Sie sind auf Seite 1von 8

Heart Health Report

For a Symptom, Drug & Stress Free Life


April 2010 / Vol. 1, Issue 2

Dr. Crandalls

By Chauncey Crandall, M.D.

Reversing Heart Disease: My Two-Part Plan for Success

es, heart disease can be reversed! Thats the definitive answer, I am glad to say. This has been repeatedly confirmed in studies.1

Its crucial, though, to understand what reversing heart disease means. This requires an understanding of heart disease itself what it is and how it begins. This is the first of a two-part series, continued in next months edition, where Ill explain in detail exactly how you can turn around your own heart health. Cholesterol is widely known as the villain of the heart disease story. This may surprise you, but your body actually needs a healthy amount of cholesterol. Its an essential nutrient that the body uses to build cells and hormones. In fact, cholesterol makes up more than half of each cell, maintaining the cell walls permeability as it protects the cells core. Cholesterol even provides the body with Vitamin D when broken down by sunlight. This natural ally of the body can become its enemy, unfortunately, as a result of the way we eat and because of our decreased activity levels. Healthy children and adults in countries where heart disease is almost unknown have total cholesterol counts of around 118 and 125. Many adults, particularly in the West, have cholesterol counts that are much higher. They can be so high, in fact, that when a doctor draws the patients blood, chills it in a test tube, and spins it using a centrifuge, the tube can have a white, fatty layer on top, like cream on top of milk. In the worst cases, the fat makes the entire test tube turn white.

Cholesterol travels through the blood in particles. These particles are much like the globules that form in a frying pan when you are trying to wash out fat after frying bacon. The smaller and denser these particles are, the more damage they can do, because a smaller size allows them to embed more easily in the artery wall. Thats why LDL cholesterol is often called the bad cholesterol, while HDL cholesterol is known as the good cholesterol. By its nature, LDL has more power to embed in the arteries than does HDL cholesterol. Ideally, both LDL cholesterol and HDL cholesterol travel as bigger particles and in less dense packets. Lets discuss density: Imagine throwing a beach ball around a room. The ball bounces around harmlessly. Even if it hits a lamp its unlikely to do much damage because it has so little density; that is, it carries very little weight for its size. Now picture a handful of BBs which are

In This Issue...
Even Mild High Blood Pressure a Killer.................. 2 Free Blood Flow Crucial to Heart Health................ 3 Case Study: All Stress Is Bad Stress........................ 4 My Targets for Turning Around a Heart Patient...... 5 Thyroid and Your Heart; Anger Can Kill................. 6 The Real Cure for Heart Disease: Change............... 7 Ask Dr. Crandall. .................................................... 8

much smaller and denser being thrown around a room. Theyll likely cause havoc, cracking the ceiling, rattling around in the air ducts, exploding light bulbs, and working themselves down into the carpet, where youll have to dig them out with your fingers. Theyll go everywhere and stay there. Arteries, meanwhile, are made up of millions of individual cells that are aligned at what cardiologists call tight junctions. This structure allows for elasticity; the artery can dilate, or stretch to get larger, and also constrict, becoming smaller. Each artery is like a balloon in this way. Being made this way lets the artery accommodate changes in blood pressure, like when your heart pumps faster during exercise, or more slowly during sleep.

