So. Statins. The wonder drug that magically lowers cholesterol. And because I am diabetic and had a highish cholesterol reading I have been put on statins (simvastatin 40mg). I was on ezitimbe and 80mg of simvastatin, but my diabetic nurse took the ezitimbe off me at my six monthly review in July due to the apparent side effects, and my GP recently reduced my statins to 40Mg. 1 month later and I had a new starvation blood test to check my cholesterol. Total value is 3.7. Whoo who you might saw, but the truth is a little different, the truth is in the values underlying that total value.

The fasting blood cholesterol tests return a number of values measured in millimoles per litre of blood, or mmol/l for short. Cholesterol levels for the average person in the UK are relatively high. The average total cholesterol for men is about 5.5 mmol/l. For women it is about 5.6 mmol/l. The recommended target value is below 5.
These numbers are levels of:

1. Total cholesterol (the amount of bad LDL cholesterol plus the good HDL cholesterol circulating in your blood) (ideally <5.0)
2. LDL cholesterol (the bad cholesterol that clogs up blood vessels) (ideally <2.6)
3. HDL cholesterol (the good cholesterol that picks up any extra cholesterol in your blood vessels) (ideally >1)
4. Triglycerides (bad lipids) (ideally <2.3)
5. Total cholesterol to HDL ratio (the proportion of your total cholesterol that is good HDL cholesterol). (ideally <6)

So the big question is what do these things actually mean? What does LDL mean?

The first thing to say is that cholesterol in itself is actually essential to healthy living, it is the type that is important. LDL means low density lipoprotein and HDL is unsurprisingly high density lipoprotein. LDL is bad because it acts just like the plaque that builds up on your teeth, in that it builds up inside your arteries. In that arteries are actually tubes (or pipes), and build up is bad, it eventually leads to a potential blockage. This is why LDL is bad for you.

HDL, however, is called “good” cholesterol because it clears excess cholesterol from the arteries. As mentioned HDL cholesterol results should be higher than 1.0mmol/L. A HDL level of 1.5mmol/L or more is considered a negative risk factor, i.e. high HDL levels are so good that they can counteract the negative effects of another risk factor such as excess weight.

Triglycerides are another fatty substance in your blood. and elevated triglyceride levels lead to increased risk of heart attack. Triglyceride levels increase rapidly after you eat, then decrease slowly as your body processes fats from your food, which is why people are asked to fast for at least eight hours before testing their triglyceride. Fasting triglyceride levels lower than, or equal to, 2.3mmol/L are considered normal.

Okay, so now we know a bit more about Cholesterol and what is good and what is bad. We know that high levels of LDL increase the risk of Cardio Vascular and Coronary Heart events. So that is why the government is considering prescribing statins to everyone, or at least making them 'freely' available, and that is why, as a diabetic (diabetes increases your risk of CV and CH problems dramatically),my GP prescribed me statins.

Statins are prescription medicines that interfere with the livers metabolic process and result in lower cholesterol production. This leads to a noticeable drop in harmful LDL levels. But you will them become reliant on drugs for relatively little benefit and, most importantly, your HDL production, (remember, the good stuff) will be affected and lowered also.

SO perhaps statins are not a wonder drug after all, my figures revealed that although my overall figure was a healthy 3.7 (well below the ideal 5), my triglycerides were at 2.5 (above the recommended 2.3) and my HDL at 0.9 is below the recommended 1.0. Conversely the LDL was very good at 1.7. The message is that my cholesterol figures were OK.

Well, not to me they aren't. I want a low LDL but a higher HLD and also lower triglyderides. What can be done? The alternative to statins to lower high cholesterol may be with simple lifestyle changes including changing diet, managing weight and increasing exercise.

Diet

Healthy eating can reduce cholesterol. Your diet should be low in saturated fats in particular, and low in fat overall. Biscuits, cakes, pastries, red meat, hard cheese, butter and foods containing coconut or palm oil all tend to be high in saturated fats, so cut down on these foods.

Large amounts of cholesterol are found in a few foods, including eggs, offal such as liver and kidneys, and prawns. However, if you're already eating a balanced diet, you don't need to cut down on these foods unless your GP or dietitian have advised you to.

It's also important to eat plenty of fibre, especially soluble fibre, which is thought to lower cholesterol. It's found in fruits and vegetables, beans and oats. Aim to eat at least five portions of fruit and vegetables each day.

There is some evidence that foods containing substances called plant sterols or plant stanols, such as the brands Benecol or Flora pro.activ, in combination with a low fat diet and physical activity, can help to lower cholesterol

Aim to get your BMI down below 25. There is a BMI calculator HERE.

DO some exercise. A brisk 30 minute walk each day is the minimum target.

Me? I am going to see my GP and see if I can't frop the statins altogether and get my risk factor low and my HDL's Higher.

You might want to also read the following:

1. Triglycerides and the heart. British Heart Foundation.www.bhf.org.uk
2. Heart disease. Food Standards Agencywww.eatwell.gov.ukaccessed
3. Cholesterol. British Heart Foundation Health Statistics.www.heartstats.org
4. Cholesterol and chronic kidney disease. National Kidney Foundation.www.kidney.org
   Law, M.
5. Plant sterol and stanol margarines and health. British Medical Journal 2000: 861-864