Cholesterol targets are different if on medication?

[DWizza]

I posted my recent cholesterol results a few weeks back and received some commee we ts about them being way better than “normal”

My GP surgery sent them to me with a note to say they were “normal” without any context.

my Serum cholesterol for example is 2.4 mmol/L , way below the normal target of 4-5.

Calculated LDL 0.7 (below 3 seems to be target of 2 below)

Se non HDL 1.1 (4 or less but seems to be a target of 2.6 below )

I’ve just been in contact with the BHF on line cardiac nurse and had a chat about how my numbers all look normal and that for the last month or so I’m feeling worse than ever , aches , pains , neuralgia type headache for a first week January, left leg painful in shin muscle and quad when sitting still … all sorts of stuff and wondered if it was my meds ( bisoprolol 1.25, Rampiril half of 1.25, clopidogrel, pantaprazole, aspirin and 80mg artovastatin). I sent her my cholesterol readings and she confirmed that they are just normal , nothing exceptional and gave a link to BHF information. None of this has ever been explained to me !

She did encourage me to get a review of my meds with my GP though 👍🏻.

“If you are getting secondary prevention treatment for your heart condition, you may have different LDL-cholesterol and non-HDL cholesterol levels to aim for. The guidelines say you should aim for :

LDL cholesterol level of 2.0mmol or less.

Non-HDL cholesterol level of 2.6mmol or less. “

[Lowerfield_no_more]

A small number of people who take statins suffer from a side effect of muscle and joint aches and pains. It is possible, especially since you are on the max dose of Atorvastatin, that you are also suffering the same side effects from what you have said. However other statins are available to try e.g. Rosuvastatin which may not give the same side effects and it certainly worth discussing this with your GP when you have your meds review. Or, since your lipids are very low, it might be worth discussing reducing the dose which may mean any statin side effects are lessened, especially since there are some of the medical opinion that very low total lipids might actually be bad for you.

webmd.com/cholesterol-manag...

[DWizza in reply to Lowerfield_no_more]

The point of my posting was that I thought my lipid results were low, according to the BHF they may not be low , just normal as I , like many of us , am on secondary treatment. I mentioned previously that when I got test results from my GP surgery they just said they were normal, no context . The BHF put the secondary treatment as the context for the results probably being normal and not exceptional. This something I will be taking up with my consultant. I was never briefed that I would need to hit a different set of cholesterol targets because I’m on secondary treatment. I am looking forward to getting the clarification once and for all. I presume there are a many more that are not aware of the different targets?

[JeremiahObadiah in reply to DWizza]

I’m not remotely suggesting you try this without first discussing with your doctors , but when I first started on statins the prescribing Dr said, if I felt that I was getting side effects, I could stop for two weeks to see if the side effects stopped and then started again after the two week pause and so could be attributed to the statin. Fortunately I have not had any issues (but I am on a lower dose to you).

The Dr also recommended that I should take vitamin D, not because this is connected to cholesterol but because many aches and pains sometimes attributed to statins are actually a deficiency.

[DWizza in reply to JeremiahObadiah]

Just starting my two week trial of not taking the statin 👍🏻. Let’s see how it goes .

[NannyPat1 in reply to DWizza]

Harefield nurse tells me LDL needs to be below 1.8 after HA which is apparently what the rest of Europe uses. Mine has never been that low so I’m on Inclisarin now

[DWizza in reply to NannyPat1]

Thanks NannyPat, It was never explained to me , left me confused with my results , no context at all.

[Cushie]

My experience of aches and pains resulted from a concoction of atorvostatin blood pressure tablets and clopidogeral. They stopped the statin, changed to a different bp tablet which now is a minimum 2mg Candesartin plus the 75mg clopidogeral. 2mg is enough to keep my blood pressure normal and my only remaining side effect is pins and needles on fingertips and toes. I was told this effect would reduce, which it has but the remaining p and n can be uncomfortable particularly at night.Yes, your review is an urgent requirement.

[DWizza in reply to Cushie]

Thanks for sharing Cushie , I also feel the cold a lot more , hands feet and a constantly runny nose 🤦🏼🤣..

My BP is pretty good , 110-117 over 74-80 . Resting heart rate is 46-50.

I hope I can try something different, I thought I’d be really keen to push on with my training , I really feel so low that I can just about get the outdoors work done on the small holding. I don’t even enjoy walking my Lurcher for 4k atm, it all seems such a hurty effort 🤦🏼

[wischo]

Mention to your GP how you feel and ask about your cholesterol as it seems excessively low. Ask for a break from your statins and see how you get on. My GP told me that the general advise for people who catch bad colds, covid infections is to take what he calls a statin break to help them recover, Cholesterol is very important for helping your bodies metabolism, and tetosterone and vitamin production which is essential for energy and good health. Leave any decisions to your Gp but personally my cardiologist is very happy with my LDL of 1.8 and total cholesterol of 3.5. Good luck.

