Is There More To A Healthy
Low-density lipoprotein, or bad cholesterol, is an accepted cause of heart disease.Credit: Juan Gaertner/SPL
Shortly after the end of the Second World War, large numbers of wealthy businessmen in the United States began dying from heart attacks. Shocked by the obituaries mounting up in his local newspaper, physiologist Ancel Keys decided to investigate. His findings would fundamentally change the way we eat for decades to come.
Keys couldnt understand why high-powered US executives, with access to plentiful food, had much higher rates of coronary heart disease than did people in post-war Europe, where food shortages were common. Then it dawned on him: could there be a correlation between fat in the diet and heart disease? Keys presented his dietheart hypothesis with gusto at a World Health Organization meeting in 1955. Six years later, his face appeared on the cover of Time magazine, in which he urged readers to shun fatty foods such as dairy products and red meat.
Landmark studies such as these laid the groundwork for the introduction of dietary guidelines in the United States and the United Kingdom during the 1970s and 1980s. The recommendations advised citizens to reduce their consumption of saturated fat to about 10% of their total energy intake, to lower cholesterol in the blood and therefore decrease the chances of a heart attack. In the public consciousness, a low-fat diet has been synonymous with good health ever since.
What Are The Different Types Of Cholesterol
There are two main categories of cholesterol in the blood:
Low-density lipoprotein : Considered cholesterol’s “bad” form, LDL enables cholesterol to create deposits that build up and harden on the walls of blood vessels a condition called atherosclerosis .
When this happens in the coronary arteries , it reduces your heart’s supply of oxygen-rich blood. This serious condition, called coronary artery disease, can cause heart attacks and even death.
Plaques can also form on the arteries that supply blood to your brain, abdomen, arms, and legs, leading to a higher risk of stroke, intestinal damage, and peripheral arterial disease.
High-density lipoprotein : HDL is the “good” kind of cholesterol, because it helps reduce LDL levels.
The role of HDL is to transport LDL cholesterol to your liver, which removes it from your blood.
What Really Causes Heart Disease
This is what most people get wrong. Its easy to blame one biomarker for a heart disease epidemic.
So far, we spoke about low cholesterol, oxidized cholesterol, and nutrient deficiencies as a possible cause of heart disease.
But its not one of those things. Its a combination of life-long factors that leads to heart disease. Factors like
- Consuming High-Fructose corn syrup
- And much more.
Instead of blaming cholesterol for our problems, lets get rid of our bad habits and build some good habits. Good habits like eating less processed foods, eating more nutrient-dense foods, and cooking with grass-fed butter or coconut oil.
Do you have any questions? Let me know in the comments below.
We hope you enjoyed our article on Is High Cholesterol and Heart Disease Myth or Truth? If you feel that it helped you or passed some knowledge, feel free to share it and pass this life-saving knowledge to your friends and family. Were sure they will appreciate it.
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The Relationship Between High Cholesterol And High Blood Pressure
High blood pressure and high cholesterol both damage the inner lining of blood vessels, known as the endothelium.
Over time, endothelial damage contributes to the buildup of cholesterol plaques and inflammatory cells in the blood vessels throughout the body, known as atherosclerosis.
Endothelial damage also results in improper regulation of blood vessel dilation. The result is stiffened, narrowed arteries that do not respond the way they should.
How Is High Cholesterol Treated
The main goals in treating high cholesterol are to lower your LDL levels and lower your risk of cardiovascular disease. To lower cholesterol, eat a heart-healthy diet, exercise regularly, and maintain a healthy weight. Some may also need to take cholesterol-lowering drugs.
Doctors determine your “goals” for lowering LDL based on the number of risk factors you have for heart disease.Ã Based on your risk, your doctor will determine the intensity of LDL reduction you need, and prescribe a medication accordingly.
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Does High Cholesterol Cause Heart Disease
Jump to: Why does it matter?What is heart disease?The Cholesterol HypothesisWhere do the cracks begin to show?Alternative hypothesesThe bigger pictureTake home message
In our guide on saturated fat and heart disease we introduced the three steps that lead to the cholesterol theory of heart disease:
1) Saturated fat in the diet increases the amount of bad cholesterol in the blood2) Higher levels of bad cholesterol clog the arteries and lead to heart disease.
