJJ]

How many in family and at what age did they have heart disease and or attacks? how did they find your clogges without any symtoms and why did they check you out? I to am worried I have CAD at 29 now, and wonder if I should have an Angiogram. Had one 5 or 6 years ago and everything was clear, however mom died @ 44 of a Massive heart attack. Do you smoke or what could have caused it, I am really interested!!

[Cleveland Clinic]

clogged,

thanks for the post. I'm sorry to hear of your troubles so early in life. I'm glad you are doing well.

There isn't a perfect answer. What I can say is that the hard evidence is associated with statins.  We know Zetia and Niacin both have effects on Lipids.  We are gaining an understanding that the effects of statins go beyond the basic level of lipid lowering, so its unclear of the exact benefit of the other medications. With the recent data, the strongest recommendation I could tell you would to be on a maximum dose of the lipitor before starting other medications.

Also,  at 29, you should definitely be followed by a preventive cardiology clinic.

I have no specifics on your odds, as you operate a bit out of the box with the early age of your event.  One thing you could look into is usCRP testing, it would be additive in addition to your lipid levels to predicting your overall risk.

I have not read the book.  I will look into it.  There are alot of hypotheses concerning the benefits of various agents into endothelial function.  Some of these have not been the panacea that people hoped for and even may be associated with some degree of harm. (hormone therapy, vitamin e.)

good luck