Smoking And Cardiovascular Disease Risk
As well as causing cancer, smoking affects the arteries that supply blood to your heart and other parts of your body. It reduces the amount of oxygen in your blood and damages your artery walls.
Smoking increases your risk of heart attack, stroke and peripheral vascular disease â which can lead to gangrene and limb amputation).
Smoking makes your blood âstickierâ, causing blood cells to clump together. This slows blood flow through your arteries and makes blockages more common. Blockages may cause heart attack and stroke.
Smoking also makes your artery walls sticky, causing them to become clogged with fatty material called plaque or atheroma. Smokers often have cold hands or feet as a result of clogged arteries, which may also lead to serious problems such as gangrene.
If your coronary artery becomes clogged, it can cause angina. If a blood clot forms in the narrowed coronary artery and completely blocks the blood supply to a part of your heart, it can cause a heart attack.
Tips For Stopping What Causes A Stroke And Heart Attack
What are the recognized causes of chronic inflammation in the cardiovascular system?
For most people it is insulin resistance.
What causes insulin resistance?
- Typically it is due to the consumption of too much sugar and high-fructose corn syrup, along with too many processed foods that lack fiber and lack the nutrition needed from fresh fruits and vegetables.
Studies have linked insulin resistance in humans to the increased amounts of fructose e.g., in high fructose corn syrup, which is the least expensive nutritive sweetener available in industrial quantities.
- Why is fructose so harmful? Fructose causes changes in blood lipid profiles, among other things, mostly due to its effects on liver function.
Stress, pollution, emotional problems, and lack of sleep also increase inflammation.
Where Do The Cracks Begin To Show
You would think, given the widespread acceptance of the Cholesterol Hypothesis, that science would back it up nicely to explain cause and effect. In other words, the factors or conditions that increase your risk of heart disease would also show an increase in blood cholesterol, and factors decreasing your risk would lower blood cholesterol.
However, this is not always the case. When we look at a list of some of the most well-established risk factors for increasing and decreasing the risk of heart disease, theres a very poor correlation between risk and blood cholesterol levels. Simply put, if someone is at high risk of heart disease, we would expect to also see high cholesterol levels, but this isnt the case:
| Key |
| Effect on heart disease risk | Effect on LDL cholesterol |
| Use of NSAIDs | |
| Using cocaine | |
| Tocopherol |
A key argument of those who support the Cholesterol Hypothesis is that cholesterol has actually been found to be present in atherosclerotic plaques.
However, there are also lots of other things in these plaques, like red blood cells. Interestingly, cholesterol is actually used in the formation of red blood cell membranes. Therefore, a different theory suggests that the cholesterol found in these plaques is from the membranes of red blood cells, rather than harmful free deposits.
Instead, it might be more helpful to go through what we do know and explore some facts that contradict the Cholesterol hypothesis.
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Myth : If You Have Heart Disease You Need To Take It Easy
“For the vast majority of people with heart disease, being sedentary is a bad idea. It can lead to blood clots in the legs and a decline in overall physical condition,” says cardiologist Dr. Richard T. Lee, co-editor in chief of the Harvard Heart Letter. Physical activity helps strengthen the heart muscle, improves blood flow to the brain and internal organs, and improves overall health and well-being.
What you can do: Ask your doctor what kind of exercise would be right for you, and how much you should do. Most people can walk, and any amount of walking is good for your heart.
The Link Between Cholesterol And Heart Attack Risk
While high cholesterol is a risk factor for heart attack, theres plenty you can do to lower it.
Everyday Health
Cholesterol gets a bad rap, but the truth is, we need it to function well. Cholesterol is an important building block for the cells of our body, says Bruce Andrus, MD, a member of the American College of Cardiologys Prevention Council and codirector of the Lipid Clinic at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.
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Tips For Preventing Heart Disease
Here are a few things you can do to lower your risk of developing heart disease:
- Watch your weight. Being overweight tends to make your LDL rise. It also puts added strain on your heart.
- Get active. Exercise can help control your weight and improve your blood cholesterol numbers.
- Eat right. Choose a diet high in vegetables, fruits, and whole grains. Nuts, seeds, and legumes are also heart-healthy foods. Opt for lean meats, skinless poultry, and fatty fish over red or processed meat. Dairy products should be low fat. Avoid trans fats altogether. Choose olive, canola, or safflower oils over margarine, lard, or solid shortening.
- Dont smoke. If you currently smoke, talk to your doctor about smoking cessation programs.
- Get an annual checkup, especially if you have a family history of heart disease. The sooner you discover you may be at risk, the sooner you can take action to help prevent heart disease.
Heart Disease In The Usa
The second interesting contradiction comes from a study done in the USA in 2006. During this time, the authors analysed 231,986 hospitalisations from heart attacks across 541 hospitals. Of all of these hospitalisations, cholesterol levels were recorded in 136,905 of the patients when they arrived at the hospital.
As you can see, this is a vast amount of data and not a small study with 50 to 100 people.
