An Article From The E
Prof. Salvatore Novo ,FESC
Results from our study on 150 patients together with findings from Framingham Heart and TNT suggest a possible synergistic role of low HDL-C and inflammation on the atherosclerotic disease progression from subclinical lesions to clinical events. It is possible to assert that the presence of subclinical carotid atherosclerosis together with low HDL-cholesterol concentrations points to a category of subjects at high CV risk.
How Can You Boost Your Hdl Cholesterol Levels
There are lifestyle changes you can make to increase your levels of HDL cholesterol, including:
- Physical activity. The American Heart Association recommends a weekly minimum of 40 minutes of moderate intensity aerobic exercise 3 to 4 times weekly.
- Diet. Avoid trans fats and limit saturated fats .
- Smoking. Try to stop smoking .
- Drinking. Avoid or limit alcoholic beverages .
According to the Mayo Clinic, although there are no drugs to increase HDL levels, there are drugs to lower LDL and triglyceride levels, including:
How Is An Hdl Cholesterol Test Different From A Lipid Panel
A lipid panel always includes a measurement of HDL cholesterol, but HDL cholesterol levels can be tested without doing a full lipid panel.
A standard lipid panel measures total cholesterol, HDL cholesterol, and triglycerides. It then uses those measurements to calculate the amount of LDL cholesterol.
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The American Heart Association Recommends
All adults age 20 or older should have their cholesterol checked every four to six years. If certain factors put you at high risk, or if you already have heart disease, your doctor may ask you to check it more often. Work with your doctor to determine your risk for cardiovascular disease and stroke and create a plan to reduce your risk.
How Long Does It Take For Consumed Foods To Help Lower Bad Cholesterol
A 2015 study from Penn State University found that obese or overweight people had a 50% drop in LDL levels after following an avocado-rich, low-fat diet for five weeks. An earlier study from Mexico reported that a similar diet in healthy people with mild hypercholesterolemia reduced total cholesterol by 17% and “bad” LDL cholesterol by 22% after only seven days.
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B Means For Lowering High Ldl
Statins are the preferred first-line pharmacological agents for their long, well-regarded history of efficacy and safety. Recent evidence indicate that lipid lowering strategies should be implemented at an early age, particularly in populations at high risk for CVD. Several agents have been evaluated in children, nevertheless as it is the case in adults, statins are the preferred drugs in paediatric practice. However, it is appropriate to raise a note of caution because this kind of therapy, initiated in childhood, needs to be studied in order to confirm its lifelong benefit .
Earlier scientific evidence on the effectiveness of statins has come from the WOSCOPS and from 4S .
- WOSCOPS was a trial of primary prevention conducted with pravastatin on 6595 subjects with hypercholesterolemia but with no past history of CAD.
- 4S was a trial of secondary prevention analysing the effects of simvastatin on 4444 patients with chronic ischemic heart disease and hypercholesterolemia .
Both studies showed a significant reduction not only in the LDL-C plasma levels , but also in the relative risk of fatal and non-fatal myocardial infarction .
What Does Hdl Cholesterol Do
HDL clears from the body via the liver. HDL may therefore prevent the buildup of plaque, protect your arteries, and protect you from atherosclerotic cardiovascular disease. It is considered the good cholesterol, and higher levels are better. A good goal to aim for is higher than 55 mg/dL for women and 45 mg/dL for men. The higher your HDL cholesterol numbers, the lower your risk is for heart disease, vascular disease, and stroke.
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Measuring Hdl Concentration And Sizes
As technology has reduced costs and clinical trials have continued to demonstrate the importance of HDL, methods for directly measuring HDL concentrations and size at lower costs have become more widely available and increasingly regarded as important for assessing individual risk for progressive arterial disease and treatment methods.
What Causes Low Hdl Cholesterol
Lower levels of HDL cholesterol can have an underlying cause such as a health problem or certain medications. If you have low HDL cholesterol, your doctor can try to find out the cause so that they can treat it and bring your HDL up to a healthy level. Below are some of the possible causes.
Smoking can lower your HDL levels because a chemical in cigarette smoke called acrolein appears to change the way HDL works in the body. It does this by changing the structure of a protein called Apolipoprotein A1, which forms part of HDL cholesterol.
This might speed up the process of atherosclerosis because HDL is less able to remove cholesterol from the artery walls.
If you have too much fat stored in your body, particularly around your waistline, the hormone insulin is less able to control your blood sugar. This is known as insulin resistance.
Insulin resistance can lead to type 2 diabetes and its one of the problems that makes up the metabolic syndrome, which raises the risk of heart attacks and strokes.
Insulin resistance also leads to characteristic changes in the pattern of fats often referred to as dyslipidaemia. Typically, this means:
- high triglycerides
- low HDL cholesterol
- normal or slightly raised LDL cholesterol. The LDL cholesterol also tend to be smaller and more harmful to the arteries.
