Discouraged About Cholesterol

[mas2782]

Hi, 30 year old male...5'10", 200 lbs., No family history of CAD...except for possibly one great uncle. My Mom has had HIGH cholesterol.
Recently I had my cholesterol re-checked and I am VERY discouraged by the results.

My original workout results during my first year of law school (March, 2006)

Total = 170
LDL = 101
HDL = 26
Triglycerides = 206

During this time I was very sedentary and ate a lot of carbs and junk

For the last twenty months I have been running 12 miles a week, eating a lot better and taking fish oil and CoQ10...my results from last week

Total = 175
LDL = 126
HDL = 27
Tri = 145

Bad news I feel...tris came down, but my ratios and my HDL/LDL are still very bad. What can I do? Do I need to start taking Niaspan AND a statin...that seems really expensive. I've been reading the South Beach Heart program and I am going to try and start that as well...

I want to believe I am not predisposed to this...what can I do. Thanks

[Cleveland Clinic]

You do not have any coronary artery disease by symptoms.  There is no family history of CAD (the uncle doesn't count that much) and as I said earlier, you don't have any other risk factors.  Therefore, your risk is low.  We know that in estimating CAD risk, high HDL takes away one point, but the opposite can't be said about low HDL.  The evidence for low HDL causing CAD is not that strong.  In fact there was a recent trial where we tried to increase HDL via taking an experimental medication, and that actually led to more problems than solutions.  With the profile that you have, i am not sure that exposing you to long term use of statins or other medications is going to be of any benefit, and may even cause harm.  Now, taking fish oil, an essentially harmless medication, may increase your HDL and lower your triglycerides.  There really is no harm in doing so.  Exercise has been known to increase HDL significantly.  I would focus on prevention at this point.  you could consider checking LPa.  If it is high, it may sway you towards being more aggressive with your lipid profile.    

[mas2782]

Doctor...thanks for your reply. Couple of questions for you or the board...

"We are not entirely convinced yet that raising HDL would do any good in someone like you." Why is this true? Seems to directly contradict the South Beach book I've been reading and the info provided by many other sources.

Should I get my Lipoprotein A checked?

Thanks again.

[Cleveland Clinic]

Your cholesterol profile is not that bad.  Given that you do not have any risk factors for CAD other than being a male, your goal LDL is about 130 or so.  The HDL is low, and this is something that is genetic in you.  We are not entirely convinced yet that raising HDL would do any good in someone like you.  I would, therefore focus on limiting your risk factors.  Avoid cigarettes, even second hand smoking, keep your weight low, eat healthy and exericse as you have.  I would not take any drugs at this point.