Total cholesterol and heart scans 19. June 2006 William Davis (0) Andy was fearful of heart disease in his life. At age 52, he'd already had four CT heart scans--one each year on or near his birthday. Yet, when I looked at Andy's scans, his scores had been increasing 20-24% per year. Each and every score was greater by 20% or more over the previous. So I asked Andy what steps he had taken to stop this relentless progression. "Well, I've always been real health conscious. But ever since my first scan, I really started sticking to a healthy diet, exercising nearly every day, and I take a bunch of supplements.""What did your doctor advise?" I asked. "Well, Dr. ---- said that nothing needed to be done, since my total cholesterol was always below 200."Men's Health magazine's fabulous story about the folly of using total cholesterol to gauge heart disease risk. Aaaauuuggghhh!! Wrong! This man was, in fact, at rapidly escalating risk for heart attack. This rate of growth simply can't continue forever without igniting this bomb. A total cholesterol below 200 is meaningless, as Andy's increasing coronary plaque proved. For instance, you can have a total cholesterol of 165 mg but with an HDL cholesterol of 27 mg. This would constitute very high risk for heart disease despite the low total cholesterol. The low HDL pattern is among the most common reasons for a misleading total cholesterol. Small LDL, high triglycerides, and lipoprotein (a) are other frequent reasons. Andy, run the other way! Do not heed this doctor's advice! You need a solid answer to the question: Why exactly do I have coronary plaque in the first place? Then, agree on a treatment program that corrects your specific causes.