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.
