Dr. Róisín Colleran on heart health & cholesterol
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What is the main topic discussed in this episode?
The Pat Kenny Show. With Timber Living Log Cabins. Saturday and Sunday from 10am. On Newstalk. Conversation that counts. Now, when it comes to preventing heart disease, one of the most important factors is cholesterol, and new international guidelines are rewriting how we think about it. Experts now say the focus should be on lifetime exposure to LDL cholesterol, the so-called bad cholesterol, and lowering it earlier for longer rather than doing it later. I'm joined in studio now to tell us what this might mean for patients by Dr. Roshin Kalaran, Consultant Interventional Cardiologist at Matter Private Network. Hey, Roshin, good morning and welcome. Good morning, Pat. Thanks for having me. So has the thinking changed on cholesterol and how it's treated?
What recent changes have been made to cholesterol guidelines?
It has. I mean, there's a move towards, I suppose, earlier recognition of high cholesterol in order that we can treat it earlier. There's more of a thinking about lifetime risk rather than, I suppose, reacting to events like heart attacks or people needing stents, angina. stroke, and I suppose identifying it earlier. So these guidelines recommend that people have their cholesterol checked by the age of 20 now, which is very new. We never really had a defined age cut off before. But I guess there are certain inherited disorders where people can have high cholesterol. There are families where they have very elevated cardiovascular risk.
Why is early cholesterol screening now recommended?
And I guess if you're only checking that for the first time in your 40s, these people often have plaque already in their coronary or cerebral arteries.
Now, the question of having familial high cholesterol anyway, that it's there, the numbers are there, and they don't seem to do anyone any harm.
Well, so there is, I suppose, a pretty rare condition called familial hyperlipidemia. And that's where people have crazy high cholesterol levels and their tens are above. And that's something that people inherit and will have from childhood. So if you check a two-year-old's cholesterol, it can be very high. And that's a different thing. It's rare, but really... And does it do them harm? It's funny, for a lot of families it will, but there are certain families that you will meet that have this condition who don't seem to manifest cardiovascular disease. So for the most part, yes, but the odd family won't.
But the fundamental message here, it's really from the age of 20, you should be checking your cholesterol and doing something about it if it's right. That's the key. Good cholesterol, bad cholesterol. We need the good cholesterol anyway. So... When they measure your cholesterol, do they distinguish between the two or do you get a global number?
Absolutely. So when I ask somebody their cholesterol level, they'll often tell me 6.2. And that's OK. I know it's high. But actually, what I really want to know is the LDL and the HDL and triglycerides to some degree. But the LDL is the one we really focus on getting. And if that is a target, then you can start focusing on things like the triglycerides. The HDL is the good cholesterol. And I tell my patients the LDL is the guy that likes to cling on to the artery walls anywhere in the body. It doesn't have to be the heart arteries. And the HDL kind of mops up after him. Now, there's only so much you can do if your LDL is very high. He's working very hard. Again, you'll see some people will have, and it's usually genetic again, they'll have a low HDL.
And in fact, our cholesterol tablets, they bring down LDL. They don't bring up HDL. In fact, they'll sometimes lower it further.
Well, you know, we're told we get a high LDL if we eat certain foods. On the other hand, can you eat foods that will elevate your HDL?
That's a trickier one. I suppose exercise can bring it up to a degree. The eating healthy, really, it's more for LDL lowering. So I suppose what we do is we try and lower the LDL as much as we can. We often won't increase the HDL to target if it is genetically low.
Now the questions are flying in. This one, I'm a 54-year-old female put on statins for about six years, 10 milligrams, would love to stop, really don't know why I'm on it.
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Chapters
5 chapters
1
What is the main topic discussed in this episode?
0:01–0:48
2
What recent changes have been made to cholesterol guidelines?
0:48–1:27
3
Why is early cholesterol screening now recommended?
1:27–7:03
4
What is familial hyperlipidemia and how does it affect cholesterol levels?
7:03–10:32
5
How do LDL and HDL cholesterol differ in health impact?
10:32–13:12