father, I have to fight high blood pressure. My hypertension never showed up during my regular check-ups thats how insidious it can be. However, when I was working under pressure, a frequent part of my job as a doctor, my borderline normal blood pressure became distinctly abnormal. I had no idea about this until I found myself in the hospital with a major blockage of the main coronary artery leading to the heart. Other inflammatory conditions, such as rheumatoid arthritis, pneumonia, even common infections, can cause inflammation in the arteries. That inflammation allows particles of cholesterol to embed in the lining at areas that are inflamed, or damaged. A vicious cycle sets in: Embedding of cholesterol leads to more inflammation, and inflammation leads to more embedding of the damaging cholesterol particle. Cholesterol that embeds in the lining causes a condition which sparks chemotactic factors, which in turn play a key role in the development and progression of atherosclerosis, or hardening of the arteries. This complex process is how cholesterol forms deposits called plaque. The formation of plaque in the arteries is whats known as atherosclerosis. People react differently to the embedding of cholesterol in the arterys lining, just as they react differently to getting a splinter under the skin. Some people handle splinters easily. They experience only minor irritation as the body repairs the damage. Other people who get splinters, however, can experience significant swelling and become infected. For one person, the embedding of cholesterol in the arterys lining can be a minor thing that happens all the time with no great damage done. For another person, though, it can be the beginnings of an eventual catastrophe. It all

Even Mild High Blood Pressure Is a Silent Killer


Constant hypertension, commonly called high blood pressure, wears out an arterys capacity to stretch and, like a balloon thats been blown up too many times, the lining of the artery becomes less elastic and ruptures more easily. Because high blood pressure has constantly stretched the artery beyond its natural capacity, arterial cells are no longer as tight. Small, dense particles of cholesterol can easily embed themselves in these tight junctions. Arteries that have been damaged by high blood pressure can also rupture, causing an aneurysm and internal bleeding into the surrounding tissues. High blood pressure doesnt cause any perceptible symptoms until the condition has become severe. But even mild high blood pressure constantly damages your arteries. Thats why its called the silent killer. As a result of my genetic inheritance from my

Dr. Crandalls Heart Health Report is a publication of Newsmax Media, Inc., and Newsmax.com. It is published monthly at a charge of $54.00 per year and is offered online and in print through Newsmax.com. Our editorial ofces are located at 560 Village Blvd., Ste. 120, West Palm Beach, FL 33409. The owner, publisher, and editor are not responsible for errors and omissions. Rights of reproduction and distribution of this newsletter are reserved. Any unauthorized reproduction or distribution of information contained herein, including storage in retrieval systems or posting on the Internet, is expressly forbidden without the consent of Newsmax Media. For permission, contact the publisher at : PO Box 20989, West Palm Beach, FL 33416. CEO Christopher Ruddy Associate Publisher Travis Davis Author Chauncey Crandall, M.D. Contributing Editor Harold Fickett Production/Art Director Elizabeth Dole To contact Dr. Crandalls Heart Health Report send e-mail to: askdrcrandall@newsmax.com. Subscription/Customer Service contact 1-800-485-4350 or customerservice@newsmax.com. Send e-mail address changes to customerservice@newsmax.com. 2010 Newsmax Media, all rights reserved. Please note that this advice is generic and not specic to any individual. You should consult with your doctor before undertaking any medical or nutritional course of action.

April 2010

depends on how the persons body reacts to these tiny, yet insistent, attacks on the artery. Reaction usually depends on the frequency of the damage, a persons general health, and other factors. Relatively new plaque deposits initiate a process thats much like the formation of a blister. Burn yourself accidently with a clothing iron or on the stove and the spot where you touched the hot surface will become red, signaling damage to the tissues. Soon, a blister will form as the body tries to repair the damage. A plaque deposit is like that blister. The artery lining has been slightly damaged by cholesterol embedding in the wall and an inflammatory condition develops. Inflammation in the arteries also can develop as a result of inflammatory conditions elsewhere in the body, such as rheumatoid arthritis, pneumonia, and various forms of infection. In this case, the inflammation itself can be the factor that attracts cholesterol to the site and results in a build-up of plaque. Deposits of plaque are also like blisters in that they have liquid centers. Plaque deposits thus are weakest around their edges, where the wall of the plaque is the thinnest. Most of the time, if left alone, they are simply reabsorbed by the body. But they can also rupture, releasing their liquid into the blood stream. The body reacts to the rupture of a plaque deposit like it reacts to a bleeding wound: It marshals its forces to repair the damage. Sometimes the rupture of a plaque deposit will result in the bodys defense mechanisms going haywire. A blood clot can form at the site and cause a heart attack, or this clot can detach and travel through the circulatory system, causing a blockage in the arteries leading to other areas of the heart or other organs. This is how a heart attack, technically called a myocardial infarction, most commonly occurs: A blood clot delivers a devastating blow to the cardiovascular system. (Blood clots also cause brain-damaging strokes.) The clot retards the flow of blood to or within the heart and heart tissue, which rapidly begins to die from lack of oxygen and nutrients. Normal blood flow must be restored as quickly as possible in order to
April 2010

