Cholesterol

[NannyPat1]

can anyone help me out here. I’ve been told by dr that post HA my LDL should be below 2, I’m told by BHF nurse it should be below 3, and by Harefield specialist nurse it should be below 1.4 which is European standards they work to though she said England drs were working towards lower than 1.8. She also said LDL was the only figure they looked at. I’m just very confused. With all my healthy eating and exercise I’ve got it to 2.2 but there’s nothing more I can do 🤷‍♀️

[Tos92]

Hi NannyPat1

My mum has also been told her cholesterol should always be below 3 too. She is on Atorvastatin to maintain and keep her cholesterol levels low. Depending on what guideline practices hospitals follow, it may vary.

I hope someone with more experience and research on this topic comes along to help.

All the best.

Tos

[NannyPat1 in reply to Tos92]

Thx

[Lezzers in reply to Tos92]

That's the same for my husband, he was told 3 many years ago. His cholesterol was only just over 4 but Dr said Papworth wanted it below 3 so he was put on atorvastatin, probably about 20 years ago now.

[Tos92 in reply to Lezzers]

Is he still on Atorvastatin 20 years on?

Hope you & hubby are doing okay x

[Lezzers in reply to Tos92]

Yep, all these years later he's still taking atorvastatin, he's never had any issues with taking statins despite the fact he's usually very meds intolerant Last year he had a MIBI (the cardiologist didn't want to do an angiogram unless it was absolutely necessary) and thetr was nothing to indicate an angiogram was needed.

We're doing very well, thank you for asking. We're very much taking the view that there's little we can do about my husband's situation so just take each day & enjoy it & strangely enough we're now less stressed than we have been for some time! Hopefully we'll still be doing that in 10/20 year's time. 🤞 Hope all is good with you xx

[Tos92 in reply to Lezzers]

I’m glad the MIBI came back clear. I dodge an angiogram every time it’s suggested 😂.

I’m well, thank you. That sounds refreshing, not having that constant worry or stress. I’ll be keeping my fingers crossed for you as well 🤞🏽. Enjoy the weekend with hubby x

[Lezzers in reply to Tos92]

You have a good weekend too x

[Chappychap]

There are similar anomalies all over the place.

Many of these trigger points are entirely arbitrary. There's nothing magical that happens when our LDL (or HbA1c or blood pressure or weight or etc, etc) hits a certain number. It's a scale, with increasing risk as we move along that scale.

Medical science is far from being perfect, settled science. All we can do is keep nudging the odds in our favour and hope for the best.

Good luck!

[NannyPat1 in reply to Chappychap]

Thx

[Sodp]

NannyPat1 Not sure about UK , my cardiologist here is Australia thinks I should keep my LDL below 1 and Hdl above 1. Even I have .8 LDL my cardiologist want me to continue on with high dose of rosuvastatin 40mg. Its funny before my stent I had 4.5 LDL and my GP goes if you go above this we will start statin . So don't know what range is correct but I am trying to keep it low as possible.

[NannyPat1 in reply to Sodp]

thx

[Flimflab]

I was told by my cardiologist that an LDL of 3 or below was the target for a "general member of the population". However, because I had CVD my risk was higher and that the target should now be 2 mmol/L.

For me diet and exercise were not sufficient to get me under this and I needed to take statins (40mg atorvastatin) to get under 2. As that was unexpected said there may be benefits of an even lower LDL level.

[JennyRx]

our local guidelines seem to be below 3 for the general populace and about 1.8 for post STEMi or other CVD risks. I have elevated lipoprotein(a) and so mine was reduced from the below 3 target to the below 2 target after that was discovered. This was by the senior lipidologist at the hospital not the GP. I’m on ezetimibe and Repatha

[flower365]

Thats very interesting. If its no too much trouble could you post links to the relevant studies please.

[MountainGoat52]

Hi NannyPat1,

When investigations were carried out to try to determine why I had a heart attack when I was fit and active, the Clinical Pathologist at the local hospital persuaded me to try Rosuvastatin (I had previously had serious issues with 3 other statins). After three months of 10mg on alternate days, she wrote a report to my GP advising that following a blood test my LDL was now an excellent 1.9 mmol/L. I now take this as the baseline target and in agreement with my GP the Rosuvastatin is now taken daily, which has enabled me to maintain it below this level.