From the 136,905 people who had their cholesterol levels taken, their average LDL levels were 105 mg/dL.
What is interesting is when this number is compared to the average LDL levels across the whole population in the USA at the time, which was 126 mg/DL.
The data showed that 78% of people who were admitted to hospital after having a heart attack had an LDL level lower than the average in the USA.
If you were looking at this study in isolation, the conclusion would quite clearly be that people who have had a heart attack are more likely to have a low LDL cholesterol level.
Key points:
- A vast study demonstrated that 78% of people who were admitted to hospital after having a heart attack had an LDL level lower than the average in the USA.
- This contradicts the Cholesterol Hypothesis.
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Myth : A Small Heart Attack Is No Big Deal
“A small heart attack isn’t a big deal in terms of how well your heart can function. It may even pass unnoticed. But it’s a huge warning sign that you have serious heart disease, and your next heart attack may kill you,” says Dr. Lee.
What you can do: Minimize your risk of heart attack by keeping your weight, cholesterol, and blood pressure in a normal range, not smoking, and seeing your doctor regularly to make sure no risk factors are elevated.
Putting An End To Bad Cholesterol
Previously, treatment guidelines directed healthcare providers to focus on treating their patients to target goal levels for total cholesterol, LDL, HDL and triglycerides. However, current prevention guidelines suggest more is needed. Your specific numbers are still important, but the best treatment considers your specific numbers and your overall risk assessment and reduction opportunities. Working with your healthcare provider to customize the approach to treat your risk will achieve better results.
Your heart is in your hands. And heart disease is largely preventable if you work to lower your risks. So get on the horn and schedule an appointment with your healthcare provider to learn what numbers youre dealing with so you can lower them if you need to. Dont wait to discover it after a heart attack strikes Kimberlys story is proof of that.
Now fully recovered, Kimberly does cardio every day and has adjusted her diet to be low in cholesterol and sodium. Shes also working hard to pass these healthy habits onto those around her.
Women, in particular, need to be reminded to take care of our bodies an pay attention when something isnt right, she says. We tend to focus so much on how everyone around us is feeling that we forget about ourselves.
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Do I Need Treatment For High Cholesterol
including whether you are also diagnosed with cardiovascular disease.Ã Many health care providers recommend treating anyone with CVD with high-dose statin therapy. This includes those with coronary heart disease and who have had a stroke.
For those who do not have CVD, treatment is determined by your individual risk for developing heart disease. Ã That risk can be estimated using calculators which factor your age, sex, medical history, and other characteristics.Ã If your risk is high , your doctor may start you on treatment preventively. They generally keep in mind your preferences towards taking medication in general.Ã For those people whose risk is unclear, a coronary artery calcium score, which is a screening test looking for calcium in the arteries, can help determine the need for statins.
For both those who have CVD and those who do not, when the decision is made to start medication, the first choice is usually a statin.
Other special groups who may need treatment:
- People with high triglyceride levels may benefit if they have other risk factors
- People with diabetes: are at high risk, and a ldl under 100 is recommended for most
- Older adults: a healthy, active older adult may benefit from the reduction you need, and be prescribed a medication accordingly.
If I Eat Lots Of Cholesterol I Will Have High Cholesterol Levels
This topic is a little more complex than one might expect. The cholesterol one consumes does not necessarily directly correlate with cholesterol levels, Dr. Lajoie explained. Eating sugars, simple carbohydrates, can result in higher cholesterol levels, even if someone doesnt eat much cholesterol.
She also explained, People who exercise are less likely to see elevations in cholesterol from eating cholesterol compared with sedentary people.
According to Dr. Greenfield, if we consume more cholesterol, we will most likely increase cholesterol. He explained why:
You dont go to the store and buy a package of cholesterol, but you do buy red meat, cheeses, and eggs. Red meat contains saturated fat and cholesterol. Cholesterol is an animal product, so items that contain saturated fat will not only increase cholesterol but increase specifically the bad, or LDL, cholesterol, which then gets deposited in the arterial wall of our blood vessels.
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Are There Any Treatments For High Cholesterol Levels Caused By Genetics
Usually, the first line of treatment for high cholesterol is lifestyle modification, but if you have FH youll need more advanced treatment. Its always important to eat a low-fat diet, exercise and control your weight. Having a healthy lifestyle is crucial for heart health and for overall health, says Martin. However, people with FH could eat an extremely low-fat diet and still not be able to control their cholesterol because theyre genetically unable to handle it. For them, cholesterol is going to build up in the bloodstream regardless of what they eat.
Fortunately, there are medications that can substantially lower LDL cholesterol levels. The most common treatment for FH is statin drug therapy. Statin drugs work by blocking an enzyme that produces cholesterol in the liver and increases your bodys ability to remove cholesterol from the blood. They can lower your LDL cholesterol levels by 50 percent or more. Statins have been safely used to reduce the risk of heart disease for 30 years and continue to be the number one option when it comes to helping people with FH.