minimize the damage and prevent death. Yet most plaque deposits do not initiate the catastrophic chain of events that lead to heart attacks and strokes. The body successfully copes with these blister-like structures and turns them into fibrotic and calcified deposits. Old plaque becomes as hard as mortar between bricks. In this state, old, hardened plaques cannot be removed from the arteries by any presently known method other than surgery. Usually, this is unnecessary. Unless an artery has been narrowed by more than 75 percent, blood flow remains largely unaffected.

Free Blood Flow is Crucial to Heart Health


Think of blood flow like traffic on a highway. On a four-lane highway, one lane can be blocked off with little effect on how fast the traffic moves. If two lanes are blocked off, traffic may become heavy but still move along at an optimum rate. Block off 3 lanes, though, and heavy traffic turns into stop-and-go traffic. The highway turns into a parking lot. Thats what happens in the arteries as well. A lot of plaque deposits can form in the arteries without
Continued on page 5

About Chauncey Crandall


Chauncey W. Crandall, M.D., F.A.C.C., is chief of the cardiac transplant program at the world-renowned Palm Beach Cardiovascular Clinic in Palm Beach Gardens, Fla., where he practices interventional, vascular, and transplant cardiology. Dr. Crandall received his post-graduate training at Yale University School of Medicine, where he also completed three years of research in the cardiovascular surgery division. He lectures nationally and internationally on preventive cardiology, cardiological healthcare of the elderly, healing, interventional cardiology, and heart transplants. Known as the Christian physician, Dr. Crandall has been heralded for his values and message of hope to all his heart patients.

