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decreasing hdl

I am currently in cardio rehab having had a cabg (triple) on 1/25/2011 and am doing quite well (I think).  I've just turned 70 and am/was in relatively good health (didn't have a heart attack or any other serious symptons/caught the blockage at a reg. exam.  I'm going up and down stairs, doing 1 1/2 miles @ 3.0 on a treadmill (at home) and doing the 3.0 mph at rehab as well as recumbent and life cycle.  BP seems fine and heart rate stays around mid 90's.  (Just got a hr monitor and keeping track on my own).  I have another appointment with cardiologist in late April and intend to talk to him about a stress EKG since I want to run a 5K the end of July with my kids and want to start pushing the exercise routine to get ready for that.  My question is:  Just had blood work done (at request of people at rehab) and got a call from my reg. Doc.  Liver functions seem fine, total chol. is 174/ ldl 76/ Trigly. have gone up a little to just over 300.  The thing that seems to have him a little preplexed is my hdl had been at 59 (probably a little over a year ago), dropped to 49 about 10 months ago and is now at 39.  He isn't changing anything at this time (currently on 20 mg simvastatin and 50mg. mopropolol 2x per day and 325 aspirin 1x).  I do drink (couple martini's and glass of wine 4 to 5 X per week).

I guess my question is why would my hdl be dropping like this?? What are the implications of this?? Any thoughts appreciated.

2 Responses
63984 tn?1385437939
Were you quite active prior to the bypass surgery?  Trigs are lowered and HDLs are increased with physical activity, and you were inactive during your surgical down time, I'm wondering if that would account for the difference.  I'm betting your wine and martini consumption was the same before and after the procedure, so doubt that is a factor in the change.  Martinis are highly glycemic, wine much less so, perhaps substituting libations might be interesting to see what happens.  
My HDL went up and my Trig level went down when I started taking 1000mg of good quality fish oil twice a day several years ago, you might mix fish oil into your drug regimen and see what happens.  I take fish oil produced from sardines and anchovies, as these fish are never farmed.  Fish oil from farmed salmon lacks the benefit of wild fish.
I'm betting you will do great with the 5K run.  I'm your age, and hoped to run one in June as part of The Race for the Cure cancer benefit with my children and grandchildren, but think I'll have to walk it.  
Sounds like you are recovering well.  Keep us informed.
159619 tn?1538180937
What your are describing is Metabolic Syndrome. It is characterized by high TGL's and low HDL and is usually due to insulin resistance. Insulin is produced by the pancreas in normal amounts in response to carbohydrate intake and helps to get the glucose into the cells to be used by your body as energy. If you consume too many refined carbohydrates, they are metabolized too quickly,  and the increased insulin production will lead to too much insulin in the bloodstream and the cells then fail to respond and become insulin resistant. Alcohol also metabolizes as sugar just like other empty carbs and will make the condition worse.

I would ask your doctor to test you for insulin resistance, your numbers fit the profile. In this case, the low HDL is a symptom of an underlying condition.

Just my thoughts, good luck,

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