Angina, always normal cholesterol - hereditary

[MrDIY]

Diagnosed with heart disease in January and after initial denial and shock now trying to answer questions. I have read that 25% of people with heart disease have no aggravating lifestyle choices and I count myself in that group. Docs have put me on statin, GTN and Monomil and I can now walk the 1/2 mile to work without the severe Angina. I have had several cholesterol tests going back 19 years and the results were always normal and I understand I am on the statins as a precaution, BUT if my cholesterol has always returned normal what has blocked my arteries?

I probably have a predisposition to get clogged arteries BUT how can this be treated effectively and verified?

I can see the logic of putting me on statins BUT how can they tell what dose to give me if the blood tests are always normal?

[84green]

Hi MrDIY. Sorry you find yourself here but welcome and I’m sure you will find the forum helpful. I was also diagnosed with CAD in January but, unlike you, my lifestyle choices were very much a contributor I suspect. There are many here who have no apparent risk factors and the first they know of any is an unexpected heart attack.

That said, my cholesterol was never high either. Like you, I also have an hereditary predisposition to CAD but that wasn’t a cause.

There are many here who know more than I do about this but I’m not sure that excess cholesterol itself is the cause of heart disease. It’s true that the blockages (plaques) consist of cholesterol but the problem is initially caused by damage to the lining of the arteries that encourages the plaques to form. This damage is linked to inflammation. It may be worth your while researching the links between inflammation and heart disease.

Like you I am on a statin but also unsure how the dose is arrived at. I guess it is the cardiologist’s judgement based on your symptoms but, as I say, there are others here with more knowledge and experience that I have.

You may also find the BHF nurses a good source of advice if you call them.

Sorry I can’t be more help.

Best wishes

[LEMCON]

11 years ago when I was 50 during a blood test for an operation my cholesterol was 9! I was shocked and horrified. I was put on 20mg simvastatin , then 40mg. After a visit with a specialist cardiac nurse following a visit to A & E with chest pain I was put on 40mg Atorvastatin. Last year my cholesterol wouldn't shift below 5 and I was put on 60mg Atorvastatin, this too didn't move it and now take Ezimibie too and it is lower now. Around this time I had a very severe chest pain, following a number of test I was diagnosed with Angina. Heart disease is hereditary in my family. If your blood tests normal for cholesterol I should image you would be prescribed only a low dose statin and be monitored. I have been prescribed calcium channel blockers for my angina, have you? Take care.

[84green]

There is a pinned post on the Cholesterol Support forum by a user (sos707) with a title beginning “How I conquered heart disease. . . “. Not saying I necessarily endorse all his thoughts, but interesting to read nevertheless.

I think it’s about taking in all the information you feel you need (specialists, GP’s, your own experience and research) and deciding a way forward that you believe will work and suits you.

Personally, I am happy to be guided by my cardiologist who believes that I need a statin, aspirin, as well as cholesterol below 4 (it’s now 3.1), BP below 130/80 (currently 115/65), and control of my blood sugar. That doesn’t stop me from doing my own research so I can ask questions about both my condition and treatments. I have found him happy to engage in such conversations.

I am also trying (not very successfully yet) not to overthink everything. This is where the internet becomes a double edged sword! For example, I try to avoid reading complex medical research that I don’t properly understand. There are also many and various diets recommended but, for me, a low carb Mediterranean diet is the way forward - simple to follow and plenty of variety.

I appreciate it’s more difficult for people where the risk factors are less clear but hopefully there are still changes that can be identified and implemented.

[Milkfairy Heart Star]

Hi MrDIY

Have you had any tests such as CT angiogram to check your coronary arteries?

All of us have some degree of plaque in our arteries. It is part of the ageing process.

Plaque formation is also influenced by smoking, diet, lack of exercise, family history, pollution, diabetes, being over weight and mental well being. Sometimes it is just bad luck.

I have also been prescribed statins when I have a normal cholesterol and I have non obstructive coronary artery disease. No blockages present but I am still at risk of a heart attack , stroke or other heart problems as my blood vessels do not function as they should.

The statins also reduce inflammation as well as stabilising even minimal areas of plaque which can either become eroded causing a blood clot to form or break away.

Both the blood clot and plaque can then go on to block an artery in your heart or brain.

There is lots of evidence based information on the BHF website about which diets and lifestyles measures are the best to help keep your heart and mind healthy.