Rising cholesterol

I haven't written on this site for over a year so hello again!

I just wondered whether I am likely to be offered a statin at my next drs visit in about 6 weeks. my BP had suddenly shot up to 150<> /90<> when I had my 6 month check up in September for no apparent reason. In the surgery it was 200/100 :( and the dr increased the dose of Losartan. At the same time I had my blood checked: cholesterol and HbA1c. Thankfully the latter had dropped to 39 mmol/L from a pre diabetic 42mmol but my cholesterol had risen. I now have a total of 6.6; HDL 2.8*; ratio 2.4; and se no HDL 3.8. [Is that last HDL figure what used to be called LDL?] . 2 1/2 years ago it was total of 5.4 with HDL at 2.0 and LDL 3.0. Trigs then were 0.8 but they don't seem to do those now. Can someone tell me please what the asterisk means?

The trouble is my dr knows I don't want a statin and she herself doesn't believe the nation should be statinised courtesy of NICE's recommendations of a Qrisk of 10%. However she does have to obey the rules and I have to decide what to do if I am offered one. My Qrisk is now 15.9% due to hypertension and my 73 years - I am female btw. She has sent me a message to make an appointment for 6 weeks hence so would like to be prepared.

I hate these box ticking exercises as I think the Qrisk is. Just wondered what the options are likely to be.

16 Replies

  • Should have added to the above that in the intervening time between cholesterol tests I have lost lots of weigh [BMI is 19] and take plenty of exercise daily. I adopted a rather loosely based High Fat, Low Carb diet and certainly the NHS's food plate went out of the window! This was principally to deal with the diabetes scare. I certainly eat plenty of vegetables and fruit and eggs and butter which the NHS would disapprove of.

  • I don't think those diet elements would be disapproved of in recent advice (as long as you're not having slices of butter or anything daft like that). Sure, they'd probably advise olive oil rather than butter, but few would get too upset by a bit.

  • Do you in yourself feel fit and healthy?

    Maybe your b/p was up because you were stressed by being at the drs and not wanting statins. Do you do your bp at home.? I self monitor on my own machine and take my readings in, as when i go to gp mine goes through the roof every time! Im a classic white coat sufferer.

    Dr can only advise you to take statin, choice is ultimately yours! Lots of people recomend them but others have nothing good at all to say for them too.

    Take look within the heart site of health unlocked, lots of posts about statins etc.

  • Hello Lisahelen, thank you for your reply.

    It's certainly true that my BP always goes up at the surgery. I both know and like my dr so no issues but it is still always goes sky high when she wraps the cuff round my arm! This time though it was higher than ever. With the increased dose of Losartan [up from 25 mg to 50 mg] it has now come down slightly but I'd hoped the increased dose would be temporary; it probably won't be.

    I actually keep a diary of my own BP readings taken twice a day. Dr says it isn't necessary but I prefer to do it that way and keep an eye on things. Rather not have any sudden shocks!

    As for the cholesterol I have this feeling I'm going to be offered a statin and though I would take one if pushed I'd really need hard evidence that it wasn't just a box ticking exercise.

    Since having a wake up call [NHS health check] almost 3 years ago I really did alter my life style to improve things and most things have improved except the cholesterol which has got worse. I think I was only called for the health check because the cholesterol was borderline: I often wish I'd never gone!! I read so much about the side effects of statins that I became a total sceptic and feel that unless big pharma and Sir Rory Collins come clean and disclose the side effects evidence then I shall continue to feel that way. A friend was put onto them and has had very bad muscular wastage and pain which has dissipated since changing brands, so that increased my fear of the things.

  • Sorry, I forgot to add that I am really fit and well. I garden a lot and walk the dog every day for a mile or two.

  • Statins are just a tablet that Doctors freely prescribe all the time , if your cholesterol level is ok then there is no reason to be on it . They were prescribed for me after my angioplasty but I don't take them , decent diet does the same thing along with exercise . As you can tell I'm not much for taking tablets lol

  • That of course in my opinion is the problem - drs prescribe statins freely! One wonders why they don't just put them in the water and statinise the whole nation. Trouble is I don't really know what cholesterol levels should be. I know what official guidelines say but I don't know whether I believe it all. The NHS are like dinosaurs in so many ways and the more I read the more doubtful I become and the less I believe them.

    Like you I absolutely HATE tablet taking. I do take the BP meds as I've been convinced it would be foolish not to, but I still hate it.

  • The asterisk is probably a range warning. NHS England test range for HDL is 0.82-2.00mmol/L, so you're above that.

