What Is The Hdl Hypothesis
The observation that elevated high-density lipoprotein cholesterol levels reduce the risk of coronary heart disease. Historically, the first hint of the validity of this HDL hypothesis was the finding of the Helsinki Heart Study that a 10% increase in HDL cholesterol levels induced by gemfibrozil accounted for the 15% larger reduction in CAD mortality compared with the first Lipid Research Clinic Coronary Primary Prevention Trial that used cholestyramine, a bile acid sequestrant resin. Both cholestyramine and gemfibrozil reduce low-density lipoprotein cholesterol modestly by 10% but only gemfibrozil raises HDL cholesterol levels by as much as approximately 10%. More recent clinical trials have further supported an independent role of HDL in mediating coronary heart disease risk.
Frick MH, Elo O, Haapa K, et al: Helsinki Heart Study: Primary prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease, N Engl J Med 371:12371245, 1987.
What To Do When Your Total Cholesterol Is High But Your Ldl And Hdl Levels Are Within The Normal Range
Cholesterol is a waxy, fatty substance normally found in the blood. It can be produced naturally by the body via the liver it can also be consumed from the diet.
Cholesterol is found in every cell in the body and is essential for the formation of cell membranes, certain hormones as well as vitamin D.
Cholesterol is insoluble in water, and since a greater percentage of blood is water, it cannot be ordinarily carried in the blood. The body uses specialized proteins produced in the liver, called lipoproteins to transport cholesterol in the blood.
These proteins may be grouped into two: High-density lipoprotein and Low-density Lipoprotein. They are both codified as HDL and LDL.
HDL helps to carry excess cholesterol deposits from the blood to the liver where they are removed from the body. It has a protective function. Cholesterol which is carried by HDL is often called good cholesterol. High HDL levels in the blood reduce the risk for heart diseases and stroke.
LDL carries most of the bodys cholesterol, and deposit them in arterial walls, and this may cause a build-up which will lead to the development of plaques. Plaques block the arteries and may lead to heart attacks or strokes. The cholesterol carried by LDL is often called bad cholesterol. Therefore, high LDL levels in the blood may lead to an increased risk for cardiovascular diseases.
How Can I Keep Healthy Blood Cholesterol Levels
Talk to your doctor about your numbers. Your risk of disease depends on other factors, too, in combination with high cholesterol. To keep your cholesterol managed, you should do the following:
- Choose healthy foods. Limit foods that are high in saturated or trans fats, sugar, and sodium . Choose foods high in fiber, such as fresh fruits and veggies, and in unsaturated fats, such as avocados and nuts. Learn more about healthy eatingexternal icon.
- Stay physically active. You should get at least 2 hours and 30 minutes of moderate exercise, such as biking or brisk walking, every week.6Learn more about physical activityexternal icon.
- Dont smoke. Smoking damages the blood vessels and greatly increases the risk for heart disease and stroke. If you dont smoke, dont start. If you smoke, learn how to quit.
- Take medicine if necessary. A healthy diet and physical activity can help many people reach healthy cholesterol levels, but some people may need medicines to lower their cholesterol. Always take your medicine as prescribed.
Learn more about ways to prevent high cholesterol.
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How And When To Have Your Cholesterol Checked
Getting your cholesterol levels checked is an important part of staying healthy. High cholesterol increases your risk for heart disease and stroke, two leading causes of death in the United States.
Knowing your cholesterol status can help you stay in control of your health. Learn about cholesterol screening and why it is important.
Cholesterol is a waxy substance that your body needs to make hormones and digest fats. Your body makes all the cholesterol it needs, but you can also get cholesterol from eating certain foods, such as egg yolks and fatty meats. Having high blood cholesterol can lead to plaque buildup in the arteries, putting you at risk for heart disease and stroke. High blood cholesterol doesnt have symptoms, which is why getting your cholesterol levels checked is so important.
Learn more about cholesterol screenings.
You should get your cholesterol checked at least every 5 years. If you have cardiovascular risk factors, talk with your health care team about getting tested more often.