Heart Health Case History of the Month

All Stress is Bad Stress: A Cautionary Tale


In each issue, I will share with you the story of one of my patients, detailing how making changes to your life can radically improve your heart health. Names and some details have been changed for privacys sake, but the problems and their resolutions are real. Dr. Chauncey Crandall
A Wall Street executive called 911 and was brought into our emergency room with a massive anterior wall myocardial infarction a potentially deadly heart attack. He was 53 years old. He arrived at the hospital an hour after the episode began. Chest pain radiated to both shoulders and down the left arm. He had no known risk factors for heart disease other than having a father who died at 46 from a heart attack. When we examined him in the emergency room, an EKG showed that his heartbeat had the classic tombstone pattern of an infarction. His blood pressure was low, 90/60. He was sweaty and his color was ashen. He had not seen a physician in the past eight years. I was called to take the gentleman to the cardiac catheterization lab for examination and intervention. At that point he had IVs in both arms. We placed him on the table and put debrillator pads on his chest in case we needed to shock him. I made a small incision in his right groin, inserted the catheter into his femoral artery, and within minutes we could see the entire architecture of the heart. He had a widow-maker lesion, an obstruction in the proximal left anterior descending coronary artery. I performed an emergency angioplasty (PTCA) at the lesion site and placed a non-coated stent there, restoring the blood ow from virtually nothing to 100 percent. His other arteries had only mild disease and no critical blockages and, with the lesion corrected, his heart responded beautifully. Our Wall Street executive survived the heart attack and left the hospital one week later with normal heart function and without any evidence of myocardial damage. He was in the best possible shape for what he had been through. I then tried to impress upon him two things: First, there was no reason that he shouldnt live a life from that point on free of heart disease. And, second, he might well die of heart disease if he did not adhere rigorously to the prescribed course of treatment. While in the hospital we learned that our executive, in addition to his family history, had multiple risk factors for heart disease cholesterol out of control, overweight, high blood pressure, and borderline diabetes. His most serious problem, though, was that he enjoyed his life so much he couldnt believe anything could be wrong with him. He loved what Donald Trump once called the art of the deal, and, with his exciting life, the executive saw no reason to see a doctor. He lived off the adrenaline rush and ignored his health. This pattern of neglecting ones health is common among men; unhappily, its particularly common among high-powered executives who, for this reason, are prone to die of heart attack. What people in this situation need to understand is that all chronic stress whether we experience the stress as exciting or depressing can have a negative effect on our health. The executives dealmaking was as much a challenge to his health as being picked on by an impossible boss or going through a divorce. The emotions might be quite different, but their impact on ones health is the same bad. I followed up with the executive and put him on my heart disease reversal diet, which is mainly plant-based and requires some calorie restriction. I used aggressive conventional methods to achieve target levels for cholesterol (less than 150), blood pressure (120/80), and blood sugar control (less than 100 in a fasting state). The executive stayed on this program faithfully for a year and a half. He lost weight and looked and felt much better, so much so that he canceled his followup appointments for the coming year. His deal-making lifestyle, though, soon crowded out attention to his health. The Wall Street executive simply could not imagine or did not want to imagine that his exciting life might have a negative effect on him. Three years after his rst heart attack the executive was back in the emergency room in the middle of the night with another heart attack. My team and I performed another act of myocardial salvage, rescuing his heart once more, but this second episode could have been prevented. Once heart disease becomes a problem or you nd that you have risk factors for it, nothing is as important as following up with your doctor and paying attention to your health! As they say, old habits are hard to break, and we all need someone to be accountable to if we are going to make real changes in our lives. Regular follow-up keeps us all from kidding ourselves that our stressful lives do not take a toll. You may love what you are doing, and I hope you do, but if you have a high-powered job with lots of pressure, you must not neglect your health. You could be literally killing yourself.

April 2010

Continued from page 3

significantly affecting blood flow. But if the arteries narrow by 75 percent or more the person is likely to experience exertional angina they lose their breath easily and can suffer left arm, jaw, and chest pain. This is a condition that can be managed as long as the plaque build-up causing the problems is stable. Early, non-critical, or unstable plaque buildups are the ones we worry about most because these are responsible for heart attacks and strokes These newer build-ups of plaque are also the ones that can actually be removed or eliminated through lifestyle changes in diet and exercise. A relatively minor reduction in plaque deposits say 8 percent within the body can result in major health improvements. This is because eliminating the young deposits of plaque is like opening another lane on the highway. Suddenly, the traffic changes from stop-and-go into moving along again at a good rate. There are mathematical models that can explain the physics of this, but believe me, its true! If you remember nothing else from this article, remember this: A minor reversal in heart disease, the removal of young plaque deposits from the arteries, results in a major improvement in health. The treatment of heart disease involves the elimination of the several factors that together produce the condition. I treat patients a little differently according to their basic condition. Many times patients have already experienced a cardiac event. Theyve had a heart attack, an anginal episode, or theyve experienced an arterial blockage thats been treated through angioplasty, a procedure that enlarges the artery by expanding a balloon within it, or the insertion of a stent, a steel mesh tube sometimes coated with drugs that keeps the artery open. We also see patients who have known risk factors for heart disease: hypertension (high blood pressure), hypercholesterolemia (high cholesterol), hyperglycemia (high blood sugar), weight gain, insulin intolerance, or metabolic syndrome. In this circumstance, the treatment can be less aggressive but it essentially follows the same course. For those who have had cardiac events, I tell
April 2010

them that we are in a war and we are going to use every weapon we have to win the war and walk in victory. The most powerful weapon, always, is recruiting the bodys resources as our ally. As all good doctors know, the practice of medicine depends mostly on creating conditions in which the bodys own natural ability to heal itself can function most effectively. This is particularly true with heart disease because it only develops and advances when the bodys own healing capacities are overwhelmed by a persons bad habits.

