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Sunday, February 28, 2021

Cholesterol Size

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Jack Hocutt
Dr. Hocutt is a Family and Sports Medicine physician in north Wilmington, Delaware. He is the former Head Team Physician of the US Olympic Luge team for 8 years and has been the team physician for several high schools in the area. He founded Kids v Cancer and ran the charity benefit for 6 years involving over 600 kids each year along with countless adults making significant contributions to Coaches v Cancer.

First there was total cholesterol.  Then there was good (HDL) and bad (LDL) cholesterol.  Then there was active and inactive good and bad cholesterol.  Now there’s large buoyant and small nasty cholesterol.

 

Thus some folks can have relatively low LDL (bad) cholesterol levels and still be at risk for early heart attack and stroke.  And conversely, a number of folks with high LDL levels are not at significant risk to have a heart attack.

 

Your family physician and/or your cardiologist will work with you to put the whole picture together.

 

Basically, you first need to know your cholesterol levels AND your family history.  Depending on your test results, your age, your family history, and your smoking history; your cholesterol particle size may then be measured.  The larger molecule size of LDL cholesterol doesn’t get around to doing much damage to the blood vessel walls and doesn’t seem to fit through the lining of the blood vessels to get into the wall where it can really do damage.

 

So, your physician/physician assistant/nurse practitioner can assess your risk factors, cholesterol levels, blood sugar levels, blood pressure AND your cholesterol size to recommend how aggressive your preventative treatment should be.

 

And, if you want to go further and be more specific, a bottom line test, the calcium score heart scan (EBT), is an excellent indicator of what’s actually going on in your body as far as your progression to heart disease, and can be a major additional determinant of how intense your treatment to prevent heart disease and lower your cholesterol levels should be.  (See 15 years to a heart attack – previous article)

 

And don’t forget Diabetes and pre-Diabetes.  An abnormal blood sugar is a very high risk for heart disease, stroke, and peripheral artery disease.  Along with hypertension and high cholesterol levels, Diabetes is one of the big three disease risk factors for heart attack and stroke.

 

Medication can certainly help.  There are doubters out there, but there is an amazing amount of proof that when appropriately used, medication can truly prevent heart disease.

 

However, losing weight, being aerobically fit, and reducing your carbohydrate intake can make a HUGE difference in your health.  You just have to actually decide to make this happen BEFORE you have damage to your arteries occur.  (See Lifestyle – previous article)

 

 

This is Dr. J Hocutt for Town Square Delaware Health Alerts.  Write to me at AskDrHocutt@TownSquareDelaware.com.  My comments are not intended as recommendations for individual treatment.  See your personal physician to decide what is best for you.

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State expects shipment of one-shot Johnson & Johnson vaccine, maybe by week’s end

The Johnson & Johnson vaccine requires only one dose, unlike the Pfizer and Moderna vaccines, which need two doses.

Smyrna still unbeaten, takes Henlopen Conference title in win over Seaford

Seaford will be the first seed in the state tournament, and Smyrna is the 6th seed.

COVID cases decline; more than 200,0000 vaccines given; state continues testing

The state has created a way for people to report violations of the state's vaccine policy
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