Acute Or Chronic Severe Inflammatory Disease
Low HDL cholesterol level has numerous causes including androgens, progestins, cigarette smoking, obesity, a low-fat diet, and drugs such as -blockers, isotretinoin, PIs, and sirolimus. Yet some may consider the most frequent cause of a low level of HDL cholesterol in hospitalized patients as an acute or chronic severe inflammatory disease with a marked acute-phase reaction. Together with albumin and transferrin, HDL cholesterol level declines and returns to reference within days after the end of the acute-phase reaction. This was confirmed in a study of high-school-aged children at boarding school with standardized activity and food service where a decline in HDL cholesterol level was seen after an acute illness when contrasted with values when the children were healthy.7477
Sotirios Tsimikas, Vincent Mooser, in, 2004
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How To Raise Your Hdl Cholesterol
Avoid a diet high in saturated and trans fats. According to the American Heart Association , a diet high in saturated fats which are found in animal products, including full-fat dairy, as well as many processed foods can raise your LDL and total cholesterol.
Trans fats sometimes found in fast food and many commercially baked breads, cookies, cakes, chips, crackers, and snack foods can also lower your HDL cholesterol.
Instead, the AHA recommends a diet rich in fruits, vegetables, poultry, fish, nuts, and nontropical vegetable oils.
Get regular exercise.
Exercise has two effects on cholesterol: It raises levels of your body’s HDL cholesterol, and it also increases the size of LDL particles, which makes them less likely to form plaque on coronary artery walls.
Keep blood sugar levels in check. For people with diabetes or prediabetes, its important to monitor your blood sugar, too. High blood sugar levels can raise LDL cholesterol as well as lower HDL cholesterol and weaken the lining of arteries.
Quit tobacco. Although the habit can be hard to kick, quitting tobacco use can help prevent high cholesterol. If you dont smoke, dont start.
Tobacco smoke causes damage to the walls of your blood vessels, making it easier for plaque to build up in them. Smoking also lowers HDL cholesterol levels.
Medical Definition Of Hdl Cholesterol
- Medical Editor: Charles Patrick Davis, MD, PhD
Reviewed on 3/29/2021
HDL cholesterol: High density lipoprotein cholesterol. Lipoproteins, which are combinations of fats and proteins, are the form in which lipids are transported in the blood. HDLs transport cholesterol from the tissues of the body to the liver, so the cholesterol can be eliminated in the bile. HDL cholesterol is therefore considered the ‘good’ cholesterol: The higher the HDL cholesterol level, the lower the risk of coronary artery disease.The average man has an HDL cholesterol level of 40 to 50 mg/dL. In the average woman, HDL levels range from 50 to 60 mg/dL. An HDL cholesterol of 60 mg/dL or higher gives some protection against heart disease. Regular aerobic exercise, loss of excess weight , and cessation of cigarette smoking increase HDL cholesterol levels. When lifestyle modifications are insufficient, medications can be used.
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High Total Cholesterol Normal Ldl Cholesterol Normal Hdl Cholesterol Very High Triglycerides
Even though triglycerides only contribute a small fraction to the total cholesterol value, very high levels can drastically skew this value and are very dangerous. High levels of triglycerides, especially without high levels of HDL or LDL, may indicate issues in the liver, where triglycerides are made. Testing your liver enzymes can help you identify whether there is in fact a problem levels of these enzymes would be high if this were the case. Elevated triglycerides can be damaging to your cardiovascular system, but can also lead to acute pancreatitis , which requires immediate medical attention.3
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Are Test Results Accurate
HDL cholesterol testing is extremely common and frequently used to evaluate cardiovascular risk. Like any test, though, HDL cholesterol tests are not perfectly accurate. Certain factors that can influence accuracy of any single test include:
- Individual variability: There can be some differences in HDL cholesterol levels based on individual factors like stress or posture during the test. Minor variation can also occur between laboratories.
- Acute illness: Levels of cholesterol in the blood are affected by inflammation, so infections or other illnesses that produce inflammation may interfere with the accuracy of HDL cholesterol tests.
