Lipids

I have several questions concerning HDL. The last two times I have had my lipids tested my HDL has been quite low (TC 226, LDL 145, HDL 35, trig 225 and after dietary changes, exercise etc. TC 193, HDL 26).

1) I just recently attended a lipids workshop and the cardiologist mentioned a drug called Niaspan that is supposed to lower LDL, raise HDL, and lower triglycerides. I got the impression that this is a new drug and does not have the side effects that taking niacin can have. Is that true?  

2) In the literature we received it said that beta blockers (I take 25 mg atenolol daily for questionable hypertension) can lower HDL. I never had my HDL measured before starting atentolol so I don't know if it has had any effect on my HDL level.  

3) If I understand it correctly, the statins work by lowering the LDL.  Yet Lipitor claims in its advertisements to raise the HDL as well. Is is worth taking this drug mainly to raise the HDL? I'm not sure what my LDL Is now, the second test I had was just a screening but I would think it would probably be a bit lower than the 145 it was the first time.

Thank you

Chris Smith

[CCF CARDIO MD - DLB]

1. It is a newer formulation of the old drug niacin. It appears that patients tolerate it much better, but it still requires monitoring for liver toxicity.
2. While beta blockers can very slightly affect lipid levels adversely, their benefits far outweigh this small risk in patients with heart disease.
3. Drugs of this class have a mild effect on raising the HDL. If your LDL is above 100, it would be reasonable to start this medicine, assuming you are at risk for heart disease.