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Medications, Imdur, Toprol, Crestor

This summer I apparently had a heart incident for which the symptom was severe arm aching.  I thought it was pain from my shoulder, I have an irreparable rotator cuff injury.  During PT for the shoulder elctro stim was used which cause significant heart rythmn s disturbances and also my arms hurt when I walked.  I had a cardiac cath on 9.24 and they found a blockage in abranch of a main artery the back one I think.  It was laready developing collateral circulation so no stent was put in.  I was put on Imdur 30mg once a day and prior to the cath I had been put on toprol.  The cardiologist added 5mg of Crestor even though my total cholesteral is 180, ldl 70, but HDL only 39.  

Taking these meds I have encountered some discomfort.  I had a burning along the right side of my spine.  I stopped Crestor and it subsided, I now fairly regularly have a little pin point pain in my chin and a lot of back pain.  When I walk my arms do not hurt as before but they can still at times ache a little.  I am fatigued also.  I also take protonix 40 mg.  Are thes pains that pop up medicine related or do I need to be concerned about the meds not working?  I did consult my physcians NP who said to stop the Crestor for a week and see what difference it made.  Well that relieved some things, the worst but not all.  I am particularily concerned about this chin pai.  I can press on and make it worse.  Thank you for your time.
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Chest pain can be quite tricky to identify. Fortunately, your problem was identified. The fact that no treatment was performed for your blockage ie stent or bypass suggests to me that your doctors have diagnosed you with asymptomatic stable CAD ( no symptoms coronary artery disease)

Crestor can cause muscle pains. I have most commonly seen it end the calf muscles. It usually resolves within 1-2 weeks of stopping the medication. I would be concerned that your spine and chin discomfort were not caused by the cholesterol agent

What about drugs for raising HDL cholesterol?

Drug therapy for raising HDL cholesterol levels has, so far, been less successful than for reducing LDL cholesterol. Statins, in particular, are often not very effective at increasing HDL levels.

Of the drugs used to treat cholesterol, niacin appears to be the most effective at raising HDL levels. Niacin is one of the B vitamins. The amount of niacin needed for increasing HDL levels are so high, however, that it is classified as a drug when used for this purpose. Furthermore, "niacin" takes several forms, including nicotinic acid, nicotinamide, and inositol hexaniacinate - and all of these are labelled as "niacin." Unfortunately, only nicotinic acid raises HDL cholesterol, and this drug can be difficult to take because of its propensity to cause flushing, itching and hot flashes. In general, taking niacin to treat cholesterol levels should be supervised by a doctor.

A three-drug regimen of niacin, cholestyramine, and gemfibrozil has been shown to increase HDL cholesterol substantially, but this drug combination can be particularly difficult to tolerate.

HDL levels below 40 mg/dL result in an increased risk of coronary atery disease, even in people whose total cholesterol and LDL cholesterol levels are normal. HDL levels between 40 and 60 mg/dL are considered "normal." However, HDL levels greater than 60 mg/dL may actually protect people from heart disease. Indeed, for several years, doctors have known that when it comes to HDL levels, the higher the better. Click here for a quick review of cholesterol and triglycerides.

How can We Increase Our HDL Levels?

Aerobic exercise. Many people don't like to hear it, but regular aerobic exercise (any exercise, such as walking, jogging or bike riding, that raises your heart rate for 20 to 30 minutes at a time) may be the most effective way to increase HDL levels. Recent evidence suggests that the duration of exercise, rather than the intensity, is the more important factor in raising HDL choleserol. But any aerobic exercise helps.

Lose weight. Obesity results not only in increased LDL cholesterol, but also in reduced HDL cholesterol. If you are overweight, reducing your weight should increase your HDL levels. This is especially important if your excess weight is stored in your abdominal area; your weight-to-hip ratio is particularly important in determining whether you ought to concentrate on weight loss.

Stop smoking. If you smoke, giving up tobacco will result in an increase in HDL levels. (This is the only advantage I can think of that smokers have over non-smokers -- it gives them something else to do that will raise their HDL.)

Cut out the trans fatty acids. Trans fatty acids are currently present in many of your favorite prepared foods -- anything in which the nutrition label reads "partially hydrogenated vegetable oils" -- so eliminating them from the diet is not a trivial task. But trans fatty acids not only increase LDL cholesterol levels, they also reduce HDL cholesterol levels. Removing them from your diet will almost certainly result in a measurable increase in HDL levels.

Alcohol. With apologies to the American Heart Association, which discourages doctors from telling their patients about the advantages of alcohol: one or two drinks per day can significantly increase HDL levels. More than one or two drinks per day, one hastens to add, can lead to substantial health problems including heart failure -- and there are individuals who will develop such problems even when limiting their alcohol intake to one or two drinks per day. .

Increase the monounsaturated fats in your diet. Monounsaturated fats such as canola oil, avocado oil, or olive oil and in the fats found in peanut butter can increase HDL cholesterol levels without increasing the total cholesterol.

Add soluble fiber to your diet. Soluble fibers are found in oats, fruits, vegetables, and legumes, and result in both a reduction in LDL cholesterol and an increase HDL cholesterol. For best results, at least two servings a day should be used.

Other dietary means to increasing HDL. Cranberry juice has been shown to increase HDL levels. Fish and other foods containing omega-3 fatty acids can also increase HDL levels.

Good Luck

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