understanding cholesterol results

[allofaquandry]

Please can you help. I am 76 years old and been on prednisolone for 6 years for PMR and GCA. I am finding my blood test results confusing in that serum non-HDL cholesterol and serum triglyceride are within range as is the serum cholesterols-HDL ratio, so all good . However my HDL cholesterol is high (good cholesterol?) and alas my serum LDL cholesterol is also high.

My readings are :

serum triglyceride 0.8

serum non-HDL cholesterol 3.7

serum cholesterol:HDL ratio 2.1

serum HDL cholesterol 3.4

serum LDL cholesterol 3.4

serum cholesterol 7.1

I find these results very confusing, the mix of good and bad results. Why is a high LDL not counter balanced by the high HDL and the positive result of the non-HDL cholesterol? The more I read and research the more confused I become!

Moreover I had a text from my doctors surgery to say that my risk of developing heart disease or stroke over next 10 years is 22.13%.

Perhaps I should add, I rarely eat meat, eat what I consider to be a healthy diet, avoiding fried foods and cakes and biscuits, am not overweight, drink no more than 1 glass of red wine and exercise and walk the dog each day!

[piglette]

Less than 10% is low risk, 10–20% is moderate risk, and more than 20% is high risk. In fact 1 in 3 people are at high risk. You are pretty close to moderate risk.

[allofaquandry in reply to piglette]

very helpful statistics piglette, thank you

[DorsetLady PMRGCAuk volunteer]

Just to add, as you are female and over 75 and have no serious cardiac issues- which it doesn’t say you have in bio you have - the advice is very often that statins do little good.

At our age, probably most people are in same range of risk as your readings give anyway…

[allofaquandry in reply to DorsetLady]

"imas you are tension and over 75" ???

your statement re risk is very reassuring. I don't want any more tablets so thank you it helps strengthen my resolve.

[DorsetLady PMRGCAuk volunteer in reply to allofaquandry]

Have amended… as I said to PMRpro - upside down at the moment! Holibobs in NZ ! Apologies… 🤦🏻‍♀️

[allofaquandry in reply to DorsetLady]

So good of you to reply, especially as you are on hols at the moment with your family.

Many thanks, all so reassuring.

Hope you are having a wonderful time. Best wishes x

[DorsetLady PMRGCAuk volunteer in reply to allofaquandry]

I am thanks.. and catching up in the down time (for me)..

[Doraflora in reply to DorsetLady]

Same as us, DL. We only returned from Oz on Tuesday and are most definitely inside out and upside down still💤

Plus hubby managed to pick up a virus as we were leaving Singapore heading home. It’s like flu symptoms and a Covid test was negative. Hey ho…

Hope you had a good trip?

[DorsetLady PMRGCAuk volunteer in reply to Doraflora]

Still on it! Have another 3 and a bit weeks 😊…

Hope hubby soon improves -and you both get right way up! 😳

[Doraflora in reply to DorsetLady]

Ow wow, that’s a great trip for you. Enjoy every minute. x

[PMRpro Ambassador in reply to Doraflora]

Sometimes Covid tests now take several days to be positive - very unreliable.

[PMRpro Ambassador]

These might help:

heartuk.org.uk/cholesterol/...

bhf.org.uk/informationsuppo...

But something to discuss with your GP.

Although in the past they have said statins don't do much for over 75s, more recent studies have concluded they reduce cardiac risk at all ages.

[allofaquandry in reply to PMRpro]

Many thanks PMRpro, I think this is where I went around in circles with my research. However, according to Heart UK ' Non-HDL cholesterol is the current treatment target for primary prevention (for those who do not have cardiovascular disease)'. I obviously am pleased with that, but will definitely will discuss with my GP/Health practitioner.

[Doraflora]

I should have a good chat with your doctor allofaquandry, or the nursing specialist at least. They might reassure you.

