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Forum Name: Miscellaneous Cardiology Topics

Question: High HDL Cholesterol


 Isno Well - Mon Nov 10, 2008 6:25 pm

What does extra high HDL Cholesterol mean? I have 4.0 mmol/L (LDL is 3.6 and Trig 0.5).Shouldn't this be good?
My doctor said the Cholesterol is extremely high and gave some medicine (Caduet 5/40) which gives me tightness on the chest, which starts on midday and gets really uncomfortable towards evening. Have been on this meds a week. This was my first cholesterol test, couldn’t I just try first making some lifestyle changes like reduce wine and cut down cheese? Otherwise I have good diet with heaps of seafood, olive oil and no butter. I am not overweight, don't smoke and don't have family history of heart disease. I am 52 female. Although I have high blood pressure (last time it was 194/104) as I have drunk too much wine. Have cut it to two glasses now as on this medication.
Please explain this high HDL, heart foundation person hadn't heard about this high figure before and thought it must be a mistake.
 John Kenyon, CNA - Wed Nov 12, 2008 12:48 am

User avatar Hello -

HDL cholesterol usually runs in the 35-50 mg/dl range, whereas your reading would be 156, which is remarkably high. While HDL is considered "good" cholesterol, if the readings were all correct you'd need something to bring down the LDL anyway (yours would be 140, and we prefer to see it below 130 in otherwise healthy people and the closer to 100, the better). Your triglycerides are also a little high, and arbitrarily 20% of triglycerides is counted as very low density lipoprotein (VLDL), which along with LDL is considered "bad." Even if your HDL were a believable number (and the higher the better, in general), you'd probably be a candidate for treatment of the overall level, and Caduet makes sense since your blood pressure readings have been unacceptably high.

All that being said, and believing the medication seems appropriate, any time a reading comes through as profoundly "wrong" as your HDL did, one has to suspect a lab error and there should be a retest just to be certain. Now even if a repeat bears out the oddly high HDL reading, this is still usually seen as an offset to other elevated components. This is usually a familial trait and in some studies has been believed to have contributed to certain families having a trait called "morbid longevity", where people live remarkably long times due to the presence of such high levels of "good" cholesterol. Again, even so, the medication (or some other combination) would be appropriate.

If you're having unacceptable side effects from the Caduet, there are plenty of other combinations of lipid-reducing statin drugs and blood pressure medications.

I don't think your wine consumption is excessive, nor should it contribute to your quite high blood pressure. In fact, alcohol consumption, if very moderate (such as your two glasses -- per day, one assumes), should help increase the HDL level, help maintain general cardiac health, and even lower your blood pressure. While there may be other factors your doctor has taken into consideration, really this moderate amount of wine is generally thought to be beneficial (though not usually specifically recommended).

Your cholesterol levels really should be retested, though, because of the extremely unusual high HDL finding. If that were to repeat, as I've said above, then it probably would work in your favor, although your LDL and VLDL, as well as triglycerides, would need to be treated anyway, along with the blood pressure problem. The wine intake should be beneficial unless there's some other reason to eliminate it altogether.

I hope this is helpful to you. Please let us know if you learn anything further regarding the very odd HDL finding, as you may actually be the benefiary of a positive genetic "disorder" -- or you may have experienced a gross lab error.

Best of luck to you. Please stay in touch here.

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