Other treatment options include medications that block cholesterol from being absorbed from your intestines into your bloodstream, or drugs that block an enzyme called PCSK9, which reduces the amount of LDL cholesterol in your blood.
What Are Early Signs Of Fh
When you have FH, early detection of high cholesterol levels is key to getting the treatment that can lower your risk of cardiovascular disease. In addition to family history of early cardiovascular problems, you may also notice lumps forming under your skin.
These fatty deposits are called xanthomas, and are particularly noticeable around tendons in the hands, knees, Achilles tendons and elbows, and under the skin around your eyes. Sometimes an ophthalmologist may spot signs of cholesterol deposits in your eyes as well.
Whether or not you have obvious signs of high cholesterol, you should get checked if heart disease runs in your family. Talk to your family doctor about your concerns a simple blood test is all it takes to see if your cholesterol levels are in the healthy range. A high cholesterol level at a young age is a particular red flag that you may have FH. If your doctor suspects you have the condition, you can undergo genetic testing to confirm the diagnosis.
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The Blood Clotting Hypothesis
Many diseases are simply the result of normal healthy processes going wrong. Blood clotting is a normal healthy process. If our bodies werent able to form blood clots then we would bleed to death anytime we cut ourselves. This theory proposes that heart disease is a disease where the normal, healthy process of blood clotting goes wrong.
A small amount of damage to the blood vessel endothelium isnt a big problem. When this happens, a blood clot will form, be shaved down in size, and then a new layer of endothelium grows on top. This means the blood clot gets incorporated into the artery wall.
Interestingly, when you look at atherosclerotic plaques, they contain many similar components to a blood clot. By this theory, theyre the same thing.
When the blood clot is being shaved down in size, it triggers repair systems that increase inflammation. As we said earlier, inflammation is the bodies natural immune response to any injury. This explains why individuals with heart disease seem to have higher levels of inflammation in the body.
So up until this point, everything is a normal healthy process. Where does it go wrong? The blood clotting theory suggests that problems occur when the rate of endothelium damage is higher than the rate of repair.
- An increased rate of endothelium layer damage occurs
- Larger, harder to remove blood clots form
- The body has a reduced ability to repair/remove these blood clots
- Atherosclerosis develops over time
1) Endothelium damage
| Tocopherol |
How Does High Cholesterol Cause Heart Disease
When there is too much cholesterol in your blood, it builds up in the walls of your arteries, causing a process called atherosclerosis, a form of heart disease. The arteries become narrowed and blood flow to the heart muscle is slowed down or blocked. The blood carries oxygen to the heart, and if not enough blood and oxygen reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.
There are two forms of cholesterol that many people are familiar with: Low-density lipoprotein and high-density lipoprotein These are the forms in which cholesterol travels in the blood.
LDL is the main source of artery-clogging plaque. HDL actually works to clear cholesterol from the blood.
Triglycerides are another fat in our bloodstream. Research is now showing that high levels of triglycerides may also be linked to heart disease.
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Family History And Cardiovascular Disease Risk
A personâs family history of disease can increase their tendency to develop:
- Diabetes.
- A particular body shape.
Although having a family history of CVD is a risk factor you canât change, it does not mean that you will develop it. However, if you do have a family history of CVD, it is important to reduce or remove other risk factors. For example, adopting healthy eating patterns, do not smoke, and lead an active, healthy lifestyle.
Cholesterol And Heart Disease In Women
Are you diligent about getting your cholesterol checked? Many women arent, and its because they think they dont have to.
Take Kimberly Montgomery, for example. She was always a glass half full kind of woman, and her refusal to see things negatively placed her at a huge advantage until it almost cost her her life.
Kimberly suffered a heart attack. She hadnt been paying attention to her cholesterol numbers despite her family history of heart disease. I just never considered that I could get heart disease, she says. I saw my doctor regularly and had great results at my company wellness screenings each year.
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What Numbers Should I Look For
Some recommend that everyone over age 20 should get their cholesterol levels measured at least once every 5 years. The test that is performed is a blood test called a lipoprotein profile. That includes:
- Total cholesterol level
What Affects Cholesterol Levels?
A variety of factors can affect your cholesterol levels. They include:
Triglycerides And Your Heart
Triglycerides are the form in which fat is stored in your bodys fat cells. Your triglyceride level is almost always strongly influenced by lifestyle. If you have high triglycerides and low HDL , your risk of heart disease is compounded. To find out if you have this added risk, divide your triglyceride count by your HDL count. Ideally, the resulting number will be 2 or lower. For example, if your triglyceride level is 200 and your HDL is 40, divide 200 by 40 and you get 5. This is much higher than the desirable ratio, and it tells you that you have a heightened risk of a heart attack that will need to be addressed.
Your triglyceride level can also offer insight into your LDL particle size. In general, the higher your triglycerides and the lower your HDL, the smaller and denser your LDL and the greater your risk of heart disease. If your triglycerides are higher than 200 and your HDL is lower than 45, it is likely that you have too many small, dense LDL particles.
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