I can’t get my cholesterol to lower enough but GP says ratios are ok and so won’t prescribe statins. It’s currently 6.4 but that is the lowest it has been. I do eat more fats now as have a low carb diet but would be hungry otherwise, really hard to find the right balance.
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Blood levels down - Cholesterol Up !!!
- Thread starter Jackiejh
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What are your lipid profile figures? Surely if your ratios are OK, then who cares about total cholesterol?
My total was 7.7 at prior reading (awaiting news of test just before Xmas) and my ratios were good with low Triglycerides and high HDL.
@Perfect10 I have just read this in vol 153 of Preventative Medicine (December 2021):
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The number of Americans dying of heart disease has been steadily climbing while the number with high cholesterol has been gradually falling.
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Current guidelines recommend aggressive reduction of LDL-C to prevent coronary heart disease, but new research suggests that other factors may be far more important in the pathogenesis of coronary heart disease.
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Despite the widespread utilization of cholesterol-lowering statins in Europe, there has been no accompanying decline in coronary heart disease deaths.
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The totality of new evidence compels us to question why our current approach to heart disease prevention through targeted reductions of LDL-C is not working.
Later it says this:
The cholesterol hypothesis, which posits that lowering serum cholesterol reduces the risk of cardiovascular disease, is the foundation of current guidelines for the prevention of atherosclerotic cardiovascular disease (Grundy et al., 2019). The Framingham Heart Study is often cited for identifying high blood cholesterol, specifically low-density lipoprotein cholesterol (LDL-C), as a risk factor for coronary heart disease (CHD), the principal cause of heart deaths. Yet in the original 1996 report, Framingham director Dr. William Castelli concluded, “…. unless LDL levels are very high (300 mg/dl (7.8 mmol/l) or higher), they have no value, in isolation, in predicting those individuals at risk of CHD.” (Castelli, 1996) Despite this conclusion, modestly elevated levels of LDL-C are commonly viewed as a causal factor for CHD and the aggressive reduction of LDL-C is routinely recommended for both primary (moderate and high-risk individuals) and secondary prevention (Grundy et al., 2019). However, some recent studies are challenging whether LDL-C should be regarded as a primary risk factor. The Women's Health Study of 28,014 women, for example, found that lipoprotein insulin resistance was the strongest biochemical marker for premature CHD (6.40 adjusted HR) compared to LDL-C (1.38 adjusted HR) (Dugani et al., 2021). The study concluded, “In this cohort study, diabetes and insulin resistance, in addition to hypertension, obesity, and smoking, appeared to be the strongest risk factors for premature onset of CHD.” (Dugani et al., 2021) Similarly, the PREDIMED study of 6901 participants concluded that, “remnant cholesterol, not LDL-C, is associated with incident cardiovascular disease.” (Castañer et al., 2020) LDL-C is also conspicuously absent from the Pooled Cohort Equations currently recommended for estimating atherosclerotic cardiovascular risk in the most recent American Heart Association/American College of Cardiology cholesterol guidelines (Grundy et al., 2019).
I attempt to post the link to the article here: https://www.sciencedirect.com/science/article/pii/S0091743521003601
Highlights
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The number of Americans dying of heart disease has been steadily climbing while the number with high cholesterol has been gradually falling.
•
Current guidelines recommend aggressive reduction of LDL-C to prevent coronary heart disease, but new research suggests that other factors may be far more important in the pathogenesis of coronary heart disease.
•
Despite the widespread utilization of cholesterol-lowering statins in Europe, there has been no accompanying decline in coronary heart disease deaths.
•
The totality of new evidence compels us to question why our current approach to heart disease prevention through targeted reductions of LDL-C is not working.
Later it says this:
The cholesterol hypothesis, which posits that lowering serum cholesterol reduces the risk of cardiovascular disease, is the foundation of current guidelines for the prevention of atherosclerotic cardiovascular disease (Grundy et al., 2019). The Framingham Heart Study is often cited for identifying high blood cholesterol, specifically low-density lipoprotein cholesterol (LDL-C), as a risk factor for coronary heart disease (CHD), the principal cause of heart deaths. Yet in the original 1996 report, Framingham director Dr. William Castelli concluded, “…. unless LDL levels are very high (300 mg/dl (7.8 mmol/l) or higher), they have no value, in isolation, in predicting those individuals at risk of CHD.” (Castelli, 1996) Despite this conclusion, modestly elevated levels of LDL-C are commonly viewed as a causal factor for CHD and the aggressive reduction of LDL-C is routinely recommended for both primary (moderate and high-risk individuals) and secondary prevention (Grundy et al., 2019). However, some recent studies are challenging whether LDL-C should be regarded as a primary risk factor. The Women's Health Study of 28,014 women, for example, found that lipoprotein insulin resistance was the strongest biochemical marker for premature CHD (6.40 adjusted HR) compared to LDL-C (1.38 adjusted HR) (Dugani et al., 2021). The study concluded, “In this cohort study, diabetes and insulin resistance, in addition to hypertension, obesity, and smoking, appeared to be the strongest risk factors for premature onset of CHD.” (Dugani et al., 2021) Similarly, the PREDIMED study of 6901 participants concluded that, “remnant cholesterol, not LDL-C, is associated with incident cardiovascular disease.” (Castañer et al., 2020) LDL-C is also conspicuously absent from the Pooled Cohort Equations currently recommended for estimating atherosclerotic cardiovascular risk in the most recent American Heart Association/American College of Cardiology cholesterol guidelines (Grundy et al., 2019).