Both before and after my heart attack my LDL had been 2.8mmol/L. While it may have been a contributory factor, the main cause of my HA was found to be a high homocysteine level increasing the risk of blood clots in combination with stress at work. Lowering cholesterol, homocysteine and stress levels with other factors such as blood pressure control and blood thinning is now the key to reducing the risk of me having another heart event.

Incidentally, I have grown to have a dislike of two things in the NHS - protocol and standards. Neither is consistent across the NHS. I do wish moves would be made to correct this.

With my best wishes,

Gerald

[NannyPat1 in reply to MountainGoat52]

thx

[Sljp0000]

On my Cardio Rehab programme recently, after my bypass and stents, we were told the 'new' guidelines were anyone with heart issues should keep LDL below 1.9. They said the cardiology team were going to be rolling it out to GPs. My GP had said he thought my 3.4 was OK but has now increased my statin to help get it down below 1.9.

[NannyPat1 in reply to Sljp0000]

thx

[Bond234]

I understand your confusion as I’m in exactly the same position but I may be able to pass on what I’ve learnt from my experience just in the last month. Luckily, having the ability to have insurance that covered me going private rather than NHS I have been able to get one to one advice from 2 of the UK’s best cardiologists, one just having carried out a complicated angiogram and angioplasty op with the installation of a long stent in my main heart artery.

Historically I have had famial hyper-cholesterolaemia (hereditary high cholesterol) and for 20 years the NHS had continued to say an LDL below 3 is the target (5.0 total) and a nominal 20mg dose of simvastatin was prescribed without change. 2 months ago my LDL was 3.3 and my GP thought that was ok.

However unbeknown to me and NHS GP’s that level had been causing me serious ‘bad’ cholesterol build up to the point that my main heart artery was 95% blocked, in fact I’d had a heart attack and hadn’t even known I had. The stenting I’ve now had has cured that issue but the key thing now is reducing LDL to 1.4 to ensure I stay heathy and that advise needs to come from a cardiologist not general doctors or nurses.

It can be done. In just 6 weeks my LDL has dropped from 3.3 to 1.9 as of yesterday and is set to come down to 1.4. How? Aggressive statins, 80mg Atorvastatin along with strict no-sat fat diet (“Mediterranean”) plus all the Benocol stuff and oats and fibre. Along with that exercise that gets the HDL up.

Hope there may be something here that helps. Very best of luck!

[NannyPat1 in reply to Bond234]

thx and we’ll done!

[GnomeHA]

Hi NannyPat,You've hit the nail on the head in your original post : If you're sticking to a healthy diet and exercising well - there's not a lot more you can do - You're already doing it !

Try not to worry about what the future MAY bring, and concentrate on planning what enjoyment the future WILL bring. Make plans and enjoy life.

[NannyPat1 in reply to GnomeHA]

good advice, thx

[Vonnie4]

Gosh. Its so very nteresting to see all the different takes on LDL levels. Studies I have read over time indicate that ldl is not the evil bio marker medics make it out to be. There are some dangers to having LDL that low. I have read that every cell in your body actually needs cholesterol particularly the brain .if LDL is too low the brain won't have sufficient cholesterol to function properly leading to memory problems etc. My GP advised me that it's important to also look at Triglycerides levels and HDL levels as well. Hdl is the good cholesterol which needs to be high. Triglycerides need to be low , less than 1.7 (fasting). High triglycerides increase the risk of heart disease and are often caused by a diet high in sugar and also when you consume more calories than you burn off. Lipid clinic advised me they wanted my ldl to below 2.5 but my triglycerides are very low and hdl a healthy 1.9 so I worry that whilst I may be less of a candidate for heart disease i may become more of a candidate fir dementia of I follow their advice. I find all the conflicting evidence out there very confusing but I do know that TC and LDL shouldn't be the only things docs look at these days when assessing the risk of heart disease.Stress, lifestyle, high blood pressure and diabetes are also contributing factors.

The very best of luck to you in your recovery.