    I don't see why you'd have two HDL figures. I think someone has made a transcription error and one of them is LDL. If so and it's 3.8, with a total cholesterol above 5, you are very likely to be recommended to take a statin. If I wanted to avoid that, I'd request a retest (if they've mistranscribed LDL as HDL, who knows what else is mistranscribed?) and do everything possible with a sensible (mediterranean?) diet, moderate exercise and maybe those stanol/sterol drinks to get it down near 5 so you're back in the grey area where I suspect most GPs will agree not to prescribe.

  • OK so the asterisk is indicating that the HDL number is too high; I was under the impression that they wanted HDL to be high and LDL low, perhaps that's wrong? It's all so confusing!

  • No, that's right, but they also want total cholesterol below 5 (I think - I've not pulled the file out again) which it can't be if HDL gets too high. High HDL may indicate some other problem - the asterisks are just the test result report drawing attention to things outside the normal ranges. Don't worry about them out of context.

  • Thank you for your reply. I have read the info via your link. I still don't know what to think; I feel certain I'm going to be advised to take statins and really don't feel happy about it but I do have a few weeks before I see the dr to think about it. You may have gathered that I'm not the sort to just do as I'm told, I need a valid reason and just being told the cholesterol is a little high isn't reason enough imo.

    The thing is I've read and believed that the cholesterol data was manipulated way back in the 1950's with the 7 countries experiment. France and Germany who both eat high fat content diets - not to mention high alcohol - weren't in the experiment and yet both have lower rates of heart disease than the UK. They didn't fit the pattern and so were eliminated. Nobody ever seems to mention this - why not?

  • There's tons of people mentioning it and you don't have to search the web hard to find them. It's true that France and Germany aren't in that study (which still continues), but it's guesswork to say that they were eliminated because they didn't fit the pattern. It seems more likely that it was a combination of where had willing participants (France and Germany were still rebuilding in the 1950s) and personal contacts with Ancel Keys. The resulting picture is incomplete but may still yield information.

  • If you google "japanese cholesterol study" you will get a number of links that will enable you read about recent research particularly wrt older people, and to discuss your case with your doctor if that's what you want to do.

    My doctor asked me to increase my statin (to comply with the guidelines) when I asked her to reduce them, and was ok with my decision to not increase the dose as she was able to record that her offer of the maximum dose was refused. We agreed that I would have a blood test to check on the anti-inflammatory effects of my current statin dose before making further decisions on reducing the dose.

  • Thank you for your reply, I will read the Japanese study you recommend. Glad to see you are questioning the drs advice too! The thing is their hands are tied by NICE which makes me cross.

  • Hi Gardengnome

    Sorry to hear about your concerns. I'm not sure if there's anything I can suggest that would help, but I think it is unrealistic and possibly unhealthy to expect a post menopausal woman to have a low total cholesterol level (below 5).

    Perhaps you could have another look at what you eat? Possibly take some of the ideas from The Portfolio diet, as long as you are keeping the carbs under control? Having a low BMI may not be the best for your health, perhaps try eating some unprocessed starchy foods, like sweet potato, or quinoa, if you don't already. Thyroid problems can affect cholesterol levels and weight, perhaps something to ask your GP about if you think it's relevant.

    Good luck with sorting this out.

  • Thank you for all your replies. It looks like I have a load of reading to do!

    An-264266, I'm not sure I could cope with Esselstyne's way of eating, not long term anyway, but in fairness I have only glanced at the page.

    Penel,I 'll look at the portfolio diet. To lower my HbA1c from pre diabetic levels I adopted a high fat and low carb diet and that has worked but it has probably been responsible for raising the cholesterolas I eat a lot of eggs and cheese. Fish and fruit and veg. Butter and olive oil in moderation and absolutely NO FLORA or BENECOL! I ditched breakfast cereals and now have eggs and never feel hungry before lunch. What's more I don't get that mid afternoon blood sugar crash that I always used to have.

    I don't have a family history of heart disease/stroke and don't smoke and drink very little so my inclination is to listen to my dr as I trust her judgement. She knows I am a sceptic on just about everything! When they lowered the bar for statins to 10% and she offered me one some months ago, she knew then that I'd refuse. I asked her if she'd take one herself if she were me and she said no; she didn't think it wise to medicate otherwise healthy people merely as a preventative and risk side effects. If you had a heart problem then that would be different she said.

    Then this hitherto active friend of mine started having pains in his legs about 3 weeks after starting statins [Atorvastatin?] which incapacitated him for months. He changed brands to Simvastatin and the pain went. Certainly put the wind up me.

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