Therefore:
3) Saturated fat increases the risk of heart disease.
We discussed how the evidence supporting this third claim seemed very weak. In this guide well be looking at the second claim: Do higher blood cholesterol levels cause heart disease?
Cholesterol Myths And Facts
Cholesterol can be confusing! Learn answers to common questions about blood cholesterol.
What do your cholesterol numbers mean? Can the foods you eat change your cholesterol levels?
Learn the difference between cholesterol myth and fact. Then commit to getting your cholesterol checked this year so you know your numbers and your risk for heart disease and stroke.
Commit to getting your cholesterol checked this year so you know your numbers and your risk for heart disease and stroke.
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The Truth About Cholesterol And Heart Disease
The sheer amount of of information about the relationship between cholesterol and risk of heart disease can be overwhelming and sometimes confusing. Here is a basic look at some of the key points you should know.
Cholesterol Is Important
Cholesterol is a waxy substance in your blood that performs essential functions in your body. It helps make the outer coating of cells, makes up the bile acids that work to digest food, and allows the body to make Vitamin D and certain hormones. It is so important that the body actually makes its own cholesterol. There are two types of cholesterol low-density lipoproteins and high-density lipoproteins . LDL is often referred to as the bad cholesterol that can clog blood vessels, while HDL is the good cholesterol that may lower your risk of heart disease. LDL is truly only bad when there is too much of it in your blood.
The Relationship Between High Cholesterol and Heart Disease
When there is too much cholesterol in your blood, it builds up in the walls of your arteries. Over time, this buildup narrows the arteries and restricts blood flow to the heart. When the blood supply to a portion of the heart is completely cut off a heart attack results.
Factors that Affect Your Cholesterol Levels
Many factors can affect your cholesterol level. Some of them you can control and others you cant:
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Is High Cholesterol Considered A Cause Of Heart Disease
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Cholesterol Chart For Adults
According to the 2018 guidelines on the management of blood cholesterol published in the Journal of the American College of Cardiology , these are the acceptable, borderline, and high measurements for adults.
All values are in mg/dL and are based on fasting measurements.
| Total cholesterol |
|---|
Your doctor may recommend a plan of treatment for high cholesterol that includes lifestyle modifications and potentially medication. This will vary based on factors like other medications you may be taking, your age, sex, and general health.
Here are some medications more commonly prescribed for high cholesterol:
Medications can also be used to treat contributing factors to cholesterol like triglycerides. These may be used in addition to some of the medications above.
New Guidelines Help You And Your Doctor Address High Cholesterol Effectively
As of 2019, your health care provider has new guidelines for assessing your cardiovascular disease risk based on your LDL cholesterol levels, along with new recommendations for getting those readings down. You and your clinician can tailor an approach that fits your individual needs, combining lifestyle changes, medications and regular follow-ups.
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Myth : Heart Disease Is Really A Man’s Problem
Since 1984, more women than men have died each year from heart disease. Heart disease is the leading cause of death in women over age 65, just as it’s the leading killer of men.
What you can do: Whether you are a man or a woman, ask your doctor to conduct a baseline heart examination that includes checking your cholesterol and blood pressure. Then follow your doctor’s recommendations.
Myth : Diabetes Won’t Cause Heart Disease If You Take Diabetes Medication
Diabetes medication helps lower blood sugar levels. Maintaining normal blood sugar levels is important for preventing complications that affect the smaller blood vessels , such as kidney disease, loss of vision, erectile dysfunction, and nerve damage.
But blood sugar control has less effect on the large blood vessels that become inflamed and diseased, increasing the risk of heart attack and stroke. “These vessels benefit more from lowering cholesterol and blood pressure,” says Dr. Alan Malabanan, a diabetes specialist at Harvard-affiliated Brigham and Women’s Hospital.
What you can do: Take your diabetes medication to prevent microvascular complications. Also do everything you can to lower high cholesterol and high blood pressure, stop smoking and drop extra weight. These measures will reduce your risk of heart disease and stroke.
