Re: Cholesterol levels,statins and bypass surgery.

On Apr 11, 1:36 pm, William Wagner <not-to-here-william...@xxxxxxxxx>
wrote:
In article <1176308858.290878.8...@xxxxxxxxxxxxxxxxxxxxxxxxxxxx>,





 tonyzs...@xxxxxxxxx wrote:
I am a 75 year old male who has enjoyed resonable health for most of
his life.  I am not overweight and do not smoke.  My blood pressure
has been in the 120's/80's for at least the past ten years.  In
January 06 , on my usual morning walk, I became aware of a dull  chest
ache on the lower left hand side.  Although I was slightly breathless
in walking uphill the ache was not related to the degree of effort.  I
did pretty well on a treadmill stress test, but a CT scan revealed two
heavily calcified plaque in two of the coronary arteries.  Angioplasty
was considered but the location of the plaques made this procedure not
advisable.  In July 06 I had a double bypass operation.

My cardiac rehabilitation went according to plan and by Christmas 06 I
was looking forward to playing golf again.  In October 06 my doctor
persuaded me to take rosuvastatin.  I had previously taken
simvastatin, but this gave me a severe rash, together with extreme
weariness, muscle aches, headaches and unsteady gait.  My doctor
prescribed 5mg of rosuvastatin at first, then 10mg in December 06 and
finally 20mg in February 07.  There were few noticeable side effects
at first but as the dose increased so did the severity of the side
effects.  In March I began to feel so unwell the I decided that
statins were not for me.  My researches into statins prompted my
recent posting 'Statins Again'.  My cholesterol levels have been as
follows:

                      December 06                           February
07

                      mmol       mg/dL                      mmol
mg/dL

Total               6.1           234.6
5.7           219.2
HDL                2.3             88.4
2.3            88.4
LDL                3.8           146.1
3.4          130.8

Although my LDL reading is above the recommended level, my HDL is way
above.   I did discuss with my doctor whether readings like this
really indicated I had a cholesterol problem.  He insisted that the
right course was to prescribe statins.  So my questions are:

(1)  with those sort of figures what sort of risk do I run of early
death or heart attack.

(2) How are the recommended levels of cholesterol established - is it
simply from the blood cholesterol of those who suffer or die from
heart attacks?   Can the levels not properly vary from one individual
to another?.

(3) There seems to be a great deal of evidence that low LDL levels are
associated with increased of heart attacks or stroke.  Am I being
naive in being persuaded by such evidence?

In the months after my operation the only chest pain I had was brought
about by the surgical wound.  About two months ago, though, I again
became aware of a dull in the lower left chest, the same location that
led to the initial discovery of the plaques.So other questions spring
to mind:

(1) I doubt that further plaques could have developed since the
operation, but is it likely that the bypassed plaques are causing the
ache?

My doctor has dismissed the idea that this is an angina ache, because
it would be located in the centre of my chest.  To which I say that
the ache is similar to the one that led to the operation.

Sorry about the length of this.  Any comments or advice would be very
welcome.

Tony Sims, Chipping Campden, UK

 Yeah I know 1995 but look at  HDL vs CHD.

Bill

................

1: JAMA. 1995 Aug 16;274(7):539-44.
Links
Comment in:
JAMA. 1995 Aug 16;274(7):575-7.
HDL cholesterol predicts coronary heart disease mortality in older
persons.
   €  Corti MC, Guralnik JM, Salive ME, Harris T, Field TS, Wallace RB,
Berkman LF, Seeman TE, Glynn RJ, Hennekens CH, et al.
Epidemiology, Demography and Biometry Program, National Institute on
Aging/NIH, Bethesda, MD 20892, USA.
OBJECTIVES--To examine the relationship of total cholesterol and
high-density lipoprotein cholesterol (HDL-C) with coronary heart disease
(CHD) mortality and with occurrence of new CHD events in persons aged 71
years and older. DESIGN--Prospective cohort study with a median of 4.4
years of follow-up. SETTING--East Boston, Mass; New Haven, Conn; and
Iowa and Washington counties, Iowa. PARTICIPANTS--A total of 2527 women
and 1377 men who completed an interview, had serum lipid determinations,
and survived at least 1 year. New CHD events were evaluated in persons
with no CHD history or hospitalization. MAIN OUTCOME MEASURES--Death due
to CHD (ICD-9 codes 410 through 414 as underlying cause of death); new
occurrence of CHD events (fatal CHD or hospitalization with CHD [ICD-9
codes 410 through 414]). RESULTS--After adjustment for established CHD
risk factors, the relative risk (RR) of death due to CHD for those with
low HDL-C (< 0.90 mmol/L [< 35 mg/dL]) compared with the reference group
(HDL-C > or = 1.55 mmol/L [> or = 60 mg/dL]) was 2.5 (95% confidence
interval [CI], 1.6 to 4.0). Elevated risk was present in subgroups aged
71 through 80 years (RR, 4.1; 95% CI, 1.9 to 8.8) and over 80 years (RR,
1.8; 95% CI, 0.99 to 3.4), and in men and women. Low HDL-C predicted an
increased risk of occurrence of new CHD events (RR, 1.4; 95% CI, 1.1 to
2.0), with similar but nonsignificant results in subgroups of men and
women. Total cholesterol was less consistently associated with CHD
mortality than HDL-C. When we compared individuals with total
cholesterol of at least 6.20 mmol/L (240 mg/dL) with the reference group
with total cholesterol of 4.16 to 5.19 mmol/L (161 to 199 mg/dL), a
significant risk of CHD mortality was seen for women (RR 1.8; 95% CI,
1.03 to 3.0) but not for men (RR, 1.0; 95% CI, 0.5 to 2.0). In the total
population, for each 1-unit increase in the total cholesterol/HDL-C
ratio there was a 17% increase in the risk of CHD death that was
statistically significant. CONCLUSIONS--Low HDL-C predicts CHD mortality
and occurrence of new CHD events in persons older than 70 years.
Elevated total cholesterol was not found to be associated with CHD
mortality in older men, but may be a risk factor for CHD in older women.
PMID: 7629981 [PubMed - indexed for MEDLINE]

--

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Please do not allow your side effects go unnoticed. A physician needs
to be aware of all the potential side effects of meds he gives and to
take measures to minimise them all to often that does not happen. An
interesting resource in this regard is SPACE DOC just google it

.

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