[Holiday12345 in reply to Vonnie4]

I was thinking exactly this …

[Art-99 in reply to Vonnie4]

several years ago I was told my cholesterol was somewhat high but as my HDL was high in comparison to my LDL, I shouldn’t be too concerned. However since a mitral valve replacement in 2020 (I also have arrhythmia so take warfarin) my cardiologist has been keen to get me on statins, particularly as my LDL is now high. I am now on my 3rd type of statin as blood tests show my liver is not reacting well to these drugs. As you say cholesterol in itself is essential and is one of the building blocks for cell renewal. I try not to get too concerned and try to eat, drink and exercise within recommended limits. In my opinion there is no ‘one size fits all’ so is best to not get too worried about the latest ‘ideal’ levels of cholesterol.

[pjw17]

Hello NannyPat1,The day of my HA (may 20) my cholesterol level was 5.9 .

After my last blood test it was 1.9 ,was told by pharmacist at meds review it needs to be below 2 .

I'm sure if you stick at whatever you are doing you will dip under .

Good luck.

[NannyPat1 in reply to pjw17]

not sure it will but thanks

[flower365]

Thank you, very useful. My next worry is the raising of my Lpa level as a result of aggresive statin therapy. Have you found anything relevant to that? I only seem to come across statements of the fact or rabid anti statinists😁

[flower365]

Yes thats my take on it. But I have seen an increase of 50% and it niggles me.

I've read an increase only occurs in 20% of patients but I've yet to see any science on the outcome for this cohort. We keep searching😁.

Thank you for your help.

[flower365]

Unfortunately I'm quoting my own figures. In 2017 and 2018 my Lpa was 155mg/dL and 146mg/dL . This june after 3 months of aggresive statin treatment my level is 223 mg/dL. As ones Lpa level is said to be fairly stable for life but is raised by statins I am assuming that it is the culprit.

On the plus side my cholesterol levels are great😁

[flower365]

Sadly no they are mg/dL. I have familial hypercholestemia.

[Lizbeth61]

Hi there. I don’t understand how they calculate cholesterol levels. A recent blood test last week My HDL is 1.7. LDL is 1.7 And then they say my total cholesterol level is 3.7. How is this calculated ?

[Reggaelover in reply to Lizbeth61]

Hi Lizbeth 61,

I think they just add the key components (HDL, LDL and triglycerides) to get the total - but I’m no expert.

[Lizbeth61 in reply to Reggaelover]

lol me neither. I think it must be within normal levels but would like to know what the risk was ie my HDL is high (good) and my bad cholesterol is 1.7 (decent also) but overall 3.7?

[Reggaelover in reply to Lizbeth61]

It seems reasonable to me but I’m no expert - perhaps consult your GP or cardiologist for clarification 🙂

[Reggaelover]

Hi NannyPat1,

I’m 63 years old and my total cholesterol is 2.6 - HDL and LDL are both 1.3. I have been taking Atorvastatin (20mg) for 5 years as a CT angiogram revealed a very slight narrowing in one of my coronary arteries - but not enough to cause any symptoms or to need a stent. Before I started the statins, my total cholesterol was 4.1 with HDL and LDL of 1.3 and 2.8. I’ve had no problems with Atorvastatin.

[NannyPat1 in reply to Reggaelover]

yeah I already take 20mg of Rosuvastatin which is worth 40mg of Atorvastatin. Just reluctant to take more as double the dose only gives you another 5% reduction according to NICE guidelines.

[dnsblr]

What I understand from my doctor is :

Optimal: LDL cholesterol below 1.8 mmol/L (or 70 mg/dL)

Near optimal: LDL cholesterol below 2.5 mmol/L (or 100 mg/dL)

Borderline high: LDL cholesterol below 3.4 mmol/L (or 130 mg/dL)

High: LDL cholesterol below 4.9 mmol/L (or 190 mg/dL)

Very high: LDL cholesterol above 4.9 mmol/L (or 190 mg/dL)

I hope it helps.

[NannyPat1 in reply to dnsblr]

Well I’m near optimal then but still getting hassle to get it down!

[dnsblr in reply to NannyPat1]

Are you taking atorvastatin regularly? See doctor and ask specifically if higher dose required.

Apart from Healthy eating and exercise, some meditation, practicing No Stress (Come what may) also help. Wish you a faster recovery😊