Ask the Cardiologist: How do I get my LDL number down?

systolic blood pressureDr. Maciej Malinski is on the medical staff at Sherman Hospital. He has been kind enough to answer some frequently asked questions related to maintaining a healthy heart in his Ask the Cardiologist series. Look for additional heart information from Dr. Malinski throughout Heart Month 2011.

Q: How do I get my LDL number down?

A: The LDL portion of cholesterol, known as “bad cholesterol”, is one of the strongest predictors of risk of coronary artery disease. There is very strong evidence for treating this risk factor, and guidelines clearly define target levels for treatment.

Therapy always starts with diet. Saturated fat (milk, cheese, meat, processed food) intake is the primary cause of elevated LDL levels, so if you’re looking for reasons your LDL number is high, evaluate how much of those foods you typically eat.

If the goal of the therapy is not achieved with dietary modifications, than we reach for medications. Statins and niacin are very effective in reducing LDL levels, along with diet, of course. Niacin is a very powerful antilipemic medication; it reduces LDL, triglycerides levels and increases HDL (“good cholesterol”) levels. If single medication can’t reduce your LDL, then you should be referred to a cardiologist or physician who has experience in treating lipid disorders.

Do you have a question for Dr. Malinski? To submit your question, either post it in the comments section below or email with the subject line “Question for Dr. Malinski.” To schedule the essential (and painless) $79 Healthy Heart CT Scan, click here.

This post is published by Sherman Health to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from your physician.

About Sherman Health

Sherman Health has provided medical care to Northern IL since 1888, and is currently home to a network of over 600 physicians. The Sherman blogs are edited by me, Luke. Questions? Comments? Links? Email address is luke at shermanhealth dot com.
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8 Responses to Ask the Cardiologist: How do I get my LDL number down?

  1. Ronald Hirsch says:

    I disagree with Dr Malinski; there has been no good data to suggest that Niacin lowers the risk of heart attacks or strokes as statins do. We learned from the Torcetrapib fiasco that it is not all about fixing a number, we need to look at clinical end points. Niacin is also a very poorly tolerated drug and certain forms have been associated with serious liver disease. I also take issue with the notion that primary care physicians cannot treat patients with complex lipid disorders- we do it every single day in our practices.

  2. Anonymous says:

    What about exercise?

  3. Marlee says:

    Dr. Malinski,
    What does the test consist of (how is it done)? What preparations does patient need to do? How long will the CT scan take? Will insurance cover if we submit it?
    Thank You

  4. Thanks for the question! Dr. Malinski has written a couple posts about exercise in the past. Look them over and if you have any other exercise-related questions that he hasn’t addressed, let us know!

    All About Exercise
    How Much Should I Exercise With My Heart Condition?

  5. Thanks for writing in, Marlee! We’ll be answering your questions in an upcoming blog post.

  6. camila says:

    i have congestive heart faluire and twice i felt fibrilations that self terminated after 3 seconds, could it be a transient ventricular fibrilation?
    or is it an atrial fibrilation? i know i had fibrilations for just 2-3 seconds but during the fibrilations there werent no contractions i just felt a fibrilation then suddenly my heart back to normal. can it still be an atrial fibrilation? or is possible that i a had a self terminated v fib?

  7. Thanks for writing in, Camila! Dr. Malinski responded to your question in a recent blog post. Check it out here:

  8. Pingback: Ask the Cardiologist: Are there any benefits to treating low HDL? | Sherman Heart & Vascular Blog

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