- Certain blood disorders: Some conditions that affect blood cells cause an increase in a type of protein, known as an M protein, in the blood. In people with these conditions, HDL cholesterol tests may show a lower level of HDL cholesterol than is actually present in their blood.
Point-of-care and at-home tests that use a fingerstick blood sample are nearly as accurate as laboratory testing, but there may be more variability in accuracy based on the brand and the quality of its test.
Good or Bad? Check your HDL Cholesterol level:
HDL cholesterol level 40-59 mg/dl is consideredborderline cholesterol. This means that it is below the normal range, but not enough to be classified as low.
This can bedue to a number of conditions, such as eating a poor diet, sedentary life,stressful life, genetics, having diabetes mellitus, smoking etc.
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Normal: < 120 And< 80 Mmhg
When your heart beats, it pumps blood through blood vessels called arteries and creates pressure in them. The higher number represents the pressure while your heart is beating. The lower number represents the pressure when your heart is resting between beats. Your blood pressure can change from minute to minute when you change your position or during physical activities, or when you are stressed or sleeping. High blood pressure can damage the walls of your arteries. If your first reading is high, your doctor may take several more readings before deciding whether your blood pressure may be a health concern.
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Start An Exercise Program To Raise Hdl Cholesterol
Regular exercise is an important part of a healthy lifestyle and can also increase HDL cholesterol levels. Aerobic exercises, such as running, biking, and swimming, along with moderate weight training are good choices to help best boost those good cholesterol levels.
For women after menopause, a study published in August 2016 in the journal Diabetes & Metabolism found that high intensity interval training led to better HDL cholesterol levels as well as significant weight loss. And a study published in May 2016 in the journal Applied Physiology, Nutrition, and Metabolism found that obese men who engaged in aerobic interval training or resistance training just three days a week for 12 weeks had significantly increased HDL cholesterol when compared with obese men who did no training.
Exercise is excellent because it may independently raise your HDL, but also leads to weight loss, which may account for additional gains in your HDL, says Haitham Ahmed, MD, MPH, a preventive cardiologist at the Cleveland Clinic in Ohio.
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What To Know About Triglycerides
In addition to cholesterol, you might hear about your triglycerides, another kind of fat found in the bloodstream. Women should pay particular attention to this. A high level of triglycerides seems to predict an even greater risk for heart disease in women compared with men, says Michos.
When you take in more calories than you need, your body converts the extra calories into triglycerides, which are then stored in fat cells. Triglycerides are used by the body for energy, but people with excess triglycerides have higher risk of medical problems, including cardiovascular disease. Drinking a lot of alcohol and eating foods containing simple carbohydrates , saturated fats and trans fats contributes to high triglycerides. High levels may also be caused by health conditions such as diabetes, an underactive thyroid, obesity, polycystic ovary syndrome or kidney disease.
Triglycerides also circulate in the bloodstream on particles that may contribute to plaque formation. Many people with high triglycerides have other risk factors for atherosclerosis, including high LDL levels or low HDL levels, or abnormal blood sugar levels. Genetic studies have also shown some association between triglycerides and cardiovascular disease.
High Cholesterol: Prevention, Treatment and Research
Living With High Cholesterol
If you have high cholesterol, you are twice as likely to develop heart disease. That is why it is important to have your cholesterol levels checked, especially if you have a family history of heart disease. Reducing your LDL bad cholesterol through good diet, exercise, and medicine can make a positive impact on your overall health.
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What Does The Test Measure
An HDL cholesterol test analyzes a sample of blood to see how much cholesterol is present within high-density lipoprotein particles. Cholesterol is a waxy substance that is important for basic cell function. Cholesterol is transported through the body in the blood within lipoproteins, which are made up of fat and protein.
There are multiple kinds of lipoproteins that can carry cholesterol including high-density lipoproteins, low-density lipoproteins , and very low-density lipoproteins .
Cholesterol in LDL and VLDL particles can build up in the arteries and cause cardiovascular problems. In contrast, HDL particles transport cholesterol to the liver so that it can be eliminated from the body. Through this and other functions, HDL cholesterol helps protect against hardening and blockages of the arteries.