My Targets for Turning Around a Heart Patient


Fortunately, the formation of heart disease is well understood and its underlying causes can be addressed. (This does not mean these causes can be instantly remedied, though. Below I discuss a realistic course of treatment.) The first thing to do is to have the patient meet a number of targets. These targets indicate that the body, with the help of medication and lifestyle changes, is winning the war against heart disease. We want the patient to achieve a total cholesterol count of less than 150. As part of the total cholesterol count, the LDL count needs to be less than 70. We have found that LDL particles that are small and dense are much more dangerous than larger, less dense particles. So we also want the LDL number to be low and for the particles to meet certain size and density specifications. Testing for LDL size and density has become a standard part of our practice, although its not yet common throughout the country. Only a couple of labs in
Continued on page 7

Exclusive to Current Subscribers


Current subscribers have instant access to any and every past edition of Dr. Crandalls Heart Health Report. Simply go here: drcrandall.newsmax.com

Check your e-mail inbox for this months password.


(Please remember to use lowercase letters.)

Quick Takes: Tips for Better Heart Health Now


High Cholesterol? Check Your Thyroid
A recent article in a publication of the Harvard Medical School points out the connection between thyroid problems and cardiovascular disease.1 The thyroid is a small, buttery-shaped gland that wraps around the front of the windpipe. Its the bodys gas pedal, controlling the rate of metabolism. The hormone secreted by this gland speeds up and slows down the rate at which the body burns energy. Secretions from the pituitary gland, a pea-sized organ located at the base of the brain, control the thyroid, stepping on the gas or backing off. The pituitary gland regulates the thyroid by secreting thyroid-stimulating hormone (TSH). Hypothyroidism shows up in a variety of other symptoms besides high cholesterol. So many, in fact, that their variety makes a proper diagnosis of hypothyroidism difcult. These symptoms include fatigue, cold intolerance, weight gain, uid retention, slow pulse, enlarged thyroid gland, depression, dry skin, hair loss, constipation, joint pain, heavier menstrual periods, carpal tunnel syndrome and, of course, high cholesterol. The opposite condition an overactive thyroid, or hyperthyroidism has its own range of symptoms, including enlarged thyroid gland, heat intolerance, exhaustion, nervousness, weight loss, shortness of breath, and heart palpitations. Both conditions can result in heart failure. An underactive thyroid is the more common culprit in heart disease, though. Hypothyroidism results in climbing cholesterol counts, and high cholesterol is the driver of cardiovascular disease. The most common test for thyroid problems actually measures the TSH that the pituitary gland secretes. A high level generally indicates an underactive thyroid. An extremely low level indicates an overactive thyroid. Measuring TSH alone often does not tell the complete story. If theres any doubt, I order a full thyroid panel, which more directly measures thyroid hormone levels. battle you are in and take note of your victories and losses. Keeping a diary is an excellent way to do this, as it will encourage good choices and discourage bad ones. For those who are people of faith, I recommend that you include in your diary a daily Scripture verse. You may want to compose a prayer in your own words as well. Scripture and prayer will remind you that God is with you in the struggle and wants you to succeed. In fact, we please God when we take care of the body he has given us.

Anger Can Be a Heart Killer


Researchers in Stockholm found that men who bottle up their anger are twice as likely to die of heart attack as those who express their dissatisfaction and deal with frustrating situations directly. Walking away or not saying anything proved a hazardous means of coping with conict. The researchers studied 2,755 men in Stockholm who had not had a previous history of heart attack between the years 1992 and 2003. In follow-up, 47 of the men either had heart attacks or died from heart disease.2 The researchers concluded that bottling up ones anger increases blood pressure and this damages the cardiovascular system. I dont think this means its OK to blow up whenever you feel like it. But you should not just let things go, either. Instead, nd constructive ways to solve tension-causing problems.

