New Cholesterol Guidelines

I am 26 years old. My mother at age 54 had a quad bi-pass and was diagnosed with heart disease 1 year later at the age of 55. Nothing could be done for her heart disease except medication because it is the small arteries that are closing up (not large ones that could be opened by surgery). She is also diabetic, and heart disease runs in our family (I have not know any of my grandparents due to early deaths).   Recently I have read the American Heart Association has gotten more aggresive (aggressive) with their cholesterol levels guidelines.  The new levels are bad cholesterol less than 100, and total less than 200.  My cholesterol, blood pressure and sugar levels have always been good (I am not diabetic but I get tested every couple of years).  I looked back at my last cholesterol test in 1999 and the bad cholestrol was 111 (which at the time was within guidlines, but now is not).  Should I be concerned with this? My total Cholesterol is less than 200, so that is within the guidlines.  I rarely eat red meat, and cook with pam fat-free sprays (never use oil). I dine out at most once a week, and try to eat healthy then too. I am 30lb overweight, but have been dieting and lose about 1 lb a week. Everyone in my immediate family (mother, brother, father) has high blood pressure as well and is on medication for it, except me.  I exercise 2-3 times a week at the gym.  I have no heart problems now, but because of my family history I am concerned over my cholesterol level now being considered high at 111 (bad cholesterol).  What is your opinion? Should I be concerned?

[CCF-M.D.-CRC]

Dear ds,
Unless you have had a heart attack the new guidelines recommend keeping your LDL (bad cholesterol) less than 130.  According to the guidelines only those individuals who already have coronary artery disease should maintain an LDL less than 100.  That being said lower (to a point) is still probably better than higher for everyone.  The other point here is that 1999 is ancient history in terms of cholesterol.  I would recommend a repeat level and then base diet changes and treatment on the new level.  Keep up the healthy diet and exercise!!

[No Bypass / No Stents]

You didn't mention it, but I think that your HDL level is probably the best predictor of Coronary Artery Disease.

I think that the minimum has been raised from 35 to 40 now.

There is a phenomenon know as "familial HDL deficiency".  After my heart attack my HDL level was 33.  My younger brother's was 29.  Our mother died of heart failure after several heart attacks and bypass surgery.

My HDL is now 48, thanks to an hour of daily walking, strenous weekend activity, and, lately, Niaspan.  I hope to get my HDL into the 50's yet this year and maintain my total cholesterol below 150 and LDL below 100.  My cardiologist tells me that every point that I increase my HDL equates to a 2% reduction in a severe cardiac event.

If I could do things over again, I would have been working at controlling LDL, HDL, and Triglycerides from age 25.  Of course the drugs are so much better now, but doctors really aren't generally aware of how effective the right combination of drugs can be.  It took me 2 years, after my heart attack, to get my cholesterol and BP drug cocktail right.  Unfortunately every doctor has their favorite drugs and many don't keep up on the research.

Good Luck.

[MennieBeats]

Cholesterol levels in the blood have nothing to do with the cholesterol coating the artery walls.  

http://www.ravnskov.nu/cholesterol.htm

The average cholesterol level in America is 250.

The drug and insurance companies love the new standard. More money.

Some people think sugar has more to do with heart disease than cholesterol does.

Anxiety can raise cholesterol levels and so can what you ate before the test was taken.