Cholesterol!

We have a test on Friday that covers heart stuff. Basically, if you come into a clinic, I'm supposed to be able to tell if have high blood pressure or high cholesterol and what to do about it. There are a lot of numbers and a lot of drug classes to remember!

My biggest surprise in the whole thing was that asking "What should my cholesterol level be?" is not a good question. There are too many other variables; 130 might be the goal for one person, another might be fine at 230. A better question might be "What should my LDL (bad) and HDL cholesterol be?" HDL is pretty straight forward, it just depends on your gender. LDL, on the other hand, depends on another host of factors.

For example, my cholesterol level (last time I checked) is 215. When I heard this number, I freaked out a little because I had always heard it should be under 200. So how do you know?

They've actually done some pretty good long-term studies on what your risk of having a heart attack is. Take me for example. I don't have any coronary heart disease (history of a heart attack, chest pain, etc.) or equivalents (diabetes, stroke). I am under age 45, none of my immediate relatives have had a heart problem under the age of 55, I don't smoke, my blood pressure is good (<140/90), and my HDL is above 40. Just based on this, I am at very low risk for a heart attack. I could take it even further and plug in the numbers and determine my risk for a heart attack in the next 10 years is less than 1%. Since I am at low risk, my LDL goal is <160. My LDL is under 160. Not by a lot, but by enough.

At any rate, this is the kind of analysis I will have to do on Friday. I don't think my patients will be as easy, but then again, clinicians tend to see more sick people than healthy ones.