Keep Those Rehab Appointments


A study found that patients who attended all 36 Medicare-funded cardiac rehab exercise sessions after heart attacks or other cardiovascular events signicantly increased their chances of avoiding a second heart attack and enhanced their long-term survival.4 Over the course of the four-year study, those who attended all 36 sessions were: 47 percent less likely to die and 31 percent less likely to have a heart attack than patients who attended just one session 22 percent less likely to die and 23 percent less likely to have a heart attack than patients who attended 12 sessions 14 percent less likely to die and 12 percent less likely to have a heart attack than patients who attended 24 sessions Fewer than 20 percent of those who qualify attend. Make sure you are among the percentage who do!
ReferenceS

Food Diary Key to Weight Loss


A recent study done by the Kaiser Permanente Center for Health Research in Portland, Ore., found that when patients keep a food diary they double their weight loss.3 The study involved researchers from nutrition and research institutions across the United States and tracked the weight of approximately 1,700 obese or overweight adults. These results make perfect sense. If you are going to take your heart-healthy regimen seriously, youll need to remind yourself of the

1 HEALTHbeat, Dec. 29, 2009 2 Journal of Epidemiology and Community Health, Nov. 24, 2009 3 American Journal of Preventative Medicine, August 2008 4 Circulation, Jan. 5-12, 2010

April 2010

Continued from page 5

the United States presently are able to run these studies for a little-known blood test called the NMR Profile (nuclear magnetic resonance). We want the patients blood pressure under control, no higher than 120/80. We want to make sure there are no thyroid disorders. We also want to check for kidney dysfunction, since minor renal (kidney) failure often plays a role in heart disease, especially among AfricanAmericans and the elderly. We want to get the persons body weight under control, with a Body Mass Index (the percentage of a persons weight thats from fat) under 25. To meet these targets, we employ all available means. We use medication, lifestyle changes, and perhaps most importantly, education. For a patient with high cholesterol, in most instances Im going to prescribe a statin drug immediately to get the patient to the target goal. Statins have become controversial and they can have negative side effects. Once you realize, though, how high cholesterol drives heart disease, you can see how important it is to control cholesterol. Eventually, Id like to take the statin medication away, but I want to use it as long as necessary in order to shut down the heart disease engine. Statins not only lower high cholesterol but they also have other positive effects. They have antiinflammatory properties, decreasing inflammation by eliminating free radicals, atoms or molecules that can cause destructive chain reactions within a cell. And they are vasodilators, that is, they help arteries open up. Usually, when people understand the positive effects of statins they become more accepting of their use. Ill also typically prescribe fish oil for additional regulation of fat in the blood, low-dose aspirin for its anti-coagulant effect, and other medications as needed. The patient needs to exercise regularly. I ask my patients to make use of a cardiac rehab facility for supervised exercise three times per week. On his or her off days, I want the patient to walk for an hour. I also put the patient on
April 2010

my heart disease reversal diet. I will be writing continually in this newsletter about the particulars of this diet, Im sure, but for now Ill just say that this is a largely plant-based diet, with plenty of fresh fruits and vegetables, whole grains, and particularly at the beginning as little fat as possible. Thats because I want the body to go after the fat thats already stored in a patients cells and fat deposits within the arteries and everywhere else it may be located. If the patient takes fat out of his or her diet, the body will quickly begin using the persons stored up fat reserves for energy. Its the bodys version of spring cleaning!

