Cholesterol Treatment Markers in the U.K.

[sos007]

I live in Canada and am curious to know which cholesterol marker is used as a treatment target with statins:

LDL-C

ApoB

ApoB/ApoA-1 Ratio

In Canada, LDL-C is used.

Thanks to all.

[sandybrown]

There is guide line given to all GPs by NHS. It depend on the GP. My GP has asked me may times to go on Station from the age of 65, I am now 70, tried it for three months when I was 66 to satisfy myself. Total cholesterol came down to 2.8. We need cholesterol in our body!

Most GPs use total cholesterol and ratio to answer your question.

Five years ago it was fasting blood test but now days any time blood test, Lipid and HbA1C.

I am not sure if our GP practice do ApoB and ApoA testing.

Total cholesterol guide line is 5, as I mentioned in another reply this used to 7.25. Money making machines brought it down to 5 as new guide line.

[foxglove in reply to sandybrown]

How does HbA1C affect cholesterol? Thought it was to dx. pre diabetes!

[sos007 Ambassador in reply to foxglove]

That test is for average blood glucose level over last 3 months. Higher glucose raises triglycerides and also causes inflammation in the body. Inflammation contributes to atherosclerosis. Type 2 diabetes is often a concurrent illness with CVD.

[foxglove in reply to sos007]

Thanks for reply.

[sandybrown in reply to foxglove]

Blood glucose used to be tested with fasting blood over 12 hours, those were the days! now days HbA1C blood test the oxygenated blood over 90 days.

You have diabetes or no diabetes! we can control blood test numbers by life style change. There are other scans that can detect health problems.

Anything we put in out mouth can give us bad health we have control over this. Weight gain, waist gain leads to fat in the body and internal organs, therefore controlling the food and drinks intake together with regular exercise cans helps to a healthy life.

[foxglove in reply to sandybrown]

Agree!!! Diabetes or NO diabetes is still a fact.

[Penel]

This is the Heart UK website, giving numbers. Our doctors also use the Q-risk calculation to decide on statin prescription.

heartuk.org.uk/health-and-h...

[sos007 Ambassador in reply to Penel]

Thank you. There appears a greater focus on non-hdl. Here they focus on LDL or non-hdl. Research though suggests that the focus should be on the ApoB/ApoA-1 ratio:

ncbi.nlm.nih.gov/pmc/articl...

[Penel in reply to sos007]

Interesting read, thanks, although do the findings only apply to people who are obese? ApoB/ApoA ratios are not routinely tested for in the U.K. as far as I know.

[sos007 Ambassador]

There numerous studies and the conclusion is that this ratio appears to be a more accurate predictor of CVD than any other lipid measure or ratio. I pay myself to get the ApoB and ApoA-1 measures. Healthcare system covers cost of normal lipid panel: TC, TG, HDL, LDL. Changing treatment marker would be bureaucratic and difficult to re-educate doctors.

[DakCB-UK in reply to sos007]

How much do you pay and who?

[sos007 Ambassador]

I live in Canada. The cost of the tests are $35 CAD each. I hear you can go to Portugal for cheaper blood tests if you live in the U.K.

[DakCB-UK]

My lipid clinic doctors target LDL-C as far as I know: the target is to have it at 50% of my baseline unmedicated-and-good-but-not-oats-or-supplements-diet reading. It's currently at 60% and I'm fairly comfortable with that.