I just found out my Total Cholesterol is 296, LDL 206, HDL 49 and TRI's 138.(numbers may be off a little, I can't remember exactly).I am a 28 year old female, 5"8" and 125 lbs.. I do smoke and I do not exercise. I have always eaten whatever I wanted including large amounts of cheese,snacking almost daily on cakes, candy. We go out to eat 3 or more times a week.My father also has high cholesterol and is 50 years old. My granfather also has high cholesterol and had a heart attack at 57. He is now almost 80 and in the best shape of his life and travels with my grandmom(also high cholesterol ) all over the world.I have 2 small boys and am soo scared I am going to die before I even hit 40 that it keeps me up crying with worry and fear. My Dr. has advised me to take Red Yeast Rice, exercise and diet,which I am working really hard at.Should I see a cardiologist? Has any one my age with these numbers done so? My Dr. doesn't seem overly concerned. She just says we will get it under control.Do you think the things she has suggested (diet,exercise and stopping smoking)will bring my numbers to normal?Or am I just a heart attack or stroke waiting to happen in the near future.I also have aniexty disorder.My Dr. does not think this can raise levels although when I made her repeat it because I didn't believe the first one(which was non fasting), the second one was higher and I had not eaten in 24 hours and was up all night crying . I am so scared my babies are not going to have a mommy too much longer. Please advise

You are at high risk of a cardiac episode with the numbers you've stated. I will say though that it is good that you know it now. I was 37 when I first had my lipid levels done. At the time mine were all in a normal range but at 41 I had to have a stent and then heart bypass so things can change rapidly. You need to do some big lifestyle changes to turn things around. Stopping smoking is the big one. You need to learn how to read food labels and how to make healthier choices in the foods you choose. You can still eat out but you have to make healthier choices. Exercise is so important in helping raise your HDL. The cakes and candies not only have a lot of fats but also sugars which raise your triglycerides. They are within a normal range right now, but they are certain to raise if you continue with the diet that you describe. For your LDL you need to watch out for saturated fats and transfats which may be in the cookies or cakes that you are eating. What is your doctor suggesting to get it under control?



[This message has been edited by cutup (edited 10-21-2003).]

Originally posted by jorndyl'smom:
I also have aniexty disorder.My Dr. does not think this can raise levels although when I made her repeat it because I didn't believe the first one(which was non fasting), the second one was higher and I had not eaten in 24 hours and was up all night crying . I am so scared my babies are not going to have a mommy too much longer. Please advise
Most people, especially doctors, do not understand the physiological correlation between stress/anxiety and heart disease. It is very real and likely more responsible than cholesterol numbers. Anxiety does not cause high numbers nor does lowering anxiety reduce numbers. However, constant anxiety causes almost constant release of the hormone Cortisol in the system. This constant release is not natural and eventually can damage the lining of the arteries making for an ideal environment for cholesterol/plaque deposits. The arteries are supposed to be smooth and slick and constant barrage of Cortisol and adrenaline from the anxiety causes them to become damaged and rough.

The number of studies directly linking coronary artery disease with stress/anxiety is plentiful. It is not well understood by most doctors. If Merck made a magic pill for it, like Zocor/Pravachol/Lipitor for cholesterol, every doctor would be talking about it and prescribing medication for it.

For those that are frozen with anxiety or fear, I think it is a good idea to consider having one of several tests to ease your mind. In order of effectiveness:

1. Standard treadmill stress test
2. Thallium stress test
3. EBT Heart Scan to determine plaque deposits
4. CT Spiral Coronary Angiography (non-invasive CT scan of the heart and coronary arteries)

You have to determine how much your constant anxiety is worth in dollars. If any of the above tests may put your mind at ease and lessen your anxiety over this, you should seriously consider one of them.



[This message has been edited by pcovers (edited 10-22-2003).]

