Lipoprotein a

I am a 57 year old female. I had a total cholesterol level of 244 found during a recent routine checkup. I lowered it to 220 in 2 months with diet changes alone. However, my lifestyle of consistent low fat diet and lots of excercise as an athlete, dont smoke, low BP does not seem to lower it any further. I then went to a lipidologist to do detailed blood work. They found lipoprotein a levels of 270mg/dl, HDL 72, LDLpart 1256, small LDL-Pnmol/L 560, Triglycerides 96, Total cholesterol 221. I have no family members with any obvious heart disease. I had a CIMT Carotid Artery Ultrasound test and found R) Artery normal for my age and the L) Artery at norms for 65 year old.
I am currently taking 750mg of Niaspan er, Omega 3 fish oil and Vitamin D3 2000mg daily (it was at 29).
What are my risks for atherosclerosis causing MI, stroke etc. What else is helpful for my situation?
Should I have a heart scan?

[hexaplus]

I'm in a very similar boat, I don't have any insight except to say that my dad had a heart attack at 53 just a few months after he had an EKG which came back fine, His only indicator was high HDL he needed a quadruple bi-pass.

He's managing now with meds (Statin=Lipitor, Digestive=Zetia). His Total 108, LDL 54, 39 HDL. His doctors says Its Genetics, Genetis, Genetics, Diet and Exercise.

[erijon]

FYI, High HDL is a good thing, it's the LDL that needs to be kept under 130. HDL is a good cholesterol that binds with LDL to remove it from your blood. An HDL over 55 is a very good number.

Also, it is not uncommon to experience a cardiac event after a normal EKG. Normally, an EKG can only detect a heart attack while it's happening or if there is some problem with the electricle impulses of the heart. It will pick up a previous MI but is not a good indicator of future cardiac events.

As far as your numbers, you are not off by much. If you have a family history of heart disease your doctor may want to consider a statin to get you at your goal.

Good luck!

Jon

[ed34]

You have to remember though that cholesterol is not the primary stage of atherosclerosis. Cholesterol is used by the body to repair damaged arteries, usually through long term high blood pressure damaging the inner lining. If you are very fit, I would have thought that your arteries would be in great shape and it certainly helps a massive amount if you don't smoke. If you have a small amount of cholesterol or a large amount, it doesn't really matter that much because the body will still find enough to use for the repairs. You are doing all the right things now and I believe you should be free of
atherosclerosis until a ripe old age. Just make sure you don't get stressed much because that is major cause of high blood pressure. When you are 87 I want you to report back here and let us know how fit you are.

[kris3576]

Thanks for the info. It is reassuring. My biggest concern however is the lipoprotein a reading which was recently found to be genetic and related to a high risk of MI and/or stroke. Mine was so extremely high, I havent heard of anyone else with such a high Lpa.

[Yvette BG]

Have you tried posting this question to the doctor on the Expert Forum? It might also  be helfpul for you to see what he/she has to say based on experience with other patients.

[ed34]

If that Doctor can explain to you the relationship between the formation of atherosclerosis and cholesterol, then he/she will probably get a prize. There are so many theories but nobody still understands the true process and why it occurs. All the evidence suggests that cholesterol levels have no relevance on atherosclerosis and yet all this evidence is ignored. The problem is that since the first autopsy found fatty substances in coronary arteries, we have all assumed that high fat levels must be the problem. However, lots of recent studies have found that sufferers of atherosclerosis have a huge range of cholesterol levels, from very low to very high and lots inbetween.