Non-HDL Cholesterol and The New Cholesterol Guidelines

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If non-HDL cholesterol was viewed as a key predictor of cardiac disease risk (on par with apoB or LDL particle testing), why was it abandoned in the new November 2013 cholesterol guidelines?

This is something I’ve been thinking about for a while.  Because for those with diabetes or high triglycerides, it was considered vital to know non-HDL cholesterol. (Do You Know Your Non-HDL Cholesterol? explains why, and how easy it is to calculate from just a standard cholesterol lipid blood test.)

Let me start with a brief, very non-technical definition (for more technical info click blog post link above).  

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Learning About Cholesterol

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It’s been rather a long while since I wrote about the importance of finding reputable online resources for learning about cholesterol. You can permanently locate links to educational resources on my Resources/Info Links page, but I thought it might be helpful to discuss in a post.

Why?

Well, quite frankly it’s because when discussing high cholesterol and heart disease risk, many doctors – who speak daily, probably, about cholesterol – rush through the conversation and use unfamiliar terms. On the receiving end it can feel like a tornado rather than a give and take discussion of personal cholesterol results and the resulting medical goals.

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Cholesterol Tests Your Doctor Hasn’t Told You About

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A standard cholesterol lipid panel  provides four measures: Total Cholesterol, LDL Cholesterol, HDL Cholesterol and Triglycerides.  But did you know that there are two other blood tests — and one ratio that’s easy to calculate — that can better predict your risk of heart disease?  Which means that even with high cholesterol, you might not need a statin medication if these tests show low cardiac disease risk.

Or you might think you don’t need a statin … and in fact do.

And yet, your doctor probably has not told you about these tests.  So let me.

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Do you know your non-HDL cholesterol?

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Reviewing my latest cholesterol test results with my doctor last week, she bandied about a term I’d never before heard: non-HDL cholesterol.

Here is how Discovery Fit & Health describes non-HDL cholesterol (which is VITAL to understand if you have diabetes or other cardiovascular disease risk factors). Unless you’re a doctor, don’t get too fussed about the jargon – I kept it here for those who like all the details.  If that’s not you, just skim over the jargon and keep reading and it should all make sense:

“Non-HDL cholesterol is the total of VLDL and LDL cholesterol,

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Mayo Clinic vs WebMD

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If you are trying to lower cholesterol without medication, your online source of information matters.  In today’s New York Times Magazine, Virginia Heffernan’s “A Prescription For Fear” explains that the Mayo Clinic website is a great source for straightforward, unbiased medical information, whereas WebMD’s slant is far more in favor of the pharmaceutical companies that fund that site:

“In more whistle-blowing quarters, WebMD is synonymous with Big Pharma Shilling. A February 2010 investigation into WebMD’s relationship with drug maker Eli Lilly by Senator Chuck Grassley of Iowa confirmed the suspicions of longtime WebMD users. With the site’s (admitted) connections to pharmaceutical and other companies,

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