I am almost exactly like you. I am 27 with chol levels of 350. My LDL is 228, HDL 44 and Tri 130. I also suffer from anxiety and am off and on Zoloft.
My Grandfather died at 28 of a heartattack but they don't think it was cholestorol. However, everyone in my family has this problem. 10 mg of Lipitor worked great for me. It brought my LDL down to 126. However, I have 1 son and want 2 more children. I consulted a heart specialist and he said time is on my side and if I can hurry and have these kids very soon, hopefully I can have minimal buildup. I have the same thoughts and often cry. I do not want to leave my son motherless however, I do want at least 1 more child. I am gambling and taking a chance. I have had other doctors tell me that I should consider myself lucky I had 1 child. If you are done having kids, I would recommend going on Lipitor or something. I definately am after my children are born. However, I am not now because of possible birth defects it can cause. I really want my doctors to run one of these tests mentioned above. I would rest alot easier if I new I was not blocked, even 10%. I think I am going to look into the prices of these tests. I had a treadmill test and an nuclear test done when I was 19, I think. It showed I was fine. I want a really GOOD picture now though. That CT scan sounds like it might do the trick. Does anyone know the out of pocket expense for these tests? Is a treadmill stress test really that good in predicting blockages?
Jennifer

Originally posted by 0603david:
I think I am going to look into the prices of these tests. I had a treadmill test and an nuclear test done when I was 19, I think. It showed I was fine. I want a really GOOD picture now though. That CT scan sounds like it might do the trick. Does anyone know the out of pocket expense for these tests? Is a treadmill stress test really that good in predicting blockages?
Jennifer

You can expect that a standard treadmill probably would be fully covered and a nuclear stress test might be covered. The other two will almost assuredly be 100% out of your own pocket.

Neither is cheap. The EBT scan is $500+/- (this is for detection of plaque) and the CT Coronary Angiogram can be as much as $1000 and is a little harder to locate a provider, but the closest thing you can get to knowing without undergoing an invasive procedure.

Is the information provided by these enough offset your constant anxiety over the issue? Is the knowledge worth the cost? These are decisions you have to make.

Treadmill stress is very good at identifying an existing high percentage blockage. It is not going to tell you if you have existing moderate blockage.

I have not yet had a stress test or nuclear scan that has indicated heart blockage. I have had a stent placed in the LAD and then needed emergency heart bypass. Both resulted from discovering blockage during an angiogram. They do not do an angiogram routinely because of the risk factors associated with it. What I'm trying to say is you can spend a lot of money on these tests and they still may not indicate that there is a problem when there actually is one. As far as these tests relieving anxiety that did not happen for me because I was certain that they were wrong. I would say that going through the tests only created more anxiety because I continued to have symptoms.

Diet helps balance out cholesterol more than people realize. It also helps tremendously with anxiety and other emotional/mental type disorders.

Successful cholesterol lowering diets include cutting out sugary, refined foods and fat. All animal products contain cholesterol (whether full fat or fat-free), especially dairy products. Increase fresh fruits and vegetables, and lots of salads with a natural, low fat dressing. You can eat huge amounts of plant food and fill up on it, for sure. Even fruits and vegetables contain adequate fat for human body needs. Watch refined grains. Reduce or eliminate overt fats such as oils. Eat covert fats such as avocado, olives, nuts sparingly. These are diets that have worked for lots of people following Pritikin, Dr. McDougall, Dr. Graham and Dr. Ornish diets...not only did they lower their cholesterol levels, they lost weight and a myriad of other health problems. For the most part these people kept their carb/pro/fat ratios at 80/10/10. fitday dot com has a complimentary calculator to help you monitor your daily ratios.

Particularly for depression and anxiety, look into stimulants in your diet like caffeine, chocolate and grains. The more naturally you eat, the less stimulants in your body, which is likely to be a trigger for existing depression and anxiety. It helps to keep a food diary, with what you ate and how you feel throughout the day. If you do it for a month and look back on it, you could likely track trigger foods.