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High Triglycerides With Low Hdl There Is Medical Treatment Available
While making positive and important lifestyle changes are definitely the best way to improve your HDL level, there are medications available that could help. Most of the prescribed medications for high cholesterol also work to reduce LDL cholesterol levels. However, some of these medications can also improve your HDL level. The 2 most used to treat low levels of HDL cholesterol include niacin and fibrates
- Niacin this is a member of the B vitamin family. It is known to boost low levels of HDL cholesterol if it is taken in prescription strength. The typically used niacin name includes Niaspin.
- Fibrates or fibrate acid derivatives these medications are effective in lowering triglyceride levels and lower LDL cholesterol. However, they are also used to treat people who have high triglycerides, as well as low HDL cholesterol levels in people who cannot take niacin. These are medications such as gemfibrozil and fenofibrate .
Baseline Data Comparisons Between Depressed And Non
In this cross-sectional study of patients with T1D , 30 depressed patients were compared to 262 non-depressed patients, and 23 users of antidepressants were compared to 269 non-users .
Table 1 Baseline characteristics for 292 T1D patients, comparisons between depressed and non-depressed, antidepressant users and non-users
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Overweight And Diet For Low Hdl
Being overweight or obesity is also a cause of low HDL cholesterol. Quite often, a person who is obese lives a sedentary lifestyle or is physically inactive. This too can cause the low level HDL cholesterol. Moreover, another typical cause of obesity is a diet that is low in fruit and vegetables, and one that is high in sugary, processed and fatty foods.
Estimating Hdl Via Associated Cholesterol
Clinical laboratories formerly measured HDL cholesterol by separating other lipoprotein fractions using either ultracentrifugation or chemical precipitation with divalent ions such as Mg2+, then coupling the products of a cholesterol oxidase reaction to an indicator reaction. The reference method still uses a combination of these techniques. Most laboratories now use automated homogeneous analytical methods in which lipoproteins containing apo B are blocked using antibodies to apo B, then a colorimetric enzyme reaction measures cholesterol in the non-blocked HDL particles.HPLC can also be used. Subfractions can be measured, but clinical significance of these subfractions has not been determined. The measurement of apo-A reactive capacity can be used to measure HDL cholesterol but is thought to be less accurate.
|High HDL level, optimal condition considered correlated against heart disease|
High LDL with low HDL level is an additional risk factor for cardiovascular disease.
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Foods To Lower Ldl Cholesterol And Raise Hdl Cholesterol
Low-Density Lipoprotein cholesterol, as we all know, if exceeded, can block the artery walls.
And conventionally known as the good cholesterol, HDL does the job of absorbing cholesterol and sending it back to the liver.
Thereafter, the liver flushes it from the body.
Hence, it has all the means and rights to be called healthy cholesterol that combats bad cholesterol aka LDL effectively.
HDL being less than 40 mg/dl for men and below 50 mg/dl for women is a matter of concern.
People with such dropped levels need an immediate HDL boost in their blood.
On the other hand, a high LDL needs to be lowered down ASAP to prevent cardiac arrest.
So, why not fill your plate with an overall nutritious heart-healthy diet?
Lets find out how to lower LDL cholesterol and go through the below-listed food sources that can lower LDL cholesterol and up HDL in the long run.
Pharmaceutical Drugs And Niacin
Pharmacological therapy to increase the level of HDL cholesterol includes use of fibrates and niacin. Fibrates have not been proven to have an effect on overall deaths from all causes, despite their effects on lipids.
Niacin increases HDL by selectively inhibiting hepatic diacylglycerol acyltransferase 2, reducing triglyceride synthesis and VLDL secretion through a receptor HM74 otherwise known as niacin receptor 2 and HM74A / GPR109A,niacin receptor 1.
In contrast, while the use of statins is effective against high levels of LDL cholesterol, most have little or no effect in raising HDL cholesterol.Rosuvastatin and pitavastatin, however, have been demonstrated to significantly raise HDL levels.
Lovaza has been shown to increase HDL-C. However, the best evidence to date suggests it has no benefit for primary or secondary prevention of cardiovascular disease.
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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.
Exercise And Physical Activity:
we are all aware of the many benefits of doing exercise. Aim for 30 to 60 minutes of physical activity most days of the week. Physical activity or exercise can give your HDL level a boost. On top of that, it can help you lose weight and give you more energy. Doing a physical energy doesnt mean you have to take out a gym membership. If you do at least 30 minutes of exercise per week, you are on the right track.
There are different forms of activity that you could do and youll probably enjoy them too. Walking briskly is a great exercise. If you find the idea tiresome, ask a friend to join you. Walking with a friend means the time will likely pass quicker and youll complete your 30 minutes brisk walk before you realize it.
