How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17515
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
21597572
Type Your Medical Question Here...
Dr. D. Love is online now

I've recently had a PLAC test with a private health company

Customer Question

I've recently had a PLAC test with a private health company and my results are 195.3 putting me in the high risk category indicating an increased risk for rupture prone atherosclerotic plaque leading to blood clots blocking supply to the heart or brain. Unfortunately when I went to my GP, she hadn’t heard of the test and advised me to have the usual blood tests for cholesterol etc which I had in July and November so it’s not going to help me much with understanding how to deal with this. My bad cholesterol levels are high but good cholesterol is high too so the ratio is in the normal range. (This has been confirmed by doctors in the practice). Added to this, the bad cholesterol has decreased over the last three years whilst the good has increased so I’m working on that with a healthy diet and exercise.
All my other tests were normal but I am still concerned to be in a high risk category for heart attack/stroke despite doing my best to lead a healthy lifestyle. Is there anything that I can do to help to reduce my risk?
Submitted: 10 months ago.
Category: Medical
Customer: replied 10 months ago.
(Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Customer: replied 10 months ago.
I have a BM! of 20.9 and BP is 116/75. No diabetes. Everything else normal. NO history of heart disease
or stroke in family
Expert:  Dr. D. Love replied 10 months ago.
Hello from JustAnswer.
Can you provide the actual values of the most recent lipid profile?
Customer: replied 10 months ago.
Triglycerides 0.6 mmol/L
HDL 3.0
LDL 4.4
Total 7.7
Total ratio 2.57
Expert:  Dr. D. Love replied 10 months ago.
Thank you for the additional information.
There is no treatment that will directly lower the PLAC, so the recommendation when the PLAC is elevated is that there should be more aggressive treatment of the modifiable risk factors, particularly smoking, cholesterol, high blood pressure, and diabetes.
In your case, your blood pressure is already excellent and you have no diabetes. You do not mention that you smoke, although I suspect that you would have said so if you did smoke.
So, the focus would be on more aggressive treatment of your lipids. Your level of lipids is such that it would usually not warrant treatment, but with an elevated PLAC, it would be reasonable to better control lipids. If you have only recently started a healthy diet and exercise program, it certainly would be reasonable to first see the effect of lifestyle interventions. But if the levels remain at this level, then it would be appropriate to consider medicines to lower the cholesterol.
There are two approaches for medicinal management of cholesterol. The approach that has been used for years is to lower the LDL to a desired goal, and the goal would vary according to the clinical situation. For someone at high risk of heart disease, the goal would be to lower the LDL to 2.6, while in someone at very high risk of heart disease, the goal would be to lower the LDL to 1.8. A newer approach that was recently recommended is that anyone that warrants treatment, including people that are defined to be high risk by clinical criteria, should be treated aggressively with statins. By this approach, there is no starting at a lower dose of statin and adjusting the dose until a goal is achieved, and instead, the goal is to use the maximal dose of a statin to get the maximal lowering of LDL cholesterol. In someone that is at higher risk of side effects, using moderate doses of statins would be an alternative.
It is also reasonable to use supplements that can help lower heart disease risk, such as the omega-3 supplements that you are already taking.
So, the appropriate next step in response to the elevated PLAC would be aggressive treatment of the cholesterol.
If I can provide any clarification, please let me know.

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
< Previous | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
 
 
 

Meet The Experts:

 
 
 
  • Family Physician

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
< Last | Next >
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
  • http://ww2.justanswer.com/uploads/DO/DoctorRich/2012-9-12_72454_Doctorweb.64x64.jpg Dr. Natasha's Avatar

    Dr. Natasha

    Doctor

    Satisfied Customers:

    7887
    American Board Certified in Emergency Medicine, Ivy League trained
  • http://ww2.justanswer.com/uploads/DR/DrK99/newpic2.64x64.jpg Dr. K.'s Avatar

    Dr. K.

    Board Certified MD

    Satisfied Customers:

    255
    Board certified with experience in primary care.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjtu60wne/2011-2-14_183449_passportphoto2.64x64.jpg docwithheart's Avatar

    docwithheart

    Board Certified Physician

    Satisfied Customers:

    0
    Board certified pediatrician, with special experience in general pediatrics, hospital pediatrics, and pediatric cardiology
  • http://ww2.justanswer.com/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Board Certified Physician

    Satisfied Customers:

    12373
    20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.