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Heart & Cardiology/low HDL & coronary artery disease fear


I am Indian male 46 years old, having mitral valve prolapse with trivial regurgitation. Two week before I did my Lipid profile test the result came Total cholesterol : 162, LDL 122, HDL 22, Triglyceride 128, VLDl 26 & Fasting Blood sugar came 98. I have severe health anxiety especially cardiophobia since last 12 years. I have different fears related to heart all this years ( I used to google about mitral valve prolapse & blood pressure, where I came to know about various cardiovascular diseases including heart blockage, heart attack, stroke, arrhythmia, cholesterol, etc & time to time different different fears). I did my TMT test in 2011, which was negative, I did my Echo in 2013, it was normal, several Ecgs including one week before it was normal. The last Lipid I did was in 2011, it was Total Cholestrol 170, HDL 43, LDL 130, Triglyceride 90, in 2010 it was Total Cholestrol 165, HDL 34, LDL 110, Triglyceride 108, in 2009, it was Total Cholestrol 156, HDL 29, LDL 120, Triglyceride 110. In 2008 it was Total Choletrol 164, HDL 42, LDL 128, Triglyceride 92. I was walking daily for 45 minutes all this years, but last 1 years I was not doing walking & lazy. I always avoid deep fried foods, but on weekend & holidays I would eat in hotels . Now I read that, Low HDL can cause cardiovascular disease & started fearing that i have my arteries blocked due to low HDL all these years. What should I Do to stop this fears. I never took seriously about low HDL, now I came to know about the importance of HDL in preventing Coronary artery disease. I stopped completely the fatty foods, taking Fish Fry in Olive Oil, avocados, walnuts, fish oils, vitamin C, Orange & Pomegranate Juice, Garlic, Flaxseed, Olive Oil etc to raise my HDL & started brisk walking for 45 days since last two weeks & 10 floor stair climbing (2 times) & jogging 10 minutes. But somewhere I have fear that, all this years I was having low HDL & it would have made plaque in my arteries. I will go & check again my Lipid after 1 month & if its normal should I worry about previous low hdl days. How to fight this fear. Plz help me. I am not able to concentrate on anything & obsessing about my low HDl. I am taking bisoprolol 5 mg & magnesium citrate 200mg x3 times supplements for my blood pressure & anxiety. I have palpitations, tingling, twitching, nerve vibrations all over my body all this years. Before I trust the TMT test, as i was thinking it was good to rule out the heart disease. Now I am doubting about tmt test also, as i read it shows the blockage up to 50% only, so i start obsessing & worrying that, what if i have 50% blockage & it will create heart problem.its creating lot of fear. I am unable to sleep & concentrate on anything. What should i do.plz help someone to fight this fear. Now I start to live like heart Patient thinking i have blocked arteries. I brisk walk daily for 45 minutes & jog. What test should i do to stop my fear. I am afraid about any test & if i did tmt or stress echo test i may doubt & unable to remove my fear. Plz help me to desensitize the feeling.

Hi, read about heart disease here

The answer to this question could literally last several pages but i'm going to simplify it for you. Although you have been anxious regarding this for a long time you are actually doing well for your age. Lets look at the facts using currently available risk score prediction models.  Your 10-year atherosclerotic cardiovascular disease risk which includes coronary heart disease, stroke, and peripheral arterial disease (all of presumed atherosclerotic origin) is only 4.5%.  This is a low value which is very good news for you.

In fact, based on this calculation, you are not even in a statin benefit group due to your 10-year atherosclerotic cardiovascular disease risk being so low. We would always stress the importance of lifestyle modifications to lower cardiovascular disease risk and this includes eating a heart-healthy diet, regular aerobic exercises, maintenance of desirable body weight, and avoidance of tobacco products.

Here are appropriate general recommendations:
1. Blood pressure goal of <140/90 mm Hg
2. Total cholesterol <170 mg/dL
3. Weight management to a BMI <25
4. No tobacco use
5. Diet - low sodium, low sugar-sweetened beverage, high fiber, and increased fruit and vegetable intake
6. Exercise - stay physically active for at least 150 minutes at moderate intensity or 75 minutes at vigorous intensity each week
7. Influenza vaccine when available

For further information, please see the American Heart Association's national goals for cardiovascular health promotion and disease reduction ("

You are doing well, relax and follow the recommendations above to ensure you continue to do well,

Hope that was helpful  

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Mustafa Ahmed MD


Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease


Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology


Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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