We have all bought into the idea that we need to lower our cholesterol to stay healthy and prevent heart disease. But is it that simple? What is cholesterol and is current testing telling us enough about our heart health?
Do the math:
Cholesterol, or total cholesterol, is calculated based on its components, HDL, LDL and Triglycerides. Total cholesterol = HDL + LDL + (Triglycerides/5). So the lower each of its components, the lower total cholesterol will be.
But HDL, or “good” cholesterol has been shown to protect against the buildup of plaque in artery walls and the pharmaceutical companies tried and failed to come out with a drug to raise HDL since they acknowledge its protective role. So a lower HDL doesn’t help.
I have patients with very high HDL (0ver 100) and total cholesterol around 230. I consider this very healthy. My HDL is 73 at last check, mostly because I exercise regularly as it was in the 50s when I exercised less.
Your standard cholesterol report will show a ratio of HDL to total cholesterol. The closer it is to 3, the lower your heart disease risk.
A new test, the Boston Heart Diagnostics Cardiac Risk Assessment is light years ahead of traditional cholesterol tests in evaluating heart disease risk. The test can be ordered through the office and is covered by all major insurances. The company also has a program to make the test affordable to all patients, a refreshing change from the norm.
The test looks at the standard cholesterol numbers and a bunch of other measurements that make a lot of sense. Among these is a genetic test to see if you will get muscle pain from statin drugs (Lipitor, etc). Also included are tests to see if your cholesterol balance tilts more toward what your body makes (the majority in most people) or if you are absorbing too much. Knowing this allows the doctor (me!) to customize your treatment. For example, if your cholesterol is high because you’re absorbing too much, lowering the bad fats and raising fiber in your diet can make a big difference. If you’re making too much, we can then look at other risk factors for hardening of the arteries and making plaque along with your general health (diabetes, blood pressure, family history) before deciding if you need a medication (natural or prescribed).
Check out bostonheartdiagnostics.com for more info and let the office know if you’re interested in the test. I am now ordering it as part of the regular bloodwork for my patients instead of the standard cholesterol tests. I consider this test superior even to the VAP that many of you are familiar with.