High Cholesterol

[Jane204]

My  apologies if this question appears twice.  I don't think my first posting went through.  
I am a 64 year old female, 5'10" 135 lbs.  I recently applied for a life insurance policy to replace one that I have had for years.  The company-administered medical test showed a cholesterol count of 285 with HDL at 117.  The insurance company rated me "standard" rather than "preferred", at twice the premium.  

Should I be concerned about the 285 count?  My primary care physician has always told me that the high HDL counter balances it.  I am getting conflicting opinions and would like your advice.

[Jane204]

OK.  Thank you very much for your advice.

[Lee Kirksey, MD]

If a detailed review of your risk factors reveals minimal cardiovascular risk, I think that diet management with follow up labs would be a reasonable option

[Jane204]

Just to be sure....In your reply to my question on May 20 you mentioned that I need not be worried about my high (285) cholesterol, considering other factors and if my LDL is 130 or less.

My LDL is 158 on the report.  Is that a cause for concern?

Thanks.

[Jane204]

Thank you for putting my mind to rest (except for the high insurance premium!)

I am not a smoker.  My father died at 73 of congestive heart failure, after smoking heavily his whole life.  As far as activity goes, I walk outside or use a treadmill daily for 20 - 30 minutes.  The other numbers on the blood chemistry report are as follows:  (The LDL is higher than 130.)

Cholesterol 285 mg/dl
HDL 117 mg/dl
Cholesterol Ratio  2.4%
LDL  158 mg/dl
LDL/HDL Ratio 1.35 mg/dl
Triglycerides 50 mg/dl

I will try to pay more attention to my fat intake per day.

Thanks again.

[Lee Kirksey, MD]

Hello
These numbers should be interpreted as a big picture in the context of your other risk factors. A couple questions for you. Smoker?Hypertension? Previous Heart Problem you or first degree relative? Activity level? What is triglyceride and LDL value?
If all of these questions are negative, your cardiac risk profil is minimal and your LDL is 130 or less, most people would agree with your physician.

If you're suggesting that your getting conflicting opinions because of your insurance company's decision vs your primary cares strategy; understand that they are two different agendas. Your pcp is weighing the risk/benefit of cholesterol treatment and your insurance company is looking for any red flag to down grade your policy and mitigate their risks.

On the topic of your cholesterol, I dont know if you have seen the cholesterol medication commercial with the "apparently fit" man who has a high cholesterol level. Your weight may be discrepant with your diet and intake of saturated fat. 80% of our cholesterol comes from our food intake.I suspect that within 6 mo you could lower that total cholesterol with a diet consuming less than 35-40 total gms fat per day  <15 gm saturated fat/ day. You would kill two birds with one stone. Good luck