Just wanted to share a bit of information here that i don't think has been brought up yet. No matter what your age (and especially if you're young), if you have a history of heart disease and stroke in your family, consider asking your doctor to order a test for Lipoprotein (a) as part of your next blood test. Lip(a) is entirely genetic and can't be controlled by lifestyle. However, if your Lip(a) is high, it puts you in a higher cardiovascular risk category. If you know this, then you can take more action in reducing your other risk factors.
I'll try not to go into too much detail about my own history here, but in a nutshell, I've been pretty diligent about diet and exercise over the past 20 years or so (I'm 55). Although I have fallen off the wagon a bit as far as choosing healthy foods over garbage. I really do like my chips and burgers and cheese and pizza. But overall I keep the calories down and have maintained my weight and good BMI.
I recently switched to a different doctor. He's a guy i have gotten to know personally and is very dedicated to fitness, diet, lowering stress, and getting good sleep. He takes a bit of an alternate approach to things, and decides to order up some blood tests that aren't routine. My numbers have always been good, with cholesterol occasionally in the borderline high range. Doc says he likes to focus on the apo(B) and lip(b) as indicators for cardiovascular risk.
Results come in and all of my standard numbers look good. LDL is pushing high as usual. The new test, Apolipoprotein B is in the middle of the normal range. So that's good. However, the other new test, Lipoprotein (a) is in the "High Risk" range. Normal is less than 125. Mine is 250. WTF is this about!!!!???
If I understand correctly, lip(a) carries cholesterol cells. If you have more lip(a) in your blood stream, it offers more opportunity for delivery of particles that can cause blockages. So, even though you may not have high LDL, a high level of lip(a) may offer more opportunity for these sticky cells to be deposited in your arteries.
I have not yet officially discussed these results with my doctor. I happened to run into him at a birthday party this weekend, and I said, "My Lip(A) was 250". With a surprised look he said, "Oh...that's not good...". I said yeah, let's talk when you're back on the clock. He gave me a few thoughts about running some additional tests and possibly a heart scan. So we'll see what that turns up.
Hopefully it's all nothing. But i thought it might be good to share this info, since it was news to me at least. I'd like to have known this 30 years ago!!