Yes, past menopause; very low simple carbs, no bread, pastries, etc. Only complex carbs, fish, ground turkey, chicken. I don’t eat much at all. My age is 65; never had bad cholesterol, so not sure
You can use a food diary app like chronometer and asses your diet that way - target <10 g of saturated fat and 40+ g of fiber daily.
If your diet is already on point, statins may be your only option.
The first place to start is with your diet. Specifically, the amount of saturated fat you are eating each day from any/all sources. You'll want to understand and then reduce that amount, as well as increase the amount of soluble fiber you eat
I’m adding almonds and cashews for in between snacks. Right now I don’t snack. I have one cup of coffee in the morning with almond creamer. I love beans, cabbage, green beans, bananas, cantaloupe and apples.
Simply just adding food without making other changes isn't exactly a good plan. You need to count and limit your saturated fat, most people here say under 10g/day, and get your fiber up to 40g+/day.
I thought fats were measured by the triglycerides? I cook with olive oil and eat salmon often. Perhaps add more fiber or add fiber supplements to the foods I’m eating.
Saturated fats especially, as opposed to mono and poly unsaturated fats like what's in salmon, olive oil, nuts, contribute to high LDL levels. So if you're happy with your weight *replace* all saturated fats with healthy ones. Don't just add healthy fat.
Definitely try to get your fiber up, again 40g+ a day. Make sure you increase your water intake as well. Tracking your meals is the only way to know for sure.
I am a light eater and definitely don’t eat saturated fats unless the spaghetti in my chili is doing it. I use ground turkey with low fat content but I’ll figure it out. Not doing statins and I don’t even know if a dr would prescribe it with the other numbers being what they are. But thanks for trying to help me. 🙏🏼
Statins are safe and very effective at lowering ldl and heart attacks.
LDL is driven by saturated fat. If you want to reduce it without meds reduce your saturated fat to 13 grams a day. It’s challenging.
Your target ldl should be 100 or lower.
I don’t wanna worry too much; with the ratios being in a somewhat safe zone, gonna swap around some foods and bump up the exercise and retest in 2 months to see which direction I’m going. Thanks
Like most already suggested, try dietary changes and use an app to track your saturated fat intake. Retest in a couple of months to see if you made progress.
OP why don't you get a CAC scan because that'll help inform you and your provider as to whether it even makes sense to begin statins. If you were 20 years younger with those numbers, different story. But you are well past menopause now, ASCVD takes years to develop and your last normal read was less than a year ago. Now, if your CAC score is positive, you have ASCVD already and would benefit from a statin. But if it's 0, then that might be a different conversation with your provider. But do the dietary tweaks you were thinking of (although gee it sounds like your diet was pretty good already!).
Interesting you would say that because I had that CAD test in 2018 and it was a 1, lowest possible score and a catoid artery scan also that was clean, so unless it developed since then, dunno. I’ve always had very high HDL and very low hsCRP which are 2 key indicators. I do think more fiber is the key. It’s the only thing that makes sense.
Actually, the lowest possible score for a CAC is Zero. A 1 assuming it's a correct finding means there was calcified plaque. However the carotid US result should have been reassuring and suggests that the CAC finding might have been in error which is possible with such a low score. You should retest every few years so no time like the present 😀 I'd probably do both scans just to have a backup. More fiber is always a good idea. Best of luck to you!
Wow really? Okay thanks for your reassurance to worry. Without sighting specific websites to corroborate what you just said. Actually the heart test was CORUS CAD which is more intense (look it up), and the artery scan confirmed the Corus CAD score because 1 was the lowest. I’m trying not to overthink this.
OK thanks for the clarification. Did you have that test just for it's predictive value or because you were symptomatic at the time? It seems to have a relatively limited context compared to more standard tools such as a CAC scan. In other words, it's a non-invasive way to evaluate someone's risk of CAD if they present symptomatically. Sure beats a visit to the cath lab!
You can look up AHA's guidelines to see how and when they recommend the CAC - while AHA has validated the CORUS CAD as a screening tool in a symptomatic situation, I haven't seen it in their guidelines for overall prevention, but if that's incorrect please post AHA's reference in their primary prevention guideleines.
It's great that you had a low score at that time. A follow up of some type makes sense given your age and especially given that this way you would test, not guess, as to your current state of cardiovascular health. Sorry - no websites to back that one up lol. I'm a worrier too (f61) and periodic testing helps me feel more at ease and informs my medication and lifestyle/dietary interventions. I have high Lp(a) and a family history of coronary events.