In practice, virtually all HDL cholesterol tests also measure total cholesterol, which is the sum of cholesterol found in all the different kinds of lipoproteins. By subtracting HDL cholesterol from total cholesterol, the doctor can determine the amount of non-HDL cholesterol that is present. In addition, tests like a lipid panel use a mathematical formula to calculate the amount of LDL cholesterol in your blood sample.
Find Out Your Heart Age With The Heart Age Tool
Once you have your cholesterol results you can work out your risk of developing heart disease over the next 10 years using the NHS Heart Age Tool. You will get a more accurate result if you know your blood pressure numbers too. The heart age tool is designed for people aged 25 to 84.
Adults age 40-74 are also invited for NHS Health Checks which includes other simple tests to look at your heart health.
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Goals For Your Cholesterol Levels
Its best to keep your total cholesterol level below 200. Women of any age should have an HDL level of 40 or higher.
If you already have heart disease or diabetes, or your doctor estimates that your 10-year risk of heart disease is 20 percent or higher, try to keep your LDL level below 100.
If you do not have heart disease or diabetes, but you have two major risk factors, try to keep your LDL cholesterol level below 130. Major risk factors are age over 55 cigarette smoking high blood pressure low HDL a father or brother with heart disease before age 55, or a mother or sister with heart disease before age 65.
If you have fewer than two major risk factors, try to keep your LDL level below 160.
What Kind Of Test Measures Cholesterol
Everyone over the age of 20 should get their cholesterol levels measured at least once every five years. Your healthcare provider will order a blood test that will indicate how much cholesterol is carried in your bloodstream. This test will give your cholesterol levels. Your provider might also order what is called a lipid panel or a lipid profile. The panel gives you the following numbers:
- Total cholesterol.
- Non-HDL cholesterol.
- Ratio between cholesterol and HDL.
There are advanced tests that break down the size and shapes of LDL cholesterol levels, and also give the LDL particle number, but those are not normally ordered. Some test makers say that the more advanced tests are better at indicating who is at risk for heart disease, but most providers still feel that the usual tests are adequate.
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Whats Your Cholesterol Level Anyway
A standard lipid blood test usually measures the concentration of total cholesterol, HDL cholesterol, and triglycerides levels. The LDL-cholesterol level is typically estimated from these numbers using a well-established formula that has been more recently revised and improved by researchers at Johns Hopkins.
So what are your target numbers? According to Michos, an ideal LDL cholesterol level should be less than 70 mg/dl, and a womans HDL cholesterol level ideally should be close to 50 mg/dl. Triglycerides should be less than 150 mg/dl. As Michos notes, total cholesterol levels well below 200 mg/dl are best.
What Is A Normal Range For Non
The higher your non-HDL cholesterol, the higher your risk of heart disease.
A study published in 2018 involved more than 36,000 people with a low 10-year risk of cardiovascular disease. A long-term follow-up found LDL and non-HDL readings of more than 160 mg/dL were each linked with a 50 to 80 percent increased relative risk of cardiovascular disease mortality.
For other cholesterol readings, the following guidelines apply if you dont have heart or blood vessel disease.
Your LDL cholesterol reading is:
- optimal if less than 100 mg/dL
- above optimal/borderline high if between 100 and 129 mg/dL
- mildly high if 130 to 159 mg/dL
- high at 160 to 189 mg/dL
- very high at 190 mg/dL or above
Your HDL cholesterol reading is:
- optimal if its 60 mg/dL or above
- low if its 40 mg/dL or lower
Your triglyceride reading is:
- optimal if less than 100 mg/dL
- borderline high at 100 to 149 mg/dL
- high if 150 to 499 mg/dL
- very high if higher than 500 mg/dL
Your doctor may have different goals for you if youre at high risk of heart disease or have already had heart disease.
- have kidney disease
Studies are beginning to highlight the importance of non-HDL in assessing cardiovascular risk.
For example, in a 2016 study, researchers looked at data from nine clinical trials involving people with coronary disease. They found that achieved non-HDL cholesterol was more strongly associated with disease progression than LDL.
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