high hdl and ldl

I am a 61 year old female with no history of heart disease in the family.
Total cholesterol is 255
HDL 96
LDL  144
Triglyceride 76

My doctor wants me to do CT Calcium score to see if I need to take drugs.  Need another expert's opinion.

Thanks,

[erijon]

Don't know that we qualify as experts, but here's my 2 cents. Your LDL is high and the current protocol with high LDL is to treat it first, even with high HDL. The problem is, high HDL is not always a good thing and you can't depend on that to off set your high LDL. I don't think much of the CT Calcium Scores as they really are not that predictive of CAD. I would opt for another cholesterol test that determines the particle size that makes up your numbers. The smaller the HDL particle size, the higher the risk. That test can also determine how many lipoprotein particles you have in your blood as well which is important as these are the component that allows LDL to pass into an artery wall. The higher the count, the higher the risk.

If it were me, I would ask for that blood test before I move to a very expensive and not all that useful CT scan. Much depends on if you are having any symptoms of CAD. If so I would think a nuclear stress test would be a better way to spend the money.

As I said, I'm not a doctor, it's just my opinion.

Hope this helps,

Jon

[erijon]

Don't know that we qualify as experts, but here's my 2 cents. Your LDL is high and the current protocol with high LDL is to treat it first, even with high HDL. The problem is, high HDL is not always a good thing and you can't depend on that to off set your high LDL. I don't think much of the CT Calcium Scores as they really are not that predictive of CAD. I would opt for another cholesterol test that determines the particle size that makes up your numbers. The smaller the HDL particle size, the higher the risk. That test can also determine how many lipoprotein particles you have in your blood as well which is important as these are the component that allows LDL to pass into an artery wall. The higher the count, the higher the risk.

If it were me, I would ask for that blood test before I move to a very expensive and not all that useful CT scan. Much depends on if you are having any symptoms of CAD. If so I would think a nuclear stress test would be a better way to spend the money.

As I said, I'm not a doctor, it's just my opinion.

Hope this helps,

Jon