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Heart attack - part four

Dr Ross Walker
2 August 2013

Cholesterol

For the past twenty to thirty years we have been bombarded with the importance of controlling our cholesterol as a way to reduce long term risk for heart disease. Most people have the misconception that if you have a high cholesterol, you are slowly clogging your arteries with this harmful substance. The problem with this concept is that in many ways, cholesterol is a vital component of many cellular reactions, building healthy cell membranes, healthy cell communication, is the basic ring for all steroid hormones, and is vitally important in bile salt and Vitamin D metabolism.

In some cases, an abnormal cholesterol profile may be spilling fat into the walls of the arteries to set up fatty plaques but this is not always the case. Basically, I do not treat cholesterol at all, rather treat cardiac risk. I assess cardiac risk by looking at the coronary calcium score I mentioned in the initial article a few weeks back to be tested in all males at 50 and all females at 60 or sooner if you have major risk for heart disease. If you have already had a vascular event such as a heart attack, stent or coronary artery bypass surgery, a calcium score is unnecessary but you certainly should have your cholesterol lowered as part of your management.

I would caution immediately being prescribed a statin drug such as Lipitor, Crestor, Zocor or Pravachol purely because your cholesterol is elevated. Unfortunately the correlation is not that close and I will elucidate this further in future articles.

Ross Walker


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