I attempt to post the link to the article here: https://www.sciencedirect.com/science/article/pii/S0091743521003601
D
Deleted member 21371
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Or then again, for those of us that don't simply want to shoot for the moon with cholesterol figures.
Get the numbers right, the ratio takes care of itself.
Posted by @Eddy Edson the official NHS guidelines.
Up to date and summarised in a helpful chart: https://www.england.nhs.uk/aac/wp-c...2020/04/lipid-management-pathway-guidance.pdf
Get the numbers right, the ratio takes care of itself.
Posted by @Eddy Edson the official NHS guidelines.
Up to date and summarised in a helpful chart: https://www.england.nhs.uk/aac/wp-c...2020/04/lipid-management-pathway-guidance.pdf
That happens to be the same as mine. However since both HDL and LDL are so easy to manipulate by adjusting the amount of carbs and fat eaten - which causes a trade-off against Type 2 diabetes in my case- (or by using the Dave Feldman protocol), plus all the drugs which raised HDL in an attempt to prevent heart attacks failed (didn't prevent heart attacks), I pay much more attention to the triglycerides.
Pandora71
Member
- Relationship to Diabetes
- Type 1
What you do depends on your view of whether higher LDL is bad for your heart. The QI risk calculator asks about HDL not LDL for example and plenty of cardiologists believe that having a low trig/high hdl ratio (these will be on your lipid profile for comparison to earlier readings) along with good blood glucose control is more important than LDL as a risk predictor. However since the trig/hld ratio is altered by good luck and a lower carb diet, doctors reach for a pill rather than give lifestyle advice and are incentivised to do so.
Anyway if your blood sugar is better because you've enjoyed meat, cheese and cream rather than carbs, I'd say carry on because having a high blood glucose and high insulin levels (t2) is what does the damage to your arteries.
There is NO EVIDENCE that reducing saturated fat will either reduce your ldl levels or improve your risk of heart disease so I'd advise sticking to a diet you can live with rather than trying to go low fat!
D
Deleted member 21371
Guest
I guess we all believe what we want to.
Is cholesterol a massive worldwide conspiracy theory with no evidence, and the NHS and the rest of the world health authorities are simply playing us all for reasons unknown?
Do they fix your heart attack, then recommend drugs and diets specifically to get you back in with another one?
If your total cholesterol is 20, and your HDL is 5.5, is that an excellent result, as your ratio is good?
Is Twitter a reliable source of information, and the place to expose worldwide conspiracies?
In the end all make our own choices, and see where we end up.
My personal choice is to believe the NHS, eat a healthy diet, keep all my blood results in range, BG, Hba1c, trigs, LDL, HDL, liver, kidneys, thyroid, and a host of other things, and only reading Twitter before Trump was banned. (It was better than Private Eye for entertainment)
Is cholesterol a massive worldwide conspiracy theory with no evidence, and the NHS and the rest of the world health authorities are simply playing us all for reasons unknown?
Do they fix your heart attack, then recommend drugs and diets specifically to get you back in with another one?
If your total cholesterol is 20, and your HDL is 5.5, is that an excellent result, as your ratio is good?
Is Twitter a reliable source of information, and the place to expose worldwide conspiracies?
In the end all make our own choices, and see where we end up.
My personal choice is to believe the NHS, eat a healthy diet, keep all my blood results in range, BG, Hba1c, trigs, LDL, HDL, liver, kidneys, thyroid, and a host of other things, and only reading Twitter before Trump was banned. (It was better than Private Eye for entertainment)
I have had the same problem. I was pre-diabetic but managed to get my levels two years running to normal levels. HBA1c not checked less frequently. However, my cholesterol had gone up to 5.8 total unstarved. GP asked me to try to reduce it and would check again in a year which has not been done yet due to all the problems with the Covid virus and the fact that our surgery was a vaccination hub and is now one again. GP did explain that the cholesterol levels have now been brought down so that you have to reach a lower level before you are classed as "normal". She did say to try to reduce it but not to worry myself sick about it. Not put on statins.
The article mentioned above is very interesting and I will have a read at it.
When I mentioned to the surgeon I used to work for about the Covid virus as we were unable to have our normal meet ups he seemed more concerned about whether I was still pre-diabetic than with my cholesterol so it seems he thought the former was a bigger risk factor. If I am honest I would rather have higher cholesterol than diabetes although would, of course, prefer to avoid both.
The article mentioned above is very interesting and I will have a read at it.
When I mentioned to the surgeon I used to work for about the Covid virus as we were unable to have our normal meet ups he seemed more concerned about whether I was still pre-diabetic than with my cholesterol so it seems he thought the former was a bigger risk factor. If I am honest I would rather have higher cholesterol than diabetes although would, of course, prefer to avoid both.
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