The Cholesterol Issue
Cholesterol has become one of the key issues of health in the last few decades. There is a large amount talk and concern over how to avoid heart attacks, bypass surgeries, and multiple hospitalizations for heart disease. Because of this, many measures have been taken to find what preventative measures can be taken to avert heart disease. Cholesterol has been recognized as one of the important things that we can control to help prevent problems that contribute to heart disease. And multiple medications and studies about healthy diets to lower high cholesterol have been studied and released over the last few years to help the general population know what to do.
Cholesterol is used in the body for the transport of fats and salts. It is made of two main types. HDL or high density lipoprotein is generally thought of as good cholesterol that helps heal arterial plaques. LDL or low-density lipoprotein is considered bad cholesterol. It can actually add to plaques, or blockages in your blood vessels that can cause clots or atherosclerosis, both of which cause heart attacks or strokes.†The American Heart Association recommends that total cholesterol be less than 200 mg/dL. High cholesterol is then treated with a combination of diet, exercise changes, and various medications. It is usually recommended and usually possible to treat high cholesterol with diet and exercise to decrease the risk of heart disease, but is much easier and quicker to lower these numbers with medications.
Recently, some have postulated that cholesterol is not really quite as important as we seem to be making it out to be, and that it is not the main risk-factor for developing heart disease. A book will even be coming out later this year that explains the concept more fully. The cholesterol myth suggests that cholesterol is simply lipoproteins that are really just shuttles for fatty substances, and not huge risk factors in and of themselves.†The real issue is the amount of inflammation in blood vessels, stress, and sugar in our lives, and if we would work overall on healthy lifestyle, exercise, and diet, it would manage to lower not only the cholesterol but also the other factors which affect blood vessel health.
There are several studies which suggest that even people with normal cholesterol levels have heart attacks, and vice versa. The Lyon Heart Study in the 1990s took men after a heart attack who had several risk factors for developing another. They then put them on either a low cholesterol diet or a Mediterranean diet. The study was stopped because the risk of fatal heart attack of those on a Mediterranean diet was decreased by 70 percent, even though their cholesterol levels remained high.†The ENHANCE trial in 2008 tested the effects of a cholesterol lowering medication. The medication lowered the cholesterol better than any others, but by the end they had twice the amount of plaque growth in blood vessels, meaning they were at even higher risk for heart attack after fixing cholesterol levels. Based on study results like these, many are thinking that our teaching that lowering cholesterol levels will reduce your risk of heart attack is not quite accurate.
In actuality, it is likely a combination of multiple factors that place at risk for heart disease. High cholesterol is clearly one of these, but the best means for treating it according to some of these studies and theories is still a little undecided. Regardless, having a healthy lifestyle and trusting the doctors who have managed these conditions for years is the best recommendation for now until clear evidence is decided for another management plan.