Ask Leyla: What does my elevated LDL say about my heart risk?

Q: I am a 71-year-young man in excellent condition. At my last physical, my HDL was 63, triglycerides 55, and LDL was 173.

I’ve been told this is on the high side for LDL. How do I reduce my LDL cholesterol and protect myself from heart disease?

A: Congratulations on such a terrific lipid profile! Why do I think it’s terrific? When I see triglycerides as low as yours, you’ve basically eliminated a major risk factor for cardiovascular disease. Indeed, high triglycerides may be a greater risk factor than LDL cholesterol. Couple that with a very healthy HDL of 63, and you’ve decreased your risk even more. But here are some tests you should have first to determine risk factors:

1. Get a VAPS or NMR test. These tests reveal the types of LDL particles such as small, dense, atherogenic pattern B, or large, fluffy pattern A particles which are desirable. This is more indicative of actual risk burden than the overall number of 173.
2. Check for high homocysteine levels. Homocysteine is an independent risk factor for cardiovascular disease, stroke, dementia, and bone fracture.
3. High sensitivity C-Reactive Protein (hs-CRP) is an important test because it’s a marker of inflammation specific to coronary arteries.
4. Lipoprotein (a) is another more critical risk factor along with the above tests. You can read more about it here.

Finally, consider getting an EBT heart scan to see if that high LDL is actually doing any damage to your coronary arteries. This is a discussion to have with your doctor. 

To your health! 

Leyla Muedin, MS, RD, CDN