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What does the following lipid profile test report indicate?

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Dr. Sandip Kabra

General & Family Physician

Practicing since :2009

Answered : 3078 Questions

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Posted on Mon, 2 Nov 2015 in General Health
Question: Recently, my dad who is 64 now, underwent a lipid profile test. Since I take care of his medications, what I need to ask is based on following data;
His lipid profile results are;
#. Parameter - value ( range).
1. LDL CHOLESTEROL: 119mg/Dl (100-129).
2.HDL CHOLESTEROL: 51(35-55).
3.HDL RATIO: 4.02
4.TRIGLYCERIDES: 64mg(<200mg).
5.VLDL: 35mg(20-50mg)
6.TOTAL CHOLESTEROL: 205mg (<200mg)

He is a diabetic patient with value around 200 after food consistent since few months(more than 6 months) now. He has high blood pressure for which he takes regular medications.
We don't have any family history of heart disease but but of pressure. My grand dad had pressure and died of cardiac arrest but had no heart disease.
Now my questions are:
1. Should he be prescribed any statin medications based on above details?
Answer this part 1st based on ur diagnosis.

2.Also a doctor recently suggested him to take a statin called atorvastatin 10 mg.
Is he required to take this medication? What do u think?

3. What is the risk factor for my dad? Is he OK or medication required? Is there a low or high risk?

4. Supposing he has low risk, Is taking a medication when there is low risk or no risk (which I can't tell), does it causes some bad effect or does it causes permanent dependency on the medication, which then can never be stopped and required to be taken life long.

Please provide a detailed analysis and answer the above points in point wise manner.
Thanks in advance.
doctor
Answered by Dr. Sandip Kabra 47 minutes later
Brief Answer:
Will answer one by one.

Detailed Answer:
Hello,
Welcome to HCM.

I have read your full query and will be answered by me one by one as you insisted.

1) His lipid profile is almost within normal limits. Although cholesterol 205 mg is marginally elevated, but has no clinical significance.So,no need to be worried about it.

2) Considering his lipid profile he may be not required statins but as you said he is also having high blood pressure (on anti-hypertensive medications),I would surely start with atorvastatin 10 mg as a treating physician because of the underlying cause of hypertension.

3) It will be difficult to say about risk factor for heart disease at right now, but yes, with regular anti-hypertensive medications (as prescribed by his doctor) with salt restricted diet and some life style modifications, if he can maintain blood pressure around 110 to 130 systolic and 60 to 80 diastolic then I can say he is at low risk of developing heart disease.

Also, he has to maintain his blood sugar between 100 to 150 mg% with medications, strict dietary control and regular exercises.

4) Lastly, if he can manage his blood pressure between desirable range with medicines and non-medical measures as i said, then I have seen some patients who can stop taking anti-hypertensive medicines further once their blood pressure is well controlled even without medications but it will be difficult to say at present.

However, in case of diabetes, he would require almost lifelong medications to control blood sugar. I have seen very few diabetic patients who can maintain their sugar even without medications.

Means, it can be possible in case of high blood pressure but would be very difficult to quit medicines in case of diabetes.

Hope this detailed analysis would be helpful.

Regards,

Dr.Sandip

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Follow up: Dr. Sandip Kabra 10 hours later
Thanks for the details.
The point number 4 above, the dependency on the medicine, I meant to ask that whether once starting the statin, will he has to continue taking statin life long?? Though its true his blood sugar and pressure related meds will be continued lifelong but what about the statin?
doctor
Answered by Dr. Sandip Kabra 7 minutes later
Brief Answer:
No dependancy of statins.

Detailed Answer:
Hello XXXXXXX
Welcome back.

There is no dependency on statins once they started as they can be stopped once blood pressure comes down within the normal range but without medications.

However,if blood pressure is not under fair control then statins should be continued along with antihypertesnive medications.

One more thing,statins are good hyolipidemic drugs which reduces our blood cholesterol and also reduces the risk of developing any cardiovascular disease in future and have fewer side effects.

Means there is no issue to take statins life long if your treating physician suggests.

Hope this will clear to you now.

Regards,


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sandip Kabra 35 minutes later
Thanks for your details. This answers my queries sufficiently. One last discussion though,
Would you like to suggest a food chart for him. What to eat and what to avoid as per the above conditions.
Foods which would keep pressure and cholesterol under control. Duration between the meals and any other precautions related to healthy living.
He is particularly regular in having good amount of exercises as per his capability as i know of, with rigorous walking an all. Any other suggestions?

Also Please keep in note that, he also have an eye pressure. SO is there any particular exercise for that. I mean he has under gone series of treatments for that. Still as doctors say that it does not have a permanent remedy.
doctor
Answered by Dr. Sandip Kabra 3 hours later
Brief Answer:
Diet and exercises as explianed.

Detailed Answer:
Hello,
Welcome again,

In diabetes and hypertension,he must be knowing about low sugar and salt restricted diet respectively with regular exercises for at least 45 minutes to one hour daily.

1) In general to reduce your Chol/HDL ratio or to decrease serum cholesterol with increase HDL follow these dietary guidelines:

- Avoid direct sugars
- Avoid fried snacks, bakery items
- Have ample of vegetable salads- at least 1 bowlful cut raw vegetables like cucumber, tomato, carrot and vegetables which you can eat raw.
- Snacks should contain healthy nuts like almonds or walnuts and a few dry fruits but no fruit juices
- Avoid soft drinks or hard drinks and smoking cessation.
- Simple Chapati and steamed rice or rotis made up of different whole grains should be your staple diet.
- Skimmed milk and milk items made up of skimmed milk are good to check on cholesterol
- Egg white is fine but avoid egg yellow means yolk.
-vitamin B3 (niacin) increases HDL cholesterol and reduces total cholesterol.

2) Exercises are equally important to reduce total cholesterol and blood sugar by increasing tissue utilization of glucose.

Initial 20 minutes of walk goes in burning your sugar and then the fat start burning which should happen for another 20 to 25 minutes through a stable, moderate speed of 5 to 6 km/hour and then you will certainly see improvement in the cholesterol and blood sugar.

3) Your father's eye pressure means raised intra-ocular pressure what I have understood from that.

Elevated intra-ocular pressure is a concern in people with ocular hypertension because it is one of the main risk factors for glaucoma.

High pressure inside the eye is because of an imbalance in the production and drainage of fluid in the eye.

There is no particular exercises from which we can reduce the eye pressure rather you should follow ophthalmologist's advice strictly to avoid any complications related to it.

Hope this detailed information will be helpful.If any more query I will be happy to answer that.

Regards,

Dr.Sandip



Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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