One of the biggest fears we have is being crippled by the onset of heart disease, heart attack or stroke. Cholesterol can be one of the largest players in bringing on one of the aforementioned conditions. It is imperative to understand what cholesterol is and how it plays a role as a risk factor for the things we dread the most. Here is a simple outline of the blood fats to include good and bad cholesterol.
Cholesterol is a waxy substance that comes from two sources: your body and food. Your body, and especially your liver, makes all the cholesterol you need and circulates it through the blood. But cholesterol is also found in foods from animal sources, such as meat, poultry and full-fat dairy products. Your liver produces more cholesterol when you eat a diet high in saturated and trans fats.
Elevated cholesterol levels can also be caused by genetic or medical conditions such as diabetes or hypothyroidism. Kidney disease, liver disease or pregnancy can also raise the amount of cholesterol in your blood. Excess cholesterol can form plaque between layers of artery walls, making it harder for your heart to circulate blood. Plaque can break open and cause blood clots. If a clot blocks an artery that feeds the brain, it causes a stroke. If it blocks an artery that feeds the heart, it causes a heart attack. There are two types of cholesterol: “good” and “bad.” Too much of one type — or not enough of another — can put you at risk for coronary heart disease, heart attack or stroke. It’s important to know the levels of cholesterol in your blood so that you and your doctor can determine the best strategy to lower your risk.
More people die of heart disease than from any other illness. One important risk factor for the onset of heart disease is cholesterol. Understanding taking personal interest your cholesterol panel and the role blood lipids play in heart disease is an important step in avoiding an unwanted health condition. By understanding your blood lipids, you will learn how they can help or harm you. Get your blood tested for heart risk factors.
Understanding Your Lipid (Blood Fat) Panel
The basic medical lipid panel measures four very important risk factors: total cholesterol, total LDL cholesterol, triglycerides, and HDL. This is one test that is routinely done to determine cardiovascular risk that is done by all practicing medical doctors. Recommendation by the National Cholesterol Education Program and the American Heart Association is that everyone over 20 years of age obtains a lipid screening and if normal gets one every five years.
NCEP guidelines suggest that total cholesterol be less than 200 ng/dl Levels between 200-239 are considered borderline and numbers greater than 240 are considered to be at twice the risk for heart attack than levels less than 200. Recent research suggests that levels should be between 160-180 to minimize risk. Optimal levels of LDL are determined by the number of risk factors that you have. Severe risk factors: Established coronary heart disease, diabetes mellitus, metabolic syndrome. If you have one or more of these severe risk factors, you need to lower your LDL to less than 100 ng/dl (NCEP guidelines).
Major Risk Factors
- Age (male older than 45 years of age or female older than 55 years of age)
- Cigarette smoking
- Family history of premature heart or blood vessel disease (age older than 55 in a female parent, sibling, or child)
- High Blood pressure (140/90 or higher, or on blood pressure medication)
- HDL cholesterol < 40
According to NCEP, if you have zero or one major risk factor, your LDL goal is less than 160. If you have two or more major risk factors, NCEP suggests an LDL goal of less than 130, with an optimal goal of less than 100. If you are in the severe risk group for heart attack or stroke, NCEP feels your LDL goal is less than 100. Although we agree with the NCEP categories, we feel LDL should be treated more aggressively in people in the high or severe risk categories.
High Density Lipoprotein (HDL) cholesterol is the “good” cholesterol. It works to remove plaque from the arteries. Elevated HDL cholesterol is associated with decreased risk of heart disease. Unlike other cholesterol levels, the HDL cholesterol test result is best if it is high. Levels may increase with regular exercise. Genetic factors or conditions such as liver disease, malnutrition or hyperthyroidism may decrease HDL cholesterol levels. Smoking and drinking alcohol may also decrease your HDL cholesterol levels.
Triglycerides are a measure of fat in the blood. Triglycerides are fats composed of fatty acids and glycerol. Triglycerides combine with proteins to form particles called lipoproteins that transport fats through the bloodstream. These lipoproteins carry triglycerides from the liver to other parts of the body that need this energy source. Triglycerides then return to the liver where they are removed from the body. The level of triglycerides in your blood can indicate how efficiently your body processes the fat in your diet. A high triglyceride level, along with a low HDL level, is classic for metabolic syndrome. High triglycerides are commonly the result of a diet high in sugary and high-glycemic index foods. Triglyceride levels less than 150 mg/dl are considered normal, and the optimal values are less than 100.
In Depth Testing
More intricate values of lipids may be necessary to determine risk for premature coronary artery disease. Your doctor may recommend a VAP panel. This is a test where LDL is measured directly, providing much more accurate information than the calculated value. In addition a VAP panel provides information about particle size and the actual number of LDL particles, and tells how many of the less dangerous, larger, fluffy “A” particles you have compared to the number of the dangerous, small, dense “B” type particles. The light and fluffy particles tend to bounce off of arterial walls and the dense small particles have a tendency to stick and sneak through vessel walls creating plaque and damage. A VAP also measures the lipoprotein (a) number, IDL, and VLDL, risk factors that are becoming looked at more closely than a standard lipid panel in the contribution and cause of heart disease.
As you can see the details of cholesterol are complex. It is a vital component in managing long term issues with high blood pressure, heart disease, hardening of the arteries and the risk for heart attack and stroke. It strongly recommended that you be familiar with your lipid biomarkers as they are representative of what you may be facing in the future in terms of chronic disease! It is never too late to put a human system on the right track to wellness!
Join us in living The Wellness Life at The Functional Medical Institute, where we challenge you to take personal interest in your health. Your health is your health insurance!