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Question
Posted by: Bet | 2006/11/11

cholestrol and preg

To my shock I found out I have high cholestrol and low BP. I don't drink, smoke, am vegetarian and have been for years. Generally fit'ish mid 30's and within my BMI limits. The optometrist told me to see a Dr as I had hardenend arteries. A blood test showed my cholesterol test to be 7. I reduced this to 6 within a month by eliminating all fats. and now I stabilise around 5'ish taking omega supplements. When I chatted to my GP she says that my rist factor is 20% for a heart attacK and that it wasn't significant risk to use statins. This worries me alot as I have a young family, its hard enough watching evertything I eat and I get irritated because I get hungry and its hard to find something fat free to keep me full for long.
No known family history of heart disease and I do suffer occassionally from stress.
Should I be worried? I feel the need to get a second opinion and not let on I have seen someone else. I know a Chlstrol count of 5 is good for now, but what about the hardened arteries? How bad are they and can I do anything to change or manage this better? I have been trying to fall pregnant, what are my risks if I continue to try and then fall preg?
I would so welcome any advise please.

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Our expert says:
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Dear Bet,

The low BP is a bonus, and added to the facts of being a non-smoker and having no family history of heart disease, this puts you in a much better position than another person with the same cholesterol, but WITH these other risk factors. Well done on the dietary measures bringing down your total – not many people manage this. And full marks to your optometrist!!!

However, there are still some unanswered questions here. Even though your total is “around 5”, you need to know what its composition is. For this you will need to have a fasting total lipogram (if you have not already had this). This test breaks down your total reading into the “bad” cholesterol, LDL, + the “good = cardioprotective” one, HDL + the total free fatty acids. You see, if your total is nearly all LDL, then even thought the number may be “normal”, you are at great risk. Perhaps you should discuss this test with your doctor, and ask to have it done if indicated.

As to the hardened arteries, this is significant. The retina at the back of the eye, is the only place in the body in which internal arteries are visible. What is happening in the retinal arteriesmirrors what is happening in the other arteries of your body – you just can’t see these others. This hardening represents cholesterol deposits in the walls of the arteries, and they may go on in time to have calcium deposited in them, turning them into rigid, stony pipes. As far as lifestyle factors to influence this, you are already doing everything that is recommended. The only thing you would now benefit from is using a statin : this would bring your total, and especially your LDL, down even more, and make you dietary restriction a little less harsh. There are also many other benefits to be had from statin therapy, eg they have an anti-inflammatory effect on the cholesterol plaques already in your arteries, and help prevent these plaques from eroding and triggering clot formation. This clot formation is what narrows the artery even more, and can be the precipitating factor for a heart attack. Unfortunately, if you are planning a pregnancy, you will have to stop the statin for some time before becoming pregnant, and will only be able to resume therapy again once you stop breast-feeding.

Bet, on balance I would suggest you first get the full information about your cholesterol profile, If your LDL is raised, then reconsider using a statin. This decision will have to be considered in the light of your planning a pregnancy. If your cholesterol profile is good, and especially if you have high HDL, then you can probably continue (if you can tolerate it) with your dietary measures. Please remember, though, that some fat intake is vital for the absorption and use of the fat-soluble vitamins A,D,E and K. Fat is also needed to make the essential cholesterol, which is a component of the wall of every single cell in the body, and is also used to make our hormones – including sex hormones and essential ones like cortisol. What this means is that you cannot have a totally fat-free diet if you want a healthy pregnancy and baby, so you will have to relax things a bit then.

If you still need advice, please ask to be referred to a physician – preferably one with an interest in cardiology. Your GP will not be offended at this request. You could also see you Gynea to discuss alternatives to the statins in pregnancy.

Good luck.

HeatDoc.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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