Cholesterol Question

[fisher6476]

Had my second rehab session today at the end of which there was a speaker about cholesterol. This nurse educated us somewhat on the good and bad cholesterol, then on the large and small particles of cholesterol. She finished by stating that the standard cholesterol test is not good enougth any more, that we need to take this new test to define how many large and how many small particles of cholesterol we have, then made a blanket statement that "anyone who has had heart surgery absolutely must be on cholesterol medication therefore some form of stantin.
Any one ever hear this? I don't want any more chemicals in me than absolutely neccessary. Thanks
Steve

 

[Georgia]

"Heart surgery" meaning vascular surgery. Doesn't apply to those of us who had valves replaced if we don't have "heart disease." Heart disease meaning clogging of the arteries.

I've been reading about the drug companies advising that everyone should take statins for everything; seems to me that they're pretty heavy duty drugs for everyone to be taking regardless of cholesterol levels. I know that there are a lot of side effects and they're also really expensive.

Call me suspicious - but I think a lot of the research done for use of statins irrespective of cholesterol levels was funded by the drug manufacturers. Hmm-m-m.

I don't take statins and don't need them.

 

[bvdr]

My total cholesterol was only 139 when I was started on Lipitor.
My good cholesterol was very good. I nevertheless do have some CAD(coronary artery disease) and it is supposed to help keep it from progressing.

 

[hensylee]

Dr Rich, over in about.com wrote an article about this. He said they have done extensive tests and found that there are far more advantages to being on statins than high cholesterol. And the results of the testing was that most people ought to take them for the benefits they provide.

 

[Susan BAV]

Hi - I'd like to know more about this. I've always resisted being put on cholesterol medication because I like to take as few medications (chemicals) as possible. But my total was 240 before my AVR surgery and I don't remember the break down but my good fats were high too. But the pre-surgical angiogram showed that my arteries were "as clean as a whistle," according to the cardiologists that performed it.

My father-in-law was on some "breakthrough" diabetes medication several years ago - you couldn't watch the evening news without hearing about it - and his regular mandatory liver panel came back "off." He was getting ill too and when they did exploratory surgery, his gall bladder was removed because the surgeon found it to be, "pusy [is that spelled correctly?] and rotten!" Only a few months later, that medication was completely taken off the market because so many people had died while on it.

I don't remember the name of that medication but it added to my cynicism toward the pharmaceutical industry. I have read that the industry gives special "perks" to physicians that meet a certain quota of prescriptions written for some, often newer, medications.

In short, one hardly knows what to believe!

 

[tommy]

A couple of years ago, I had my first cholesterol test in a long time - it was post AVR. Total was under 200, but HDL was only 29. At that point, all other indications and readings for me were within expectation from recent AVR. I had no history of coronary artery problems or blockage.

I asked my cardio what we should do about the low HDL - is there medicine that I could/should be taking? He said, "You are progessing very nicely. We are not going to go DECORATING". I had never heard "decorating" before (or since) in medical context, but knew exactly what he meant. He said exercise and weight loss would help, but he didn't recommend medicine.

With exercise and weight loss, my total is down to 186 and my HDL is up to 37.

I read here http://www.americanheart.org/presenter.jhtml?identifier=183 that a perspective on cholesterol is not only looking at individual numbers for total, LDL, and HDL, but looking at the "cholesterol ratio". Divide the total by the HDL. A ratio under 5 is desirable, 3.5 optimal.

My ratio was 6.7, now 5.1. Since I am able to exercise, and the HDL is improving, I choose stay on that track. (pun intended).

 

[dwfreck]

"Chemicals"

"Chemicals"

Steve & Susan W,

While I whole-heartedly agree with you about "as few medications as possible" I feel I should defend "chemicals." From a chemist's point of view, EVERYTHING is a chemical. Also, the most abundant substance on earth, and in your body, and the one that is commonly considered the original "natural" substance, has a chemical formula: H2O. Just some nit-picky food for thought...

Whatever Dr. Rich and Steve's nurse said, I doubt that our insurance companies, or our pocketbooks, are prepared for "everyone" to take statins. It also occurs to me to ask whether or not we can get the "additional benefits" that statins provide through some other, non-medicinal, means.

Now if anyone can point us to some reliable information about statins, that would be a big help!

 

[Harpoon]

Ummmm.....


First off, not everyone in cardiac rehab is there for the same reasons, coronary artery desease caused by high cholesterol and plaque buildups in vascular tissues.


My cholesterol is GREAT. Always has been. Why should I take a medication that I don't need? What benefit, other than cholestorol reduction, does this stuff provide? Is it neccesary?


Humans have been around for a VERY VERY long time without this drug, why is it so important now for everyone to be on it?


I'm a little skeptical and would like a LOT more information.


Besides cost, all medications have side-effects. What side-effects to statins have? Do the benefits far outweigh these side-effects?


