HDL and LDL levels

[osiag]

How do you view a reduction in both LDL and HDL?  I have heard that the risk of CAD goes down proportionately with the decrease in LDL.  That is, for ever 1% decrease in LDL, the risk of CAD goes down by 1%.  I have also heard that for each 1mg (mg rather than %) increase in HDL, the risk of CAD goes down by 2%.  Is this correct?  Does this formular hold true when the patients LDL and HDL are low to begin with.  My LDL went from 80 to 39 and HDL from 50 to 34.  So, I have a 51% reduction from LDL lowering.  My HDL decrease of 16mg would increase my risk by 32%?  Overall is the reduction 19% (51 -32)?  

Related to this, I have heard that HDL was beneficial qualities besides reverse cholesterol transportation (anti-oxidant, anti-flamatory and anti-thrombotic).  Does that mean that it does more than just counteract LDL?  Or are these other qualities also a counteraction of LDL?

[toby45]

Wow! Thank you for your candor and answering the question and the issues head on!

Why the devil can't we find more Cardio's like you Dr. Kirksey! I mean it...I really mean it!

Best explanation, and gives me a little more faith that there are a few of you out there who acknowledge your limitations - you are a refreshing dose of reality in an industry of blow hards who speak with feigned confidence and malleable certainty.

And thanks for all that you do! Best wishes in 2010!

Sincerely,
Toby

[Lee Kirksey, MD]

Hello
Thanks for your detailed question. One thing that should be emphasized is that medical research is not an exact art. For example-for many years we have struggled to find the best way to characterize blockages in coronary blood vessels. For the time being, the standard is cardiac catheterization. We assess the degree of blockage with the use of contrast and if the blockage is severe-it is treated with balloon, stenting or bypass. However, this does not explain why half of people who experience a heart attack have had no previous symptoms and why some have even had recent stress tests or cardiac cath which did not show critical disease. We now know that inflammation plays a substantial role in plaque rupture. Sometimes causing minor plaques to rupture and become critical in one short event.  This is a long way of saying that I encourage people to understand that there is a lot we do not know or understand and beware of the desire to interpret as the "gospel truth" all of the unsubstantiated scientifc exertions. Especially as it becomes increasingly clear that the pharmaceutical industry has manipulated large amounts of science with the use of "ghost" writers in industry supported data.

Having said that, the reversal trials show that if the ldl consistently stays at 70 or below there is reveral of plaque after 18 months.  
for every one point the hdl falls below 50 (or at least 40) you begin to increase your risk for heart disease so even though the LDL decreases, you increase the risk.  Interval training, hormone replacement can help with hdl as well as crestor and niaspan sometimes help more the hdl.

I would encourage you to read more about the berkeley heart panel at www.optimalhealthtoday.com under cardiac risk profile testing. It is clear that medicine's use of the traditional cholesterol panel is far short of the existing capabilities for fractionating cholesterol components

For more information about the latest innovations in a comprehensive approach to cardiovascular risk modification consider my book www.personalwellnesswheel.com.
It provides insight into many factors which are as important, or more, than a static number on a lab sheet. Good luck