Login

u/SignaturePatient4844

r/Cholesterol r/HeartHealth r/REI r/Fjallraven
▲ 8 r/Fjallraven+1 crossposts

I am looking for a great coat for Chicago winters. I have been leaning toward the Nuuk. Does anyone agree? Disagree? If you agree, let me know why. If you disagree, let me know why and what you would suggest instead even if it’s not Fjallraven.

Please and thank you!

reddit.com
u/SignaturePatient4844 — 13 days ago
▲ 2 r/HeartHealth+1 crossposts

41M with Lp(a) of 351 nmol/L—does an LDL target below 100 seem aggressive enough?

I’m a 41-year-old male weighing 201 lbs at 5'7". I currently take:

  • Atorvastatin 20 mg
  • Zepbound 7.5 mg
  • Lisinopril/HCTZ 20/12.5 mg

My blood pressure is well controlled at approximately 120/80. My diet is average; not terrible, but not optimal. I generally stay below 15 grams of saturated fat and get at least 20–30 grams of fiber daily.

I sleep about 6.5–7 hours per night. I have an office job and am currently minimally active.

Latest bloodwork:

  • Total cholesterol: 152
  • LDL-C: 101
  • HDL-C: 38
  • Triglycerides: 63
  • ApoB: 91
  • Lp(a): 351 nmol/L

Historical rolling averages:

  • Past year (2 tests): Total cholesterol 164, LDL 110.5, HDL 39.5, triglycerides 69.5
  • Past 3 years (5 tests): Total 183.6, LDL 121.2, HDL 39.6, triglycerides 104
  • Past 5 years (9 tests): Total 217.7, LDL 154.4, HDL 39.1, triglycerides 111.2
  • Past 10 years (17 tests): Total 244.5, LDL 179.1, HDL 39.6, triglycerides 121.1

My cholesterol and triglycerides have improved considerably, especially compared with my longer-term averages. However, my LDL is still 101 and ApoB is 91 despite taking atorvastatin, while my Lp(a) is extremely elevated.

My doctor’s response:

“Your cholesterol is improved on the higher dose of atorvastatin. Your target is for the LDL to be less than 100. Currently, it is 101 and very close to target, so I recommend continuing the same dose for now.

Your lipoprotein(a) level is elevated, which, as we discussed, tells us you have an increased heart-disease risk. This is managed by the atorvastatin.”

Would you agree that an LDL target below 100 is appropriate in this situation? With an Lp(a) of 351 nmol/L and a long history of elevated LDL, should I be aiming closer to an LDL below 70 and a lower ApoB?

I’m trying to determine whether my doctor’s approach is reasonable or whether I should get a second opinion from a preventive cardiologist or lipid specialist. Based off of what I have researched it seems as if my doctor is not up to date on the latest science is or not taking this as seriously as I believe she should.

Thank you!

reddit.com
u/SignaturePatient4844 — 2 months ago