If such and such is going to lower my cholesterol 10% but give me a low grade headache all the time, do I really need to be on it?


I take an ACE inhibitor called lisinopril that causes a tickle cough in the back of my throat. I've had this cough ever since I started taking lisinopril a few years ago and I will probably always have it. The cough is annoying, sometimes downright bad, but I live with it because the ACE inhibitor lowers my blood pressure and eases the workload on my heart. The benefit outweighs the side-effect.

Without the lisinorpil, I wouldn't have the tickle cough any more, but I could slip back into heart failure. Which is more desirable???


Coumadin has the same kind of arguments as does many many other prescription drugs.


NyQuil was always my drug of choice when I had a bad cold/flu type infection. NyQuil worked great ot relieve all of my symptoms and it didn't knock me out like it does most people so I could run around and do what i needed to do as if I wasn't sick.

The ingredient pseudoephedrine in NyQuil is a stimulant which makes your heart race, even a normal, heart-healthy person's heart race. It's near "cousin" ephedrine has caused sudden cardiac death in a lot of people, including college basketball stars, and is banned from sale in most markets now.

Yeah, it may work great in relieving symptoms, but will I ever take it again???


Nope.



I wouldn't take any medication unless my doctors, people I've known and trusted for many years, say it's neccesary to maintain (or improve) my health and even then I ask all kinds of questions about what the med does, it's effects on me, the side-effects, and possible alternatives if the side-effects seem to much to bear.

 

[Kenny F]

My cardio feels that nearly everyone will be on statins at some point, altho he doesn't necessarily suport that notion.

Once again, everyone in heart care assumes you are a vascular patient! While nearly everyone in rehab with me is, I am not! BUT - I don't want to be either, which is why I am i n rehab and do take lescol to maintain my levels. My cardio has a lipid clinic, with finger stick testing and 5 minute readouts.

I was only able in the past to get a minor reduction in LDL thru exercise/diet. With Lescol the effect was immediate and large. While not a big fan of RXs, I think that this may be one wonder drug that is - as long as you monitor liver function.

 

[Abbanabba]

Harpoon - you really hit the nail right on the head!!

I recently had all my "vitals" tested and aside from the dodgy old ticker, I am in excellent health with all my readings (cholesterol included, of course) either normal or better than average. I eat very well, maintain regular, moderate exercise (..when I can, although I've slowed right down over the last 12 months..), and generally enjoy life. I'm also just a tad skeptical at the frequency that medications are prescribed to people before other options are explored and more holistic treatments are tried - and this is for all sorts of things!

I guess we just have to trust our own judgement when deciding what we believe is in our own best interests.

Cheers
Anna : )

 

[tommy]

My surgeon but me on cholesterol medicine and blood pressure medicine post AVR. A month later my cardio took me off of both. I have no artery or blood pressure problems.

My cardio once referred to taking medicine to raise my HDL as "decorating". How refreshing that he didn't "jump" to drugs. My HDL was 29, now 37. Still a bit low, but exercise and losing weight are bringing it up.

 

[HFK]

Hi ,
Alot of people are on statin drugs,but they aren't without risks.
Cholestral level is only one number,the ratio is what's also important and the patient's family and medical history. Also they now are looking CRP levels which are marker's for CAD as well.
My chol. level is 226 but my HDL is 92 and LDL is 42. Statin's have a high profile of side effect's one being liver damage and cancer.
If it's justified take them if you have REALLY tried diet and exercise, the problem is many who take these drugs eat whatever they want and just take the drug. I thing I learned as a pharmacuetical rep. was no drug comes without side effects ,some are worse than others. All the publicity for these statin drugs and all there benefits,smells like the whole hormone replacement thing we just heard of last year. HFK

 

[JimChicago]

My PCP gave me a cholesterol test recently and my scores were:
total: 219
triglycerides: 68
HDL: 82
LDL: 123

My PCP said that though my total was 219 since the HDL was 82 he thought my score was OK.

However I'm pretty sure when I go to my cardio he will probably want me on anti-cholesterol meds as they put everybody on them. Like others have mentioned I'm leery of the side effects of another medication and have heard c-reactive protein and homocysteine were better markers for possible cardiac problems (I've already had bypass + valves).
With my scores can I assume my cardio will not be upset if I say I prefer to go with my PCP's opinion and not take the anti-cholesterol meds?

I've got an interesting book called "The Cholesterol Myths" by Uffe Ravnskov MD PHD and hear many say the cholesterol link is over stressed, that cholesterol is iessential to health and so forth and that other factors are the real cause of artery damage.

 

[HFK]

Just noticed a typo my LDL was 142 not 42 and I also have tri level of 66. Jim , I think your numbers look good but see what cardio says? I know of patients who's Total cholesterol was less than 200 and had bypass,it is multifactorial. HFK