Friday, January 22, 2010

Seeking the Perfect Lipid Profile -- The Situation Now

Friends have asked about the ups and downs of my attempts over the years to control cholesterol and thereby lessen the risk of heart attack and stroke from the build up of plaque in my circulatory system. I got a good report earlier this month on my "lipid profile" and thought this might be a time to put it in context. The next eighteen months will be a crucial time during which I'll be looking for indications that my plaque build-up is stabilized or perhaps (happy thought) reveresed slightly.

On January 8, I took at standard lipid panel (not a VAP or Berkeley Heart Labs panel). Total Cholesterol: 140 mg/dL. This is the second lowest score in the past five years, which is when I started following my lipids closely. In fact it has been nearly five years since I scored 132 in July of 05.

My LDL-Cholesterol is 77, is cut in half from my last test in March of this year. This is good news. LDL-Cholesterol is a better predictor of heart incident than Overall (or Total) cholesterol. My goal is to lower this to below 70. Important here is the fact that my recent HBCT heart scan showed considerable placque build-up in the heart and that without changes (lifestyle, medication) I have (or had at the time of the test) about a 1 in 5 risk of a heart attack soon. Also important here is that I have the dreaded "Small-LDL Trait" which is also closely correlated with heart attack and stroke.

I will be talking about this later, but this means that I have smaller, denser, grittier LDLs (Low Density Lipoproteins) than normal. These are well-adapted to create plaque build-up. They fit into crevices in your ateries and ratchet up the plaque like gangbusters. It is possible, however, to make them less dense and even bouyant through medication. Doing so means moving from "Type B" to "Type A" in this aspect of our lipid inventory. I've made it in the past almost to the "A" range of the spectrum. Typically, though, I've been mired in the gritty end ("B"). My last lipid panel was a standard one which doesn't test this. VAP or Berkeley Heart Labs panels do test this, so I will looking closely for results in this area when I take a VAP test in March. In fact, the size/bouyancy dimension extends over the range of lipids, including High-Density-Lipoproteins (HDL-the "good" cholesterol). Increasing the bouyancy of all lipids protects against heart incident.

My "good" cholesterol - HDL - is 45 on my last test. This is good for me, but because of a familial pre-disposition, not what it could/should be given my level of exercise. That is, all things considered, it should be about 70. My brother shares my anomalous tendency for 1) slightly elevated overall chosterol, 2) elevated triglycerides (typically >150 mg/dL standard), and 3) diminished HDL, often <>60"]

The final difference is taking Rx Omega3 consistently and in large quantities - 3 to 4 grams a day.

More about VAP tests and key indicators (CRP test, calcium heart-scan, thalium stress test, and others) in subsequent posts.

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