Physicians and Cardiologists - do you think that Total Cholesterol (TC) is a better risk marker than TC/HDL?

Question

I've been monitoring my serum cholesterol levels for some time now. I find that Physicians like to focus on the Total Cholesterol number while sometimes ignoring the HDL numbers - which are obviously atheroprotective - and thus reduce CHD risk. There's been a lot of work done (Framingham Study, etc.) which show that the Total Cholesterol/HDL ratio correlates better with CHD risk than Total Cholesterol alone. What are your thoughts on this? Thanks :-)

Answer 1

TC/HDL ratio is a much better predictor than TC alone. If you have access to a specialist lab apoB/apoA ratio is probably the best lipid prognostic marker.

Answer 2

T cholesterol/HDL cholesterol is a better index to be monitored. No doubts. Many physicians do no invest time on reading the updates in science. Every body with hypercholesterolemia should know that HDL cholesterol, like a scavenger, pick up the cholesterol from the vascular bed and deliver it to LDL cholesterol. LDL if it is in excess has no way to go out and deposit onto blood vessels. HDL matters! We have very rare people with pure hypercholesterolemia due to high HDL who live longer than normocholesterolemic people. Exercise is the only proven way to increase HDL.