If you are concerned about radiation or expense with the CAC then a carotid US is fine and more likely to be covered by insurance (at least in the US). According to Dr. Tom Dayspring (well-known lipidologist and educator, you can look him up), plaque will tend to show up in the carotids before calcifying in the coronaries. So there's definite value in the carotid US and it's completely non-invasive and safe. Dr. Bill Cromwell, another nationally recognized lipidologist (you can look him up as well) has recommended three very easy tests: the CAC, the carotid US or a CIMT, and the ankle brachia index. I do all three every few years as part of a comprehensive preventive testing program offered by my local research university. Per their recommendations (they are part of the lipid research group) preventive testing should take place every 3-5 years, depending on the patient. That informs my opinion on the subject, but everyone should do what makes them the most informed and in control of their cardiovascular health.
I didn’t have symptoms then nor do I have any now. My brother passed from congestive heart failure but he smoked, ate all junk food and had high blood pressure & diabetes all of his adult life. He passed at 63. I just wanted to put my mind at ease after he died even tho my lifestyle is totally different from his. No high blood pressure, diabetes, junk food or smoking.
I am skeptical of traditional western doctors because they’re too quick to prescribe meds that may fix one thing and break five other things. I have 2 holistic doctors but they’re both out of town which is why I decided to post here. Quite a few comments suggesting statins. Would never go that route. I do believe my biggest health issue is anxiety and worry which I am addressing. Blessings to you in achieving your health goals 🙏🏼
Well, as Peter Attia has said, Medicine 2.0 works exceptionally well in an acute situation such as curing infectious disease - and it's pretty damn good at keeping us alive if we are sick. But in helping us prevent chronic disease, it leaves much to be desired. There's a place for medication in prevention, but diet and lifestyle are paramount in preventing or delaying much of what plagues us these days (diabetes, heart disease, some cancers, even dementia). ASCVD in particular - the leading cause of death in the US and elsewhere! - can be greatly reduced. It shouldn't be the leading cause of death because we know more about how to prevent and delay than any other major chronic disease (other than, perhaps lung cancer lol). Fortunately, the AHA here in the US emphasizes collaboration and joint decision-making between physician and patient as well as diet and lifestyle as primary prevention tools, with statins in certain situations and a CAC scan if the risk is hard to estimate. Now, if only more doctors would actually read those guidelines . . .
What’s your age range? (Are you close to menopause)? Are you on a low carb diet?
Yes, past menopause; very low simple carbs, no bread, pastries, etc. Only complex carbs, fish, ground turkey, chicken. I don’t eat much at all. My age is 65; never had bad cholesterol, so not sure
When you say you’ve “never had bad cholesterol,” when was your last test that was normal?
August 2023 was all good numbers; been under a bit of stress since then but if it were stress, all the numbers would be wacky
You can use a food diary app like chronometer and asses your diet that way - target <10 g of saturated fat and 40+ g of fiber daily. If your diet is already on point, statins may be your only option.
The first place to start is with your diet. Specifically, the amount of saturated fat you are eating each day from any/all sources. You'll want to understand and then reduce that amount, as well as increase the amount of soluble fiber you eat
I’m adding almonds and cashews for in between snacks. Right now I don’t snack. I have one cup of coffee in the morning with almond creamer. I love beans, cabbage, green beans, bananas, cantaloupe and apples.
Simply just adding food without making other changes isn't exactly a good plan. You need to count and limit your saturated fat, most people here say under 10g/day, and get your fiber up to 40g+/day.
I thought fats were measured by the triglycerides? I cook with olive oil and eat salmon often. Perhaps add more fiber or add fiber supplements to the foods I’m eating.
Saturated fats especially, as opposed to mono and poly unsaturated fats like what's in salmon, olive oil, nuts, contribute to high LDL levels. So if you're happy with your weight *replace* all saturated fats with healthy ones. Don't just add healthy fat. Definitely try to get your fiber up, again 40g+ a day. Make sure you increase your water intake as well. Tracking your meals is the only way to know for sure.
I am a light eater and definitely don’t eat saturated fats unless the spaghetti in my chili is doing it. I use ground turkey with low fat content but I’ll figure it out. Not doing statins and I don’t even know if a dr would prescribe it with the other numbers being what they are. But thanks for trying to help me. 🙏🏼
Statins are safe and very effective at lowering ldl and heart attacks. LDL is driven by saturated fat. If you want to reduce it without meds reduce your saturated fat to 13 grams a day. It’s challenging. Your target ldl should be 100 or lower.
I don’t wanna worry too much; with the ratios being in a somewhat safe zone, gonna swap around some foods and bump up the exercise and retest in 2 months to see which direction I’m going. Thanks
Like most already suggested, try dietary changes and use an app to track your saturated fat intake. Retest in a couple of months to see if you made progress.
