Total Cholestrol of 423!!

[Jeannie2]

My husband is not very worried about his total Cholestrol of 423.  He is 42, rarely exercises and only eats once a day, though snacks on garbage (candy, etc).  How dangerous is this test result other than my interpretation that he is a heart attack waiting to happen!!?

[Cleveland Clinic]

A very elevated cholesterol is very directly linked with risk for heart disease including heart attacks, heart failure, atrial fibrillation and strokes. Also with development of peripheral vascular disease, which interferes with a person's ability to ambulate. Diet and exercise are important first steps, but in his case there is likely to be a  very strong genetic component, so medical therapy should be started immediately probably with crestor 20 mg daily.

[Uboat]

I expect his physician had something to say to him about it. How did he respond? Cholesterol that high usually is genetic. Have any of his relatives had heart attacks at a young age? He should be on a statin immediately. Even with his current diet and sedentary lifestyle, a cholesterol lowering statin would go a long way to getting his numbers better. My total cholesterol went from 264 to 110 on a low dose of Crestor.

[TJ83153]

Try having him take fish oil tablets with each meal instead of taking the chance of damage to his organs from statins. With diet, exercise, and fish oil it will come down significantly.   Take 2   1000 mg capsules before each meal. Good luck

[babyboo1234]

I have been taking krill oil for about a year.  I read someplace that the body uses the oil it needs and any excess raises your cholesterol. This was exactly what happened in my case and I was only taking 2000 mgs and my cholesterol went up, so possibly a high does would not be prudent.

[Bob_D]

Hi, Jeannie,

I am not a doctor and this does not constitute medical advice.

Your husband's cholesterol level is one factor in a total clinical picture that
includes such factors as family history of heart disease, weight, waist measurement, blood pressure, cholesterol, blood sugar, EKG, and physical exam, including listening to the heart.

All of the above factors could be within clinical guidelines and he, or anyone, could still suffer a sudden cardiac arrest resulting in death. Or, if there is no heart disease in his family and they lived to advanced ages, he might do so, as well, by doing nothing.

Since the clinical guideline for cholesterol for someone with no existing heart disease or other complicating factors is (I think), 200, there is cause for concern. If my cholesterol were that high, I would also want to know the numbers for the individual components (HDL, LDL, etc.) A statin is one option to lower cholesterol, although lifestyle modifications (diet and exercise) would likely be recommended either prior to the statin or in tandem.

If your husband has no insurance, you should consider a generic statin (such as simvastatin) which is likely to be far cheaper than an on-patent name brand (such as Crestor) and be just as effective.

Other posters have recommended your husband take fish oil. The American Heart Association does not do so. For people without existing heart disease, it recommends eating fatty fish at least twice a week and including foods rich in alpha-linoleic acid ( see AHA web site for details).

You mention that your husband eats candy. Although there are probably millions of web sites warning, without any evidence, that to consume sugar is a death sentence, I'm not convinced any particular diet (except perhaps the French one, eaten in France, with French people) has been shown to have any conclusive beneficial result in the prevention of or care of coronary heart disease.

If your husband wants a long life, and since heart disease is the number one killer in the United States, and he's over 40, now would be a good time for a complete assessment of the health of his heart.

Cheers,

Bob D

[gman2009]

Jeannie2,

I had a total cholesterol of 450-600 for over 20 years and I now have 25 stents and very diffuse disease at the age of 41.  The reason for my high TC was due to the fact that my triglycerides were 2000, when they should be less than 150.  There is some evidence that lowering your LDL to 40 using statins, exercise, and a strict diet can reverse plaque buildup, but I am not a doctor so check with your cardiologist first.  

I take Tricor for the triglycerides and 20mg of Crestor daily.  I also exercise 5 days a week for 1/2 hour - 1 hour and medidate to keep my stress levels down.  Don't panic, but be preemptive in the approach to your husbands heart health.  Get a check of his calcification, but also demand a nuclear stress test.  You can have low calcification and still have diffuse or even single spot "soft plaque".  

Depending on the results, you could try drug therapy and life style changes first, PCI second, and CABG third.  Don't panic about CABG, it is a well understood operation and there are many ways they can perform CABG without putting the patient on a heart-lung bypass machine and stopping the heart.  It depends on the surgeon, and which arteries need to be bypassed.  All of these come under the auspice of minimally invasive bypass surgery.  There are some places that can bypass multiple vessels using only a da Vinchi robot (the patient will only have a number of small incisions made to fit the instumention in - sort of like endoscopic surgery).  There are other beating heart approaches as well that do not require the sternum to be cracked.  Even with full-blown CABG, the results are often quite good and Clevland Heart Clinic probably has some of the best docs in country.  God bless and good luck to you and your husband.

[gman2009]

Jeannie,

One more thing.  I also was like your husband and not too worried about things.  I also smoked.  Tell your husband that it is a big deal and if he still does not believe you, tell him you will be asking him that question after he gets his first CABG or 11th PCI and is stuck taking Plavix the rest of his life.  I can guarantee is he is flippant about it now, he won't be later.  There is an old adage that a fool who persists in his folly becomes wise.  However, with your heart you can't afford to play the fool.

[Sweetwaterguy]

It is good you asked an expert for advice regarding your husband.  Those who offer other quick and/or easy fixes may be well meaning, but in fact, are dangerous.  The idea of fish oil therapy to adequately lower extremely high cholesterol is just plain goofy.  
  I would also recommend an excellent book by Arthur Agatston, the author of The South Beach Diet.  Agatston is not just a  diet guy, he is a renown cardiologist and his book, The South Beach Heart Program is worth reading.  He talks about "aggressive prevention" of heart disease.  He also writes about the importance of managing cholesterol, weight, and blood pressure.  He is a strong advocate of statins.  The research is strong and suggests statins are indeed life savers.