Q: I am an Indian expatriate working in Zambia for the past 10 years. When I visit India, which is usually once every 2 years, I go for a routine medical check up. This time when I went for the same, the Lipid Profile was as follows: Total cholesterol - 188 mg/ dL HDL cholesterol - 38 mg/ dL LDL cholesterol - 84 mg/ dL VLDL cholesterol - 66 mg/ dL Triglycerides - 332 mg/ dL The doctor feels that a triglyceride level above 200 needs treatment and accordingly I was prescribed Stanlife 160 mg once a day for 1 month and advised to recheck it and adjust the dosage of Stanlife if necessary. My query is as follows: a) How, at this stage in life, did I get this problem? b) Is it genetic and could I have contracted this through genes? c) Is Stanlife the best form of treatment? d) What risk do I have for cholesterol-related problems? (my coronary risk chart says I stand less than 5% chance of a heart problem in the next 10 years) e) What changes should I make in my current lifestyle to control this? I am 35 years, married, and lead a fairly active life style. I do not smoke but consume beer occassionaly. I like red meat and consume plenty of water and fruits.

A:Triglyceride elevation is frequently seen in South Asians. It is often associated with low HDL cholesterol. It is a risk factor for coronary heart disease and thus lowering to levels close to 150 is recommended. It is usually genetic in origin. High carbohydrate intake and alcohol esp too much beer can also increase it. Fenofibrate (Stanlip) is an effective drug. Other drug is Niacin in high dose which also increases the HDL cholesterol. Your doctor has to decide the choice of medication. Regular exercise and limited intake of carbohydrates (breads, rice etc.) also help. Red meat in moderation is ok for you.