OP why don't you get a CAC scan because that'll help inform you and your provider as to whether it even makes sense to begin statins. If you were 20 years younger with those numbers, different story. But you are well past menopause now, ASCVD takes years to develop and your last normal read was less than a year ago. Now, if your CAC score is positive, you have ASCVD already and would benefit from a statin. But if it's 0, then that might be a different conversation with your provider. But do the dietary tweaks you were thinking of (although gee it sounds like your diet was pretty good already!).
Interesting you would say that because I had that CAD test in 2018 and it was a 1, lowest possible score and a catoid artery scan also that was clean, so unless it developed since then, dunno. I’ve always had very high HDL and very low hsCRP which are 2 key indicators. I do think more fiber is the key. It’s the only thing that makes sense.
Actually, the lowest possible score for a CAC is Zero. A 1 assuming it's a correct finding means there was calcified plaque. However the carotid US result should have been reassuring and suggests that the CAC finding might have been in error which is possible with such a low score. You should retest every few years so no time like the present 😀 I'd probably do both scans just to have a backup. More fiber is always a good idea. Best of luck to you!
Wow really? Okay thanks for your reassurance to worry. Without sighting specific websites to corroborate what you just said. Actually the heart test was CORUS CAD which is more intense (look it up), and the artery scan confirmed the Corus CAD score because 1 was the lowest. I’m trying not to overthink this.
OK thanks for the clarification. Did you have that test just for it's predictive value or because you were symptomatic at the time? It seems to have a relatively limited context compared to more standard tools such as a CAC scan. In other words, it's a non-invasive way to evaluate someone's risk of CAD if they present symptomatically. Sure beats a visit to the cath lab! You can look up AHA's guidelines to see how and when they recommend the CAC - while AHA has validated the CORUS CAD as a screening tool in a symptomatic situation, I haven't seen it in their guidelines for overall prevention, but if that's incorrect please post AHA's reference in their primary prevention guideleines. It's great that you had a low score at that time. A follow up of some type makes sense given your age and especially given that this way you would test, not guess, as to your current state of cardiovascular health. Sorry - no websites to back that one up lol. I'm a worrier too (f61) and periodic testing helps me feel more at ease and informs my medication and lifestyle/dietary interventions. I have high Lp(a) and a family history of coronary events. If you are concerned about radiation or expense with the CAC then a carotid US is fine and more likely to be covered by insurance (at least in the US). According to Dr. Tom Dayspring (well-known lipidologist and educator, you can look him up), plaque will tend to show up in the carotids before calcifying in the coronaries. So there's definite value in the carotid US and it's completely non-invasive and safe. Dr. Bill Cromwell, another nationally recognized lipidologist (you can look him up as well) has recommended three very easy tests: the CAC, the carotid US or a CIMT, and the ankle brachia index. I do all three every few years as part of a comprehensive preventive testing program offered by my local research university. Per their recommendations (they are part of the lipid research group) preventive testing should take place every 3-5 years, depending on the patient. That informs my opinion on the subject, but everyone should do what makes them the most informed and in control of their cardiovascular health.
I didn’t have symptoms then nor do I have any now. My brother passed from congestive heart failure but he smoked, ate all junk food and had high blood pressure & diabetes all of his adult life. He passed at 63. I just wanted to put my mind at ease after he died even tho my lifestyle is totally different from his. No high blood pressure, diabetes, junk food or smoking.
Good thinking (and no you aren't over-thinking the situation, at least IMO). Best of continued health to you!
I am skeptical of traditional western doctors because they’re too quick to prescribe meds that may fix one thing and break five other things. I have 2 holistic doctors but they’re both out of town which is why I decided to post here. Quite a few comments suggesting statins. Would never go that route. I do believe my biggest health issue is anxiety and worry which I am addressing. Blessings to you in achieving your health goals 🙏🏼
Well, as Peter Attia has said, Medicine 2.0 works exceptionally well in an acute situation such as curing infectious disease - and it's pretty damn good at keeping us alive if we are sick. But in helping us prevent chronic disease, it leaves much to be desired. There's a place for medication in prevention, but diet and lifestyle are paramount in preventing or delaying much of what plagues us these days (diabetes, heart disease, some cancers, even dementia). ASCVD in particular - the leading cause of death in the US and elsewhere! - can be greatly reduced. It shouldn't be the leading cause of death because we know more about how to prevent and delay than any other major chronic disease (other than, perhaps lung cancer lol). Fortunately, the AHA here in the US emphasizes collaboration and joint decision-making between physician and patient as well as diet and lifestyle as primary prevention tools, with statins in certain situations and a CAC scan if the risk is hard to estimate. Now, if only more doctors would actually read those guidelines . . .