The Real Cure for Heart Disease: Change


This is perhaps the most important thing of all: We want to see the patient once a month for the first six months and every two months during the following six months. These visits are allimportant in the education process that must go on if the patient is going to successfully implement the recommended changes in his or her life. The habits of eating fatty foods and getting little exercise are usually ones that a patient has developed over the course of years and years. Reversing these habits is difficult even with ones life on the line! In fact, I rarely see a patient who is able to make changes immediately and continue with them for long without a system of accountability. Regular visits with the doctor are crucial to keeping patients on track. Lifestyle changes can gather momentum. The more a person implements the recommended changes, the better he or she feels. This positive feedback promotes additional change. In next months Heart Health Report, I will bring you Part 2 of this report, detailing the seven strategies you must implement to reverse your own heart disease or, if you are well now, avoid it altogether!
ReferenceS

1 Atherosclerosis Regression, Vascular Remodeling, and Plaque Stabilization, Journal of the American College of Cardiology, January 2007 7

Ask Dr. Crandall


Dear Readers, I will try to answer as many questions as I can. However, because of the volume of questions, I cannot answer each letter personally. Please include your full name, city, and state when submitting. If you have a question for me, please e-mail it to: askdrcrandall@newsmax.com. Even when I was in my 20s I had elevated triglyceride levels long before my cholesterol counts started to climb. I am now in my 50s and am taking a statin drug to control my cholesterol, but my triglyceride counts remain stubbornly high (although the statin does help). Are there any risks associated with high triglycerides? Tim P., Las Vegas, Nev.
Triglycerides, like cholesterol, are a form of fat that circulate in the blood. Elevated triglycerides are often associated with underlying blood sugar disorders, particularly late-onset diabetes. As someone develops glucose intolerance, triglyceride counts go up. Elevated triglycerides also are associated with metabolic syndrome, hypothyroidism, and are a risk factor for heart disease. In particular, triglycerides seem to play a part in developing hardening of the arteries (arteriosclerosis). Since your elevated triglyceride levels were detected so early in your life, its likely that genetic factors have something to do with your counts. Since you are under a doctors care (you allude to the statin drug you are taking), I presume he has tested you for diabetes, hypothyroidism, kidney disease, and other conditions associated with elevated triglycerides. Elevated levels of triglycerides often respond surprisingly well to the consumption of omega-3 fatty acids. You can add omega-3 fatty acids to your diet through fatty fish such as mackerel, lake trout, herring, sardines, albacore tuna, and salmon, or through supplements. Either eat fish three times per week or add 1 gram to 4 grams of fish oil per day to your diet. You should also strictly control all sweets, carbohydrate intake, alcohol consumption, and keep your weight down. High triglycerides are also associated with pattern B LDL cholesterol. This pattern indicates that the LDL particles are small and dense (and thus deadly) and embed more readily in the arteries than pattern A cholesterol. Your doctor should investigate this and may want to prescribe niacin (vitamin B3) in order to plump up your LDL cholesterol and thereby reduce your risk for heart disease.

My doctor has prescribed a statin drug for the treatment of high cholesterol. The statin certainly has brought my cholesterol count down and did so quickly. Unfortunately, since Ive been taking the statin, Ive felt consistently tired and fatigued. Should I stop taking it or should I just put up with feeling less energetic? Sandra R., Miami, Fla.
Theres a third option. Why dont you ask your doctor to try a different statin drug? There are a number on the market and they are all metabolized (put to use by your body) a little differently. Many people find that they dont have the same side effects, like fatigue, with one statin that they do with another. Your doctor probably prescribed the statin he thought would best treat your cholesterol. However, theres probably another one that will give you similar results in terms of cholesterol reduction without sapping your energy. To your heart health,

Please note: All information presented in Dr. Crandalls Heart Health Report is for informational purposes only. It is not specic medical advice for any individual. All answers to reader questions are provided for informational purposes only. All information presented in Dr. Crandalls Heart Health Report should not be construed as medical consultation or instruction. You should take no action solely on the basis of this publications contents. Readers are advised to consult a health professional about any issue regarding their health and well-being. While the information found in Dr. Crandalls Heart Health Report is believed to be sensible and accurate based on the authors best judgment, readers who fail to seek counsel from appropriate health professionals assume risk of any potential ill effects. The opinions expressed in Dr. Crandalls Heart Health Report do not necessarily reect those of Newsmax Media.
8 April 2010