[Tappo]

There is a very good book called A Statin Free Life by Aseem Malhotra. He is a British cardiologist and his work is evidence based. It is an excellent, easy to understand book and will give you all the information you need about cholesterol and heart disease. I hope it helps:

amzn.eu/d/1EN5OsS

[DorsetLady PMRGCAuk volunteer in reply to Tappo]

Has been mentioned before in previous posts…

[Tappo in reply to DorsetLady]

Better to repost than for the lady to miss it 🥰

[DorsetLady PMRGCAuk volunteer in reply to Tappo]

Absolutely..

[pmr_nikola]

You have almost the same issue that I had. Each sub-component of the cholesterol is within limits ( LDL slightly elevated at 3.4, limit is 3.0) but your total cholesterol is high due to HDL ( 3.4), almost 3x of normal. Since HDL is good cholesterol, why would you be at risk? and why would you even consider taking meds to lower cholesterol?

When I pointed out that to my Dr, he agreed with me that statins were unnecessary in my case.

[allofaquandry in reply to pmr_nikola]

Exactly, I'm hoping I will get the same response at my appointment at GPs

[Tappo in reply to allofaquandry]

DL said information I gave about Aseem Malhotra’s book has been posted before. Sorry if you had already seen it, just trying to help. I always think better to repost than for someone to miss potentially really helpful information. 🥰Even if your GP doesn’t agree that you don’t need statins, it is entirely your decision as to whether you take them or not. An interesting point Malhotra raises is that LDL cholesterol is protective against Alzheimer’s and this is the very cholesterol that is lowered (as well as triglycerides) through use of statins. He points out that there is a rise in the prescribing of statins alongside the rise of Alzheimer’s. Obviously it’s only a statistical link, but it’s one we should be mindful of when making our decision about what we decide to do with our bodies. We all have to die of something. Personally, I would rather go a little bit earlier of something heart related then live out a long life in the distress of Alzheimer’s! However, everyone’s different. Good luck with your GP x

[PMRnewbie2017]

I'm similar. I have always had an above normal HDL. Years ago a doctor asked how I managed it! We decided it was genetic. These days everything is based on numbers and there doesn't seem to be much joined up thinking. Forgive my frankness, but you're 76, fit, not overweight which many are these days and eat healthily. Statins may not help and may give you side effects which for us PMR sufferers can cloud the picture. You always have a choice and I'm saying this as a Pharmacist albeit retired.

[allofaquandry in reply to PMRnewbie2017]

Yes, I have been coming off various accompanying medications, (which were prescribed for the side effects of prednisolone) because they in their turn were causing other unpleasant side effects so the last thing I want ( the last thing anyone wants) is side effects from other medication. It is so difficult sometimes to track what is causing what with polymyalgia!

I am so pleased I have raised this here, you all have been very helpful. Many thanks All

[Potemkin]

I follow a nutrionist - Dominique Ludwig on Instagram and I've also done a couple of her courses. She has an article on cholesterol that might be helpful.

dominiqueludwig.com/dl_arti...

There are also several cholesterol calculators online.

My friend has high cholesterol but because her BP and sugar levels are fine they are not putting her on statins. She has tried everything in her diet and with exercise and only managed to lower it slightly. The Dr has told her that it's likely to be genetic and as long as she maintains a healthy lifestyle they are not worried.

Chat to your GP if you are worried.

[Potemkin in reply to Potemkin]

I've also just reread that article and one contributor is stress. With our PMR we are under a lot of stress so that's probably not helping. Maybe some breath work or mediation might help - wouldn't do any harm

[PMRpro Ambassador in reply to Potemkin]

MediTation I assume? I doubt the cholesterol will listen to a mediator ....

[Gimme in reply to Potemkin]

And not to overlook that quite a few of us consider our PMR to have been caused by stress in the first place.

[PMRpro Ambassador in reply to Potemkin]

Funny - it is usually the patients with the genetic version they worry about most - it is often associated with early cardiovascular disease and death and statins do make a difference.