Originally posted by cutup:
I have not yet had a stress test or nuclear scan that has indicated heart blockage. I have had a stent placed in the LAD and then needed emergency heart bypass. Both resulted from discovering blockage during an angiogram. They do not do an angiogram routinely because of the risk factors associated with it. What I'm trying to say is you can spend a lot of money on these tests and they still may not indicate that there is a problem when there actually is one. As far as these tests relieving anxiety that did not happen for me because I was certain that they were wrong. I would say that going through the tests only created more anxiety because I continued to have symptoms.

cutup, as you have experienced, tress tests of either type are highly irregular in their ability to detect blockages. A standard treadmill test did indicate my 95% blockages, this after my heart atack and just before placement of three stents in the LAD and RCA.

If you or I would have had either the EBT scan or the CT Coronary Angiography, it is quite likley that the problem would have been discovered. The new 16 slice CT spiral scanner has a sensitivity nearing 90% which is almost as good as an invasive cath angiogram.

I do beleive that an EBT scan, or CT Coronary Angiography if it can be afforded, are quite valid tools available to those seeking knowledge of thier conditions.

pcovers it's good to know in my case that these tests are available now. Twice I came close to losing my life because the other tests never showed anything. I walked to the cath lab for my last angiogram. I had 98% blockage at the top of the LAD which required emergency heart bypass. I get angry to think that because those tests didn't show a problem I could have died on my way to the cath lab. How long have these other tests been available because my bypass was just a little over a year ago? I thought my hospital which is Jewish Hospital in Louis***** Kentucky would have had the latest equipment.

Originally posted by cutup:
How long have these other tests been available because my bypass was just a little over a year ago? I thought my hospital which is Jewish Hospital in Louis***** Kentucky would have had the latest equipment.

The use of the new 16 slice CT scanner for coronary angiography is very recent. And because of how our insurance system works as well as how most doctors are really not at all up on the latest, we have to take things into our own hands.

I just completed a CT Coronary Angiography as a one and a half year follow up to my MI and stent placements. My cardiologist was not a big proponent of it. I am sure that the reason is that it is not "conventional" and it also is a threat. When the day comes that CT angiographies are well established and common, the $4000+ per invasive cath procedure will mean a big, big hit on the pockets of cardiologists.

Bottom line for me is that I am my own best advocate and most reliable resource. I have far more interest in keeping up to the minute on the latest research, procedures, and tests than my cardiologist does. He is a great guy, but he is busy making plenty of money on the older, well-established procedures and practices.

I found a great radiologist that worked with me on the CT Angiography and I am pleased with the results.

pcovers,

Thanks for that excellent discussion on alternatives to surgical angiography.

It will help with my visit to the cardiologist in the VERY near future.
Unfortunately your indication that the surgeons are resisting the non-invasive in favor of the $$profitable$$ fills me with anxiety. The thought that they would increase my risk to fatten their wallets is scary beyond the pale!

Stress test: I was told my chest pain was "probably non-coronary" in spite of my compaining no less than 5 times during the 12 minute test (starting from minute ONE) of an extreme BURN in the middle of my chest.

The son of a beetch actually had the nerve to write in the report: "no ischemia reported by patient during the test."

I guess you know my opinion of the stress test!

Originally posted by zip2play:
It will help with my visit to the cardiologist in the VERY near future.
Unfortunately your indication that the surgeons are resisting the non-invasive in favor of the $$profitable$$ fills me with anxiety. The thought that they would increase my risk to fatten their wallets is scary beyond the pale!
Unfortunately, if your cardiologist writes "angina" on the report, the insurance company will pony up for the $4000+ cost of an invasive angiogram. They will not pay the $700-$1000 cost of a non invasive CT Coronary Angiography. Such are the sytems we live under.

The following may be of interest. It was written in 2002 and things change fairly rapidly. CT angiographies are by no means foolproof or perfect. For me, it is one more tool for providing yet another piece of valuable info.
http://www.medreviews.com/pdfs/articles/RICM_32_77.pdf