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lipids

my lipid test shows HDL 43.63 and LDL 37.47. Can LDL be LOWER than HDL? This makes a ratio of about 1.16 instead of the ideal of above 0.4. I have CAD and one stent. Should I be concerned?
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367994_tn?1304957193
With medication my chol is 114, HDL is 58, LDL 45....prior to medication chol 148, HDL 38, LDL 95.  I read somewhere when HDL exceeds LDL there is a reversal of CAD.

My doctor goes with the American Heart Association's view: Cholesterol research scientists and doctors are divided on the effectiveness of using the ratio of HDL/LDL to predict the chances of developing heart disease. At this point, it is recommended that healthcare providers use the absolute numbers for HDL and LDL instead to determine if you have "healthy cholesterol." It is believed that the absolute cholesterol numbers are more useful to plan treatment than the HDL/LDL ratio or any other cholesterol ratio.
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Avatar_m_tn
I have just caught up with your, as always, thorough reply. Thank you. I had a feeling that 'ratio' is a vague measure.   I find the "I read somewhere when HDL exceeds LDL there is a reversal of CAD" most heartening. I shall scour the net for it. I note your Hdl/LDL is 58/45.
I will take it as a target. My meds are Coreg 6.25 and lipitor 20 one day 40 the next..In the past two weeks I have worked to exhaustion up a 5m ladder cutting old ivy and bouganvillea. I have never felt better in years. I walk/run 5km. Pulse 104 and no symptoms that could in any way be related to CAD.
hope you are thriving.
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Avatar_m_tn
I put the HDL greater then LDL possible reversal of CAD to my cardiio. I got a 'could be' gesture of hands and shoulder,s as I expected from a dedicated interventionaist. If I hear a whisper of it elsewhere I will share it. By the way I meant my pulse is 104 after exercise. Normally it is 60s tp 70s.
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159619_tn?1318997813
For what it's worth, from a recent study done in Japan;

A 6-month prospective observational study was conducted with 84 CAD patients receiving pravastatin treatment in order to evaluate the relationship between lifestyle modification, in particular aerobic exercise, and plaque volume as assessed by intravascular ultrasound (IVUS). Lifestyle during the study period was assessed by the-lifestyle modification score. A significant decrease in plaque volume by 12.9% was observed after 6 months of pravastatin therapy (P<0.0001 vs baseline). The change in plaque volume correlated with the change in the serum level of high-density lipoprotein cholesterol (HDL-C) (r=-0.549, P<0.0001), non-HDL-C (r=0.248, P=0.03), low-density lipoprotein cholesterol/HDL-C (r=0.505, P<0.0001), apolipoprotein (apo) A-1 (r=-0.335, P=0.007) and apoB/apoA-1 (r=0.335, P=0.007), and lifestyle modification score (r=-0.616, P<0.0001). There was a clear positive correlation between a change in the serum HDL-C level and lifestyle modification score. Multivariate regression analysis revealed that the increase in serum HDL-C level and lifestyle modification score were independent predictors of coronary plaque regression.

CONCLUSIONS: An appropriate combination of statin therapy and lifestyle modification, in particular, physical activity, may result in coronary plaque regression. This combined treatment strategy, inducing an increase of the serum HDL-C, may contribute to coronary plaque regression.
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Avatar_m_tn
That does it! Thank you very much for that detailed and most encouraging email. I will stay faithfully with my 20mg dose of Lipitor and  daily bout of exercise whatever the weather or my energy level.
best
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976897_tn?1379171202
You know, I keep wondering why they don't try and synthesise the HDL protein and inject us poor sufferers with them a couple of times a month if it reverses CAD. After a few months things should look a lot cleaner. However, to have HDL more numerous than LDL does sound a bit dangerous, doesn't it? Would that basically mean ALL LDL would be returned to the Liver and no new cells or repairs to damaged cells could be carried out? what about the brain forming permanent connections for memory and such like?
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367994_tn?1304957193
There is a theory that HDL quality is as important if not more important than the amount. There is good HDL and bad HDL. The good HDL helps remove damaged LDL. If there is too much of the bad HDL then it no longer protects you and actually helps cause heart disease.  To analyze requires getting an "expanded lipid profile" to learn the particle size and number of your HDL cholesterol molecules.

"For many years, HDL has been viewed as good cholesterol and has generated a false perception that the more HDL in the blood, the better," said Angelo Scanu, M.D., a pioneer in blood lipid chemistry from University of Chicago and first author of the study. "It is now apparent that subjects with high HDL are not necessarily protected from heart problems and should ask their doctor to find out whether their HDL is good or bad."


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159619_tn?1318997813
The difference is in the size of the HDL-C particles. The larger "fluffy" HDL-C particles do not bind as well with LDL and are considered and additional risk factor, much as LDL is now.

I have a link I could pass along, let me know.

Jon
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976897_tn?1379171202
are those bad HDL considered as faulty, like genetically wrong?
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159619_tn?1318997813
They are the result of a genetic disorder, don't know if that makes them genetically defective or not, I need to re-read the text.

Jon
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976897_tn?1379171202
I'm wondering if Statins have any effect on them.
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Avatar_m_tn
statins claims to decrease LDL and with less fanfare, increase HDL, but not by much.
Does it distinguish between good and bad HDL? Is itpossible to do so? What about niacin?. For that matter what about the claimed champion HDL-raiser aerobic excercise.?
This is the sort of doubt that makes one wonder what we're doing pounding out our five kms a day and, of course, swallowing that damned pill
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Avatar_m_tn
on my most recent blood test , my HDL is 23 and my LDL is 108
It had been HDL 27 LDL 63 before I went off of Niacin 3 months ago.
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