DEAR DR. ROACH: My husband and I are both 72 and of normal weight. I have fought high cholesterol and triglycerides for many years and have taken various statins for a long time. My triglycerides still trend high, but my other numbers are now normal.
My husband eats a ton of processed meats, all the fat he wants and drinks three to five beers per day. His lipid panel results came back today, and his total cholesterol is 167, his LDL is 90, his HDL is 71, and his triglycerides are 29! He has never been on statin drugs. His only med is lisinopril for slightly high blood pressure.
What I am concerned about is a CT scan done as part of a study we participated in. My husband's results have mentioned calcification of heart arteries over the years, and the most recent says he has "SEVERE calcification of coronary arteries." I want him to go to a cardiologist, but his family doc says that this is not a problem and as long as he keeps his blood pressure low, he can live a long time with this. He is satisfied with that answer.
I'm really anxious to hear your thoughts about him needing to see a specialist. I hope you will be able to shed some light on the calcification and the reason why it happens with such good cholesterol readings. -- D.B.
ANSWER: There are several important lessons in your story.
The most important is that a poor diet increases the risk for heart disease even in a person with normal or good cholesterol results. Of people with a heart attack, 21% had cholesterol levels that would not trigger treatment with a statin drug. I suspect, but can't be sure, that your husband has blockages in his coronary arteries; the severe calcification of the coronary arteries is an indicator that it is very likely.
I would add my recommendation to yours that your husband see a cardiologist. He has a LOT of work to do at improving his diet, he is drinking more alcohol than recommended and because of the coronary artery calcification, I suspect his new cardiologist would be strongly considering medication treatment to reduce heart disease risk.
DEAR DR. ROACH: I am 70 years old. I seem to be getting more polyps (which are removed). In the past five years, I have gone from one diverticulum to extensive diverticulosis throughout my entire colon. I try to have a high-fiber diet and use psyllium in my oatmeal daily. What more can I do? Eliminate red meat entirely and go vegan? -- J.D.
ANSWER: Polyps in the colon confer a higher risk of colon cancer, and the more polyps a person has, the more frequently they should be screened, preferably with colonoscopy. There are some lifestyle changes most people can make to reduce the risk of polyps and of colon cancer.
Regular exercise and eating plenty of fruits and vegetables are clearly shown to reduce colon cancer risk. Fiber has long been thought to be protective, but the results of trials have been contradictory.
Among the many other possible protections to colon cancer, aspirin probably has the most benefit, but aspirin has other risks as well. People at high risk for colon cancer should discuss the use of aspirin with their doctors.