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Follow up for heart cath
In 1999, I underwent a heart cath following an abnormal treamill stress test and follow-up nuclear stress test, both of which showed some possible abnormalities. The cath exam showed perfectly normal heart function and clear vessels, and the stress tests were determined to be "false positives".
I am currently 63 years old. My last annual physical (October 2007) showed cholesterol at 168, with HDL at 83, LDL at 69,trig at 81. I exercise regularly, including 15-25 miles of road biking daily.
In view of the skewed stress tests and favorable cath, my doctor has not recommended any further heart testing, other than an EKG every year with my annual physical. (I do have a RBBB with left anterior hemiblock, but the EKGs continue to be unchanged.)
My question is, based on my lab scores and the all-clear results from the 1999 angiogram, should I have any further cardio tests at this time other than the EKG? My annual physical is coming up in the fall. Thanks.
I am currently 63 years old. My last annual physical (October 2007) showed cholesterol at 168, with HDL at 83, LDL at 69,trig at 81. I exercise regularly, including 15-25 miles of road biking daily.
In view of the skewed stress tests and favorable cath, my doctor has not recommended any further heart testing, other than an EKG every year with my annual physical. (I do have a RBBB with left anterior hemiblock, but the EKGs continue to be unchanged.)
My question is, based on my lab scores and the all-clear results from the 1999 angiogram, should I have any further cardio tests at this time other than the EKG? My annual physical is coming up in the fall. Thanks.
If you aren't experiencing any symptoms such as chest pain, shortness of breath, fatigue, etc., an EKG can provide information regarding your RBBB as well as any ischemia (occluded vessels) in the event there is ischemia without any symptoms. If the EKG is positive for ischemia, then a stress test is the usual protocol.
My chol is 115, HDL 57, LDL 58, trig 64. You have good lipid levels, but your very high HDL 83 outstands. Very high HDL (greater than 70) level has some negative inference although not conclusive. The other side contributes HDL to longevity and contribute the condition to genetics and exercise.
The major apolipoproteins of HDL are apolipoprotein (apo) A-I and apo A-II, the alpha-lipoproteins. Elevated concentrations of HDL which is associated with lower risk cardiac heart disease (CHD). Conversely, LDL increases the risk of CHD. The levels at which HDL confers benefit or risk are not discrete, and the cut points are somewhat arbitrary, especially considering that HDL levels are, on average, higher in US women compared with men and higher in blacks compared with whites.
Presenting the findings from the analysis at the European Atherosclerosis Society (EAS) 76th Congress in Helsinki, Finland, investigators showed that increased levels of HDL cholesterol, when adjusted for apoB and apoA-1, were associated with an increased risk of major cardiac events, particularly at levels greater than 70 mg/dL
High total cholesterol and low HDL cholesterol increases the ratio and is undesirable.
A high HDL cholesterol and low total cholesterol lowers the ratio and is desirable. An average ratio would be about 4.5. Ideally, one should strive for ratios of 2 or 3 (less than 4). Your ratio calculation is 2.02...a higher HDL would put the ratio below 2.0 ?!
The total cholesterol to HDL cholesterol ratio (total chol/HDL) is a number that is helpful in estimating the risk of developing atherosclerosis. The number is obtained by dividing total cholesterol by HDL cholesterol. (High ratios indicate a higher risk of heart attacks, whereas low ratios indicate a lower risk).
Traditional thinking has been the higher the HDL, the better.
A new drug called torcetrapib caused HDL levels to soar and seemed especially promising. Unfortunately, this did not translate into the expected shrinkage of arterial plaque. In fact, the drug was associated with progression of plaque in one trial. It also increased blood pressure, and studies were halted in December 2006.
More recent research may help explain the puzzling findings with torcetrapib. It seems that very high levels of HDL cholesterol can be a two-edged sword, depending on the size of the HDL particle.
It's speculated that very large HDL particles, enriched in cholesterol, may deposit cholesterol instead of picking it up.
The latest evidence has jarred the traditional picture of HDL out of focus and sent researchers scurrying back to the drawing board. (Dec.2007)
My chol is 115, HDL 57, LDL 58, trig 64. You have good lipid levels, but your very high HDL 83 outstands. Very high HDL (greater than 70) level has some negative inference although not conclusive. The other side contributes HDL to longevity and contribute the condition to genetics and exercise.
The major apolipoproteins of HDL are apolipoprotein (apo) A-I and apo A-II, the alpha-lipoproteins. Elevated concentrations of HDL which is associated with lower risk cardiac heart disease (CHD). Conversely, LDL increases the risk of CHD. The levels at which HDL confers benefit or risk are not discrete, and the cut points are somewhat arbitrary, especially considering that HDL levels are, on average, higher in US women compared with men and higher in blacks compared with whites.
Presenting the findings from the analysis at the European Atherosclerosis Society (EAS) 76th Congress in Helsinki, Finland, investigators showed that increased levels of HDL cholesterol, when adjusted for apoB and apoA-1, were associated with an increased risk of major cardiac events, particularly at levels greater than 70 mg/dL
High total cholesterol and low HDL cholesterol increases the ratio and is undesirable.
A high HDL cholesterol and low total cholesterol lowers the ratio and is desirable. An average ratio would be about 4.5. Ideally, one should strive for ratios of 2 or 3 (less than 4). Your ratio calculation is 2.02...a higher HDL would put the ratio below 2.0 ?!
The total cholesterol to HDL cholesterol ratio (total chol/HDL) is a number that is helpful in estimating the risk of developing atherosclerosis. The number is obtained by dividing total cholesterol by HDL cholesterol. (High ratios indicate a higher risk of heart attacks, whereas low ratios indicate a lower risk).
Traditional thinking has been the higher the HDL, the better.
A new drug called torcetrapib caused HDL levels to soar and seemed especially promising. Unfortunately, this did not translate into the expected shrinkage of arterial plaque. In fact, the drug was associated with progression of plaque in one trial. It also increased blood pressure, and studies were halted in December 2006.
More recent research may help explain the puzzling findings with torcetrapib. It seems that very high levels of HDL cholesterol can be a two-edged sword, depending on the size of the HDL particle.
It's speculated that very large HDL particles, enriched in cholesterol, may deposit cholesterol instead of picking it up.
The latest evidence has jarred the traditional picture of HDL out of focus and sent researchers scurrying back to the drawing board. (Dec.2007)
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