You could also ride your bicycle to work. Or if that is not suitable, walk to work. If you cant walk to work, take a fast paced walk during your lunch hour.
Try joining a Tai Chi group. Tai Chi is also called the moving meditation and is great for people of all ages. It is a gentle form of exercise with proven results.
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What Does Ldl Cholesterol Do
LDL is considered the bad cholesterol. It carries cholesterol to your arteries, where it may collect in the vessel walls and contribute to plaque formation, known as atherosclerosis. This can lead to decreased blood flow to the heart muscle , leg muscles , or abrupt closure of an artery in the heart or brain, leading to a heart attack or stroke. Over a third of the US population has high LDL cholesterol. Diagnosis is made via blood testing, so if you dont check, you wont know.
For LDL, the lower the number the better. A good goal to keep in mind is less than 130 mg/dL if you dont have atherosclerotic disease or diabetes. It should be no more than 100 mg/dL, or even 70mg/dL, if you have any of those conditions or high total cholesterol. Its very important to set your own target cholesterol levels with your doctor. Obesity, a large waist circumference, a sedentary lifestyle, or a diet rich in red meat, full-fat dairy, saturated fat, trans fats, and processed foods can lead to high LDL cholesterol.
How To Increase Hdl Cholesterol
Although HDL levels are driven by family genetics, you can improve HDL levels in three key ways:
- If you are a smoker, research clearly shows that quitting smoking can increase HDL.
- Adopting a heart-healthy diet low in fat and high in fiber can also modestly raise your HDL.
- Aerobic exercise can also have positive effects on HDL. Have trouble exercising? Find a buddy research shows it helps motivate you. That exercise can be as simple as increasing the amount of walking you do each week.
Lastly, although primarily used to decrease high LDL, some statin medications may potentially increase HDL levels moderately. Any medical treatment option should be discussed with your doctor. Importantly, high HDL does not protect you from the untoward effects of high LDL.
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Same Numbers Different Ratio
Two people with the same total cholesterol number can have different cholesterol ratios. The ratios indicate different levels of heart disease risk. Harvard Medical School cites the following example: If your total cholesterol is 200 and your HDL is 60, your cholesterol ratio would be 3.3. Thats near the AHAs ideal level. However, if your HDL is 35 below the recommended level of 40 for men and 50 for women your cholesterol ratio would be 5.7. This ratio places you in a higher risk category.
Health Effects Of Abnormal Hdl Levels
The largest risk of low HDL cholesterol is developing heart disease. There is a large body of data suggesting that HDL cholesterol has a heart-protective effect and up to 1/3 of patients with heart disease have ânormalâ total cholesterol but low HDL levels, highlighting the important role this molecule plays in protecting the heart .
HDL also plays an important role in immune function. A large prospective population study of 20,000 adults found that participants with very low HDL had a 75% higher risk of infection. Interestingly, very high levels of HDL can also be problematic, as those with very high HDL cholesterol had a 43% higher risk for infectious disease than those with ânormalâ levels. Very high HDL may be correlated with heart disease as well .
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What Are The Dangers Of Low Cholesterol
Although the emphasis is generally on reducing cholesterol levels, cholesterol levels that are too low may also be problematic, although research is still inconclusive.
- When LDL cholesterol levels are too low, it can lead to increased risk of health issues such as cancer, depression, anxiety, and cardiovascular diseases. Too low levels of LDL cholesterol during pregnancy may increase the risk of having a baby with low birth weight or a preterm baby.
- When HDL cholesterol levels are too low, it can increase the risk of atherosclerosis, which is when your arteries harden, as well as cardiovascular diseases like heart attack and stroke.
How Can I Raise My Hdl Level
If your HDL level is too low, lifestyle changes may help. These changes may also help prevent other diseases, and make you feel better overall:
- Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of bad fats. This means limiting saturated fats, which include full-fat milk and cheese, high-fat meats like sausage and bacon, and foods made with butter, lard, and shortening. You should also avoid trans fats, which may be in some margarines, fried foods, and processed foods like baked goods. Instead, eat unsaturated fats, which are found in avocado, vegetable oils like olive oil, and nuts. Limit carbohydrates, especially sugar. Also try to eat more foods naturally high in fiber, such as oatmeal and beans.
- Stay at a healthy weight. You can boost your HDL level by losing weight, especially if you have lots of fat around your waist.
- Exercise. Getting regular exercise can raise your HDL level, as well as lower your LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on most, if not all, days.
- Avoid cigarettes.Smoking and exposure to secondhand smoke can lower your HDL level. If you are a smoker, ask your health care provider for help in finding the best way for you to quit. You should also try to avoid secondhand smoke.
- Limit alcohol. Moderate alcohol may lower your HDL level, although more studies are needed to confirm that. What we do know is that too much alcohol can make you gain weight, and that lowers your HDL level.
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