[Hidden]

Just had my cholesterol tested 2 months now on 80mg Atorovastin.

There's a comment on my test which says Aim for LDL cholesterol is 2.6 mmol/L.

My serum cholesterol =2.7

HDL cholesterol =1.1

Non HDL =1.7

HDL ratio = 2.5

Triglycerides =0.7

Serum LDL cholesterol =1.4

I eat porridge for breakfast, eat salad and beans for lunch and indian veg curries/ lentils at night, meat once a week. Always done this.

Will discuss my results with GP but also that when my hands and feet get so cold quickly, appreciate its cold outside but never felt it like this.

[DWizza in reply to Hidden]

That’s good that you got some targets that to aim for in the comments. that’s the frustration I have , no context provided , just normal.

The cold hands and feet 🥶🤦🏼.. I’m going to watch Harlequins today , I will be wrapping up 🥶

[Hidden in reply to DWizza]

double gloves, hat, scarf, jumper and flash of whisky should do the trick, enjoy the Rugby.

I've got a dull day of shopping, taking my daughter to drama class and then washing the car. I have an exciting life lol

[DWizza in reply to Hidden]

Might take a cheeky flask of rum 🤣. I’ve been off booze , feeling rough enough … my Mrs is astounded if I have a beer these days .. 🤦🏼

[Smitty1956]

Hi, DWizza,

I have been reading some articles that suggest that if one has had a heart attack or stroke, then target goals for LDL cholesterol should be much lower than the medical standards usually stated. For example, the LDL number should be no higher than 70 mg/dL, or 1.81 mmol/L.

I have been watching American Heart Association television ads recently that say that total LDL levels should be no more than 55 mg/dL, or 1.42 mmol/L, in order to possibly avoid a second heart attack, or stroke.

In the first year following my HA, my LDL cholesterol went from 132 mg/dL to 66 mg./dL. I thought that I was doing great with taking my 40 mg. Atorvastatin and eating healthier. Now, I realize that I need to try to get that level even lower.

You might want to check out this article from the Harvard Medical School:

health.harvard.edu/blog/ldl...

If you click on the high-lighted words “recent meta-analysis” in JAMA, you will be shown the original article.

I agree that it might be a good idea to question a “one-size-fits-all” notion of cholesterol standards. Best wishes! 😊👍

[DWizza in reply to Smitty1956]

Cheers Smitty 👊🏻, I found it very frustrating to get my results back with no context and what appears to be the standard goals for for anyone not on secondary treatment.

Will give this a read , thank you 🙏

[Smitty1956]

😄👍

[TasteLessFood4Life]

I am on statins (Lipitor 40mg) and followed a overly healthy and strict food diet with exercising combined initially. My cholesterol dropped to 2.1 and LDL at 0.8. Whilst my cardiologist was raving about the numbers, I wasnt feeling the greatest. I looked pale, had brain fogs, dizziness - I think my cholesterol just dropped too low. 6m in, I slightly altered my diet and added more fat to my diet. I am feeling a lot better now. My cholesterol has slightly increased to 2.8 and LDL to 1.1, but crucially I feel so much better now. I think this is a much healthier level to maintain and within the required parameters for me. No need for me to get the levels that low.

[magnilink in reply to TasteLessFood4Life]

hi

What level do they recommend to halt the Plaque build up , as I'm sure I read that the lower you get LDL the better , mine was 0.8 on 40mg statin , but I dropped it to 20 as my liver tests came back raised, my GP was not worried , but my cardiologist said you can go to 10mg statins if you want as your body reacts to stains well , but I go privately and I'm not sure if I should go onto 30mg of statins , my LDL on 20mg is 1.07

[DWizza in reply to magnilink]

That level would be acceptable to me , but I’m not on your medical team 🤣.. I had to find a balance between feeling awful on artovastatin 80mg , tried Pravastatin 40mg , now on 10mg rosuvastatin and will increase in the future if necessary . My calculated LDL on artovastatin was 0.7 , then went to 1.7 on the rosuvastatin which is below the guideline 2. That’s acceptable to me as I feel better on this statin . Obviously it will be reviewed annually and the statin titrated up if need be to a tolerable level.

I’m only on half a 1.25mg tablet ramipril , aspirin , pantaprazole and consultant said I could stop bisoprolol.

[magnilink in reply to DWizza]

Hi

I don’t take blood thinners as I have had bad acid reflux in the past, and my cardiologist agrees that Omprosol is bad when taken over a long period, but at 63 with CAD score of 65 , I’m near what you can expect at my age , it’s only in one artery so I’m am anxious that it sticks at 65 and doesn’t go anywhere else all others are 0, it’s in American podcasts that I’ve heard the lower LDL score is the more chance of a halt to progression

[TasteLessFood4Life in reply to magnilink]

I think the plaque build up is more nuanced than simply the LDL number. Apo B plays a part too and I am sure there are array of other factors like inflammation. Also, it is the type of plaque that matters too.