I have angina sometimes. I have total cholestrol of 180 with 40 HDL & 120 LDL. Based on my angina, I believe that I have some clogged arteries. Two months back Dr. did Echocardiography. He could not see any evidence of clogging. My ejection fraction is also good. Doc, simply said to forget about angina. But, I know that he is not understanding the issue. I tried to reduce cholesterol by dieting & excercise. But it is not working. But, I have maintained this level of cholestrol from last 5 to 6 yrs. So, What to do now?
phd,
If you can reproduce angina symproms with 5 minutes of extreme exertion and the symptoms pass with 5 minutes of rest and you can demonstrate this behavior with some regularity then you MUST take matters into your own hands and see another cardiolgist.
My first guy poo-poohed the whole thing and I waited 5 years with increasing discomfort on exertion. My new cardiologist said I had textbook angina had it happened to him, he'd have had an angiogram 8 years ago. We skipped the stress testing altogether.
If your angina on rest is a monthly event, well then maybe some "watchful waiting" is in order, but if it's with every workout, get your stent :everyone who's ANYONE is getting one this season!
(but think long and hard about chest surgery!!!!!)
Hi phd (Ph.D.?):
An echo is not going to detect any "clogged" arteries. It's used to identify any structural abnormalities in the heart (valve problems, wall thickness, etc.). The definitive test is an angiogram, but your doctor should at least consider having you do a stress-test. I would discuss further with your doctor, and if he/she insists on ignoring the symptoms, find another doctor who will listen.
I am having this kind of angina from last 10 yrs. In 10 yrs my BMI is reduced from 26 to 23. My total cholestrol has not changed much from last 6 yrs. The range is 168 to 180. Before that time, I have not measured my total colestrol. But I am going to assume that it was not much different from 170-180. My angina is not TOO severe. It is mild. I know that if I say that I am having this angina from last 10 yrs, most people dismiss this as GERD or something like that. But I know GERD and had GERD and know its treatment. It was treated with anitbiotics + antacids because of h. pylori. Yes, I had stress test. I passed without any issues. I can run at 4 mph for 1 hour without any angina. It is only after repeatedly stressing the heart several times frequently I may get angina. I know it is angina because the pain is directly at the center of the heart and occurs only at extereme stressing of heart. My only question is: How to reduce my cholesrol to less than 150 with out taking statins. I can not take niacin since I am a type 2 diabetic without medication and controlling with diet & excerice and niacin aggravates type 2.
I'd say your TC is about as low as you are going to get it without drugs. But if you wish to try the EXTREME, you can give a shot at a month of an almost no-fat(<10%, <2% saturated, 0 hydrogenated oils) nearly all vegetarian diet with no meat and only occasional fish. Something along the lines of the strictest of the Pritikin regimens (the health diet version.)
Your carbs will be almost sugar and quick starch free.
With a diet like this (and with your weight surely dropping) you will determine what is your practical minimum "natural" cholesterol. I'm sure the lowest levels will occur at a BMI more like 20 or even 15.
Personally, I'd much rather pop a pill than torture myslef like that, but it will answer your question (and maybe get you published!)
Make sure you consider your entire lipid panel. Getting just a total cholesterol is of limited use.
p.s. If you can run for an hour even at a slow 4 mph, I'd say that any angina you might have is slight and will keep on the back burner without the need for treatment. If it worsens it will quickly let you know.
My only question is: How to reduce my cholesrol to less than 150 with out taking statins. I can not take niacin since I am a type 2 diabetic without medication and controlling with diet & excerice and niacin aggravates type 2.
any suggestions?
PhD, we talked briefly along these lines about 1.5 years ago--at that time, I didn't know that you were a type 2 also. Zip is right on target (in my opinion) with what he suggested. The way I was able to take my cholesterol down to < 150 mg/dL (well 96-102 mg/dL) was to try to eat almost no fat whatsoever in my diet. During that time, I might have taken in, at most, 25 g fat total per day, of which < 5 g was saturated. The other factor was that my exercise at the time consisted only of walking. This kept my HDL rather low (37 mg/dL) as well as the LDL (51 mg/dL), and thanks to the low body fat, my TG were around 40 mg/dL.
After moving up to running for exercise, my HDL soared upwards, and my LDL came up some also, so that ended the sub 100 mg/dL cholesterol days. Now mine is closer to 150 mg/dL total, but with HDL > 60 mg/dL.
As for niacin, I took this while a type 2, even though I was a diet and exercise contolled T2. The average increase to blood glucose (that I saw in one study) was only 9 mg/dL. Have you tried niacin yet to see if you would experience only a slight gain--granted some will have a much more significant increase.
My fasting glucose went from from 77 mg/dL to 91 mg/dL while on 1500 mg Niaspan. It did help increase my HDL to 44 mg/dL, yet, the impact of running (exercise) to my HDL was far greater than a combination of Niacin and walking.