Topic: Heart Attack Prevention

Dr. Lee:
A viewer has normal total cholesterol level of 200, but the HDL is low at 30. Does anything need to be done in this situation?

Dr. Gregory Thomas:

It depends on the other risk factors that this patient has. Let us assume that he is an average adult with an average family history (one of his parents had coronary heart disease). I would recommend taking measures to raise his HDL.

In estimating risk of heart attacks, every HDL point below normal is worth about 4 LDL points that is high. Average normal HDL for adult men is 45, for women is 55. At an HDL level of 30, this viewer is 15 points below average for a man--quite a low number.

Measures to raise the HDL include losing excess weight, achieving and maintaining ideal body weight, exercising regularly, quitting cigarettes, taking medications (under doctor supervision) like niacin, gemfibrozil (lopid), or a statin such as Lipitor, Pravachol, Zocor, or Mevacor.

I have a rule of fives as an approximate guide to raising HDL:

  1. If one manages to thin down to ideal body weight that can raise one's HDL by 5.
  2. If one is smoking, stop smoking will raise the HDL by another 5.
  3. If one starts to exercise regularly, it raises the HDL by 5.
  4. Medications can raise it by 5.