Lupus, Hypertension & off the charts HDL

[Kydiana]

After going through several horrible years, I finally have a diagnosis of SLE--funny how finding out you have a potentially serious disease can actually be a relief...

My question here is about possible heart disease complications. I just got back my most recent Lipid Panel and don't know if I should be worried. I am a 53 year old white female, non-smoker, no diabetes and with a BMI of 21.5 and, of course, lupus. I am on 3 blood pressure medications now to control what was urgent hypertension (186/116) last summer. I seem to be edging up again even with the meds. My last lipid panel (fasting) came back with these results (which are consistent with the upward trend of these numbers over the past 7-8 years):

Cholesterol Total     278
TG                         151
HDL                       149

My doc seems to think that since the ratio is good I shouldn't worry about the High Total and what seems to be an unheard of high level HDL. I've read some materials about pro-inflammatory HDL which can actually increase coronary heart disease risk but he dismisses this as "speculative" and tells me not to worry about it. He says I  should be happy that I am some sort of HDL Champion. Is he right?? Any ideas? References??

[Cleveland Clinic]

Your non HDL cholesterol is the around 130. If we follow current guidelines, with your age and risk factor for CAD of are hypertension, then you are at goal and should only be treated if your LDL cholesterol is over 190 mg/dl.
You are correct in being concerned however, as most patients with Lupus and other autoimmune diseases suffer from acute coronary events. I would recommend starting a daily aspirin, and urgent control of your hypertension with medications known to decrease the risk of myocardial infarction such as beta blockers, dihydropiridine calcium channel blockers or ace inhibitors..

[Kydiana]

For me it was about 2 years after I had realized that my symptoms were forming some sort of pattern before I had a diagnosis but various symptoms had appeared well before that.

The earliest symptoms, starting ten or more years ago, were 3 miscarriages (out of 6 pregnancies), autoimmune thyroiditis (Hashimoto's disease) and Raynauds of increasing severity.

Later I started having various joint problems, especially in my feet, periodic episodes of severe inexplicable edema (both in extremities and abdominally--called ascites),  dry mouth and eyes, frequent bloody noses and mouth sores.

Within the last year I began to have periods of debilitating fatigue, mental confusion and fever. I actually had had the notorious "butterfly rash" for a while, but had never reported it to my doctor because it wasn't "permanent."

And, yes, I did have diagnoses of depression along the way--am still not sure if this is a part of the lupus or a result of constantly feeling crummy and thinking it must all be in my head!

Hope this helps--good luck!

[Kydiana]

Thank you for your answer--it helps me to focus on the right issues! I am now on Toporol XL(100 mg/day) and Benicar/ HCT (40/25 mg/day)--are they in the categories you recommend? Is there room to move up? My BP this morning is 148/91.

[bluecheese]

"I finally have a diagnosis of SLE--funny how finding out you have a potentially serious disease can actually be a relief"

Regarding that comment....I was wondering, did you go a very long time with doctors "not knowing what was wrong with you"  or possibly receiving an anxiety or depression diagnosis?    

What were your symptoms?