I am a 48 year old male - relatively fit, 178cm height and 60kg so healthy weight.
My father died of a heart attack aged 53 which I guess puts me in the high risk category. I had a cholesterol blood test the other day at my GP's and results came back as:
Ratio = 3.5 serum non high density lipoprotein level = 3.7 mmol/L
My GP said these results are satisfactory and no other action required.
I had a similar conversation with the GP last year as I was concerned that at over 5.0mmol/L total cholesterol that was too high for someone at high risk but they argued it was fine and again they appear happy.
Also just to add I have tried improving my diet and have a daily cholesterol lowering drink plus porridge for breakfast!
I don't want to sound like a hypochondriac and keep nagging them but most sites I look at such as British Heart Foundation and NHS tell me that it shouldn't be more than 4.0 for high risk.
Should I be concerned and keep discussing with the doctor or just stop worrying??!
Thanks
Written by
Georgeb46
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Thanks for your reply. The reason for the blood test was the 5 yearly health check up that the NHS offers for over 40s. Mine was last done in 2014 so I enquired if I was due another and they did the blood test.
It's difficult to know what to believe regarding cholesterol.... I've read so much about the cholesterol con
Please ask for qrisk or jbs3 analysis and take it from there. Always look out for hidden and free sugar in all food and drinks for a healthy life. Regular exercise is also very important.
They are basically yoghurt drinks that contain a certain amount of Plant Sterols that have been found to reduce cholesterol levels with regular use. You can also find these added sterols in spreads etc
Your total cholesterol value has little clinical significance for CAD risk.
75% of all plasma cholesterol is produced by your own liver and has little to do with your diet.
That said, a healthy, plant-based diet is optimal for adding fiber and antioxidants to keep your disease risk at lower levels. Fiber helps eliminate and reduce LDL-C.
Your HDL is very high and that is a good thing and thus your non-HDL metric is close to optimal (should be below 3.37 mmol/l.
Your TC/HDL ratio is 3.47 which is within the optimal ratio of <3.5.
I notice you did not provide your triglyceride values - these should be kept as low as possible, ideally below 0.79 mmol/l. I have kept mine between 0.4 and 0.69 mmol/l.
Triglycerides reflect your consumption of sugar and other simple carbohydrates. Triglycerides are part of the process for initiating endothelial damage and thus the accumulation of arterial plaques. This is actually the most important metric in the standard lipid panel.
The optimal metric for CAD risk in a blood test, is LDL-P (particle number) which requires a test called NMR Lipoprofile.
Alternatively, you can more easily find a proxy for LDL-P by getting a value for your Apo B.
When you do this, also request the ApoA1 test so you can get an ApoB/ApoA1 ratio to help determine your risk of CAD.
Other blood metrics worth identifying are:
- fibrinogen and homocysteine - risk of blood clots
- hs CRP - level of inflammation in the body
- uric acid and ALT - proxies for sugar and simple carbohydrate consumption;
- HbA1C - average blood glucose level over the last 3 months
- ferritin - iron levels which can initiate tissue oxidation if in excess. Men over 50 and post-menopausal women tend to accumulate iron which can lead to oxidative damage that might trigger a cancer.
If you are of a normal body weight for your frame, and exercise daily, the probabilities of CAD are low. However, you can determine a genetic pre-disposition to CAD risk by getting a test to identify the value of your Lp(a).
Other non-dietary risk factors that may trigger a heart attack are:
- excessive daily stress
- sleep deprivation - we require a 9 hour sleep opportunity window in order to get an optimal 8 hours of sleep each night.
Guard your sleep zealously and ensure you take time to relieve stress through mindfulness and other relaxation techniques. A good daily workout also relieves stress and increases seratonin levels.
I don't think father alone dying early makes you high risk. Father and grandfather or uncle, or father and LDL>5mmol/l would. And total of low 5s is itself usually borderline. Don't worry. Worrying only raises cholesterol?
You’re probably right. Problem is there’s so much conflicting information on cholesterol depending on who and what you read. I’ve just started reading the Great Cholesterol Con which pretty much disregarded everything that I’ve read on the nhs websites.
Probably not worth worrying about but just one of those things the closer i get to the age my father died.
You can always get a Calcium Score test done to see how much/how little disease you actually have , not just guessing by the markers. My BIL has triglycerides so high they can't be measured,LDL of 7 and yet at over 60yrs of age has a zero calcium score making him low risk.
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