Re: Is statin appropriate to raise HDL?
From: Dr. Andrew B. Chung, MD/PhD (andrew_at_heartmdphd.com)
Date: 09/01/04
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Date: Wed, 01 Sep 2004 19:39:26 -0400
DC wrote:
> "Dr. Andrew B. Chung, MD/PhD" <andrew@heartmdphd.com> wrote in message
> news:413647BE.FE24E8A4@heartmdphd.com...
> > DC wrote:
> >
> > > Male, age 46
> > > Weight, normal
> >
> > What is your height and weight.
> >
>
> 6'3", 190 lbs (BMI ~ 24)
>
You might be 15 pounds over "ideal." Losing these 15 pounds may lower BP
(requiring less or no medications) and may raise your HDL.
>
> > >
> > > Borderline High BP, taking Ziac to keep it controlled.
> > > Recent Bloodwork:
> > > Total Chol = 119
> > > LDL = 64
> > > HDL = 34
> > > TriGly = 107
> > > Glucose = 87
> > >
> > > My (new) family doc wants me to start on Pravachol with the primary
> purpose
> > > being to raise my HDL levels.
> > >
> >
> > You may be at a higher risk for a cardiovascular event because of
> metabolic
> > syndrome (MetS). This may be the impetus for your family doctor to be more
> > aggressive about raising your HDL.
> >
>
> We didn't talk about MetS. I seem to have two strikes (low HDL, taking
> antihypertensive). But not the three.
>
Do you have a family history of heart attacks or strokes?
>
> > >
> > > After doing my research, I don't necessarily agree, and it seems
> > > diet/excercise and perhaps Niacin would be better first choices.
> >
> > Would agree about the former but the latter is associated with worsening
> MetS.
>
> If niacin raises HDL (maybe removes one strike), how does it worsen MetS?
> Does it effect triglycerides or glucose? (which are normal now).
>
It can worsen insulin resistance.
>
> >
> > > The lipid
> > > ratios seems pretty good, although I do recognize that the HDL is low by
> > > accepted standards. I really don't feel like taking the statins, though,
> > > unless I can convince myself that it's really necessary.
> > >
> > > Does anyone take statins just to raise HDL?
> >
> > Some of my patients are.
> >
> > >
> > > Is having a low HDL a risk by itself if the lipid ratios are all
> favorable?
> > >
> >
> > Yes.
> >
>
> Is it worth finding out the makeup of the cholesterol? i.e. get the
> subtypes?
>
Depends on how aggressive you want to be at prevention.
>
> Thanks.
You are welcome.
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