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Myth: I Dont Need Statins Or Other Medicines For My Cholesterol I Can Manage My Cholesterol With Diet And Exercise
Fact: Although many people can achieve good cholesterol levels by making healthy food choices and getting enough physical activity, some people may also need medicines called statins to lower their cholesterol levels. Guidelinesexternal icon also suggest that other medicines in addition to statins may be needed to help control cholesterol.2
People who may need statins or other medicines to manage cholesterol levels include the following:
- People with familial hypercholesterolemia or people with very high levels of bad cholesterol. FH is a genetic condition that causes very high LDL cholesterol levels beginning at a young age. If left untreated, cholesterol levels will continue to get worse. This greatly raises the risk for heart disease, heart attack, and stroke at a young age.
- People with cardiovascular disease . People with CVD may already have narrowed arteries because of too much plaque. Medicines that lower cholesterol may help reduce the risk for heart attack or stroke.
- People with diabetes.Type 2 diabetes lowers HDL or good cholesterol levels and raises bad cholesterol levels. This combination raises your risk of heart disease and stroke.
Other groups of people may also need medicines to manage their cholesterol, including people who have a high risk for CVD. Always talk to your health care provider about the best ways to manage your cholesterol.
Box 2 Recommendations Of The Us Preventative Services Task Force 2008
-
Screen men aged 35 and older
-
Screen men aged 20 to 35 if they are at increased risk for coronary heart disease
-
Screen women aged 45 and older if they are at increased risk for coronary heart disease.
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Screen women aged 20 to 45 if they are at increased risk for coronary heart disease.
-
No recommendation for or against routine screening men aged 20 to 35, or in women aged 20 and older who are not at increased risk for coronary heart disease.
*Increased risk for CVD is defined by risk factors. These include men with diabetes, a family history of heart disease in a close male relative younger than age 50 or a close female relative younger than age 60, a family history of high cholesterol, or a personal history of multiple coronary disease risk factors .
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Cholesterol And Peripheral Vascular Disease
In addition to your heart and your brain, cholesterol plaque can cause symptoms in your legs and other areas outside of your heart and brain . Legs and feet are most common. You might notice cramps in your calves when you walk that get better with rest. This is like angina — it works the same way — but in your legs instead of your heart.
Cholesterol And Erectile Dysfunction
Erectile dysfunction is when a man canât achieve or maintain an erection during sex. Over the long term, high cholesterol seems to trigger a narrowing of the smaller blood vessels of the penis when they should be stretching to allow more blood for an erection . In addition, when you have too much LDL cholesterol, it can build up in arteries and then join with other substances to form plaque that hardens and narrows further blood vessels . The result can be less blood flow to both the heart and the penis, which can lead to erectile dysfunction.
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S To Lower Cholesterol And Risks Of Related Diseases
A few simple changes can lower your cholesterol and cut your risk for conditions linked to high cholesterol.
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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What Can Happen If Your Arteries Become Clogged Up
If your arteries become clogged up with blood fats, your blood can’t flow around your body easily. This can lead to a number of diseases of the heart and blood vessels.
These diseases are known together as cardiovascular disease cardio refers to the heart, and vascular refers to the blood vessels.
-
Coronary heart disease
This is where the arteries have become clogged up and stiff with atherosclerosis. The blood cant flow around the body and back to the heart easily, and blood clots can form. This can lead to chest pain, heart failure, heart attacks and strokes.
-
Angina
This is a dull, heavy or tight pain in the chest which can spread to the left arm, neck, jaw or back. It happens when the arteries leading to the heart have become narrowed and the heart doesnt get enough oxygen. The pain can be brought on by exercise or activity, as the heart needs more oxygen during physical activity.
-
A heart attack
This is a medical emergency. It happens when an artery leading to the heart becomes completely blocked, often by a blood clot, cutting off the blood supply. Part of the heart muscle quickly dies, but if its treated very early the blockage can be removed.If you think you or someone you are with is having a heart attack, call 999 straight away. The signs of a heart attack include:
- a crushing pain in the chest
- sweating
- feeling weak or faint
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