Q: I am a 49 years old male. My latest lipid profile shows, total cholesterol: 183, HDL: 23, triglyceride: 588, LDL: 42.40, VLDL: 117.60. My lipid profile has been normal since the last six years. I do not have any other problems and I am leading a fairly active life in terms of physical activities. I do swimming, cycling, walking, jogging etc. But my HDL has never gone up. My food habits are normal, I take less oil and drink occasionally. So far my doctor had not prescribed any medicine, but now he has advised fenofibrate capsule (finate) once daily and olevon capsule one daily. I am a patient of migraine since the last 35 years and have been taking either of the following medicines - analgesics, dispirin, nimesulide or diclofenac. My doctor says that my problem is genetic. I have been taking four cloves of garlic since the last 15 years. Is the medication correct and warranted? What things should I strictly avoid in my daily diet? For how long will I have to take these medicines? How serious is the situation?

A:Your triglyceride level is very high and HDL is low. I hope your BP is less than 140/85 mms Hg and your waist girth is less than 100 cms. In addition your fasting blood sugar is <110 mgs. The combination of high triglyceride, low HDL, truncal obesity, blood pressure elevation (even modest) along with or without elevated blood sugar is a common genetic trait in South Asians. This is scientifically called Cardiovascular Dysmetabolic Syndrome. This makes subjects prone to cardiovascular problems. It is good that you have no other problem. I think you definitely need to take 200 mgs of fenofibrate, long term, under medical supervision. In addition, continue physical exercise, low carbohydrate high protein diet low in saturated fats. garlic, fenugreek seeds, etc are OK but these agents do not bring down cholesterol and triglycerides by more than 5%-10%. You need much more potent agents.