I have high “good” cholesterol, but I have recently read that if HDL is too high, there can be increased cardiovascular risk. Cholesterol is confusing.
A few places suggest that “too high” HDL may be >90 mg/DL for it potentially to be non-helpful or harmful compared to levels in the optimal range, but there does not seem to be much on the subject, perhaps because that is uncommon.
Perhaps it also matters why HDL is high, such as being due to exercise versus alcohol consumption versus genetics?
Mine is a little higher than that. I have found some information about causes, but based on my other levels and my lifestyle, nothing really jumps out. My PCP is not concerned, but I try to make sure I do my own research. My PREVENT score is good & my cardiovascular age is lower than my actual age … so I will just continue to exercise and eat properly, I guess.
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Me too on the high good cholesterol. I was especially worried about the link to dementia since my mom died of Alzheimer’s. I talked to my MD last year about it and he was also not concerned. His hypothesis was that people with high good cholesterol live longer and the longer we live, the more we are at risk of dementia.
My Prevent score is also lower than my actual age by 5 years. I’ll take it.
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My prevent age is 1 year older than my actual age. I’m surprised that there were no questions regarding physical activity.
Im 62. My PREVENT age is 60. My MESA age without considering the calcium score is 52, but when you do add it in, it’s 72. Lp(a) damn you!
I was too initially but then wondered if, generally speaking, physical fitness and weight are probably reflected by the blood pressure data.
Not necessarily. My BP first started measuring a bit high sveral years ago. I took up yoga, started running and lost weight. BP didn’t budge.
I no longer run but am very active physically, eat a healthy diet and am at a healthy weight and BMI. BP still needs medication. My dad had the same issue. OTOH my mother ate a lot of junk and was not physically active and her BP was fine.
There are always exceptions but in general there is a VERY strong inverse correlation between physical fitness and blood pressure and it seems reasonable to guess that the results from the simplistic PREVENT calculator hinge on using averages in its age/risk calculations.
The calc’s reported risk also doesn’t have a simple linear relationship with blood pressure. Changing some of the variables, I noted that my risk level decreases if I increase my blood pressure up to 120. Increasing my blood pressure reduces my reported cardiovascular risk.
I expect this relates to not being well represented by the persons used to complete the population based stats in the calc outputs. My workout intensity/frequency is quite high and has contributed to having a resting heart rate in the low 40s. This type of low resting heart is not uncommon among endurance athletes, and my other cardiovascular stats like VO2Max are well aligned with being an athlete, rather than having a medical problem. Endurance athletes with low HR, high VO2Max, … average lower blood pressure than population norms. When the heart doesn’t need to work as hard, there is often less pressure on walls.
However, I expect population based studies used to generate calc outputs find that rather than being an athlete, it is more likely that significantly less than 120 systolic blood pressure is a sign of a medical problem and can lead to heart need to work harder or beat faster to compensate for the low pressure, as well as other factors that increase cardiovascular risk.
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I had a visit with my cardiologist yesterday. I have all of the issues that raise my heart age - hypertension, diabetes, high cholesterol. These conditions worsened once I was no longer able to exercise with the same intensity due to a hip injury. I take medications for all three. I still exercise regularly. When I took the PREVENT quiz, my heart is a full ten years older. I asked my cardiologist about these results and he reiterated that these studies should not be relied upon for individual results. He told me to keep doing what I was doing.
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I’m in the very high HDL camp. High 90s usually. I always thought it was a good thing, but now I guess I’ll have to read up more. My overall is less than 200, for what it’s worth.
According to this calculator, my heart age is two years less than my actual age. I guess I’ll just keep doing what I’m doing.
I don’t know about other people, but I always have ideal blood pressure no matter how fat and out of shape I get. My sister on the other hand is normal weight and stays in shape, and always has high blood pressure.
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I exercise a lot, eat properly, and am not overweight. My blood pressure is relatively high, and it’s frustrating. My doctor doesn’t put patients on bp lowering meds at my bp unless there are other factors that I don’t have. However, if it inches up, I will go to a cardiologist. H’s PCP wanted him to go on meds for his bp, but when he went to a cardiologist and had a full work up, she did not recommend meds.
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I think that’s the most important point. The calculators are based on population averages. If you aren’t average, lets say because you have elevated Lp(a), then the results don’t mean anything. That’s why actually looking in the heart would be/is valuable.
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They discuss normal range to aim for … but the only way to lower it seems to be dealing with an issue causing it. If it’s genetic & there is no underlying issue, there doesn’t appear to be a fix.
My HDL, without a statin, is well over 100. It is around 90 with medication. Family history is really important in evaluating the risk of a high HDL level as well as other factors that may contribute to the development of heart disease. My cardiologist is great. I see him twice a year and he spends close to an hour with me each time. A controlled HDL of 90, tied with all other factors, is a risk we’re both comfortable with.
Note that the linked page suggests using CT scans for coronary artery calcium check only in some cases (borderline and intermediate risk by other indicators, not lower or higher risk), not mass screening.
Concern about increasing cancer risk from CT scans is non trivial, according to Radiation from CT scans and cancer risks | National Institutes of Health (NIH) , which suggests that 93 million CT scans in 2023 “could result in almost 103,000 future cancers”.