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Cardiovascular Disease Prevention (Expert Forum)
hypercholesterolemia
Answered by
Lee Kirksey, MD - Peripheral Arterial Disease, PAD, Cardiovascular Disease, stroke, treatment, angioplasty, spider veins, laser ablation, wound treatment, surgery, leg pain, Prevention, Varicose veins
Penn Presbyterian Medical Center of the Univ. of Pennsylvania Healthcare Clinical Assistant Professor at The University of Pennsylvania School of Medicine
Philadelphia - PA
Questions in the Cardiovascular Disease Prevention forum are answered by Dr. Lee Kirksey, associate professor at The University of Pennsylvania School of Medicine.
hypercholesterolemia
by SheShe62, May 14, 2008 01:45PM
My husband works out an hour a day, is in the best shape of his entire life at 46, eating a very clean diet that I cook for him. He has no family history at all of heart disease, although everyone has high cholesterol in his family. The past three years, he has worked out vigorously, is very muscular, has no beef, fried foods, pork, or fast food, and eats a very high fiber diet. His BP is fine. My question is, does he really need to go on lipid-lowering medication? This appears to be his only risk factor besides being male. He has a rather high bilirubin too (1.6), so could it be some kind of liver problem causing his cholesterol to rise?
Doctor's Answer
by Lee Kirksey, MD, May 14, 2008 02:58PM
, May 14, 2008 02:58PM
To: Ssheshe62
Congratulations on your efforts to live a healthy and enjoyable life. Its works very well when its a family effort. Cholesterol comes from food or family and it seems like through your diet you are controlling your fatty intake. The fact that he has a family history of high cholesterol is important. It would be interesting to know how severe the family cases are and what age they began.
Its also important to not only know the total cholesterol but the breakdown specifically the LDL. This determines a lot of treatment strategies. Current recommendations are for treating LDL>130 in people with known disease or equivalents after dietary and behavioral changes have failed.
T bilirubin is not as important as the transaminase liver function enzymes in determining the liver function as it pertains to cholesterol
I would recommend considering calcium scoring to give you another indication of the need for treatment.
Good luck
Its also important to not only know the total cholesterol but the breakdown specifically the LDL. This determines a lot of treatment strategies. Current recommendations are for treating LDL>130 in people with known disease or equivalents after dietary and behavioral changes have failed.
T bilirubin is not as important as the transaminase liver function enzymes in determining the liver function as it pertains to cholesterol
I would recommend considering calcium scoring to give you another indication of the need for treatment.
Good luck
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Thanks for your reply. My husband's cholesterol is 260, but his ratios, both HDL/cholesterol and HDL/LDL are in the good range. Would you suggest a CRP be drawn to help decide whether statin's are necessary. His bilirubin is 1.3 and we're both nervous about taking statins in treating him.