Blood Lipids How LDL Cholesterol Obstructs the Circulatory System What You Must Know Triglyceride
Familial Hypercholesterolemia Traditional Prescription Drug Treatments Natural Alternatives
In the next paragraphs you will find a comprehensive but simple to understand explanation of how blood lipids—low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride—and free radicals affect your risk of developing cardiovascular disease (CVD). If you are not familiar with the subject, we suggest you take a few minutes to read these important concepts. Otherwise, if you are familiar with blood lipids, cholesterol, and the causes of CVD, find out why a Red Yeast Rice supplement have been proven effective in the promotion of healthy cholesterol levels.
Blood Lipids — Important Concepts
Cholesterol is a waxy, fat-like substance carried in the bloodstream, and it comes from two sources. It is produced by an enzyme in our body (a liver enzyme called HMG-CoA reductase), and it also comes from the food we eat. The human body needs some cholesterol because it is essential to form cell membranes, some hormone, and other needed tissue. But an abnormally high level of cholesterol in the blood (hypercholesterolemia) is a major risk factor for cardiovascular disease, which leads to heart attacks and stroke, the number one cause of death in many countries around the world.
Many people know that the healthy function of the brain, heart, cardiovascular system and most organs depends on the unobstructed flow of blood for the delivery of oxygen and nutrients and the removal of harmful metabolites and waste. Unfortunately, fewer people understand that cholesterol and other fats cannot dissolve in the blood; they have to be transported in the bloodstream by special carriers of lipids and proteins called lipoproteins.
There are several kinds of lipoproteins. The two most important ones are low-density lipoprotein (LDL), which is the major carrier of cholesterol in the blood, and high-density lipoprotein (HDL), which carries one-third to one-fourth of blood cholesterol. There are other lipoproteins, such as very-low-density lipoprotein particles (VLDL) that are often ignored but are also important in determining the level of risk of developing CVD. Only a qualified health care provider can determine the influence of each of the lipoproteins in your particular risk of developing CVD.
When too much LDL is circulating in our bloodstream, it can slowly build up within the walls of the arteries feeding the heart and the brain. Together with other substances, LDL can form a thick, hard deposit (plaque) that can clog the arteries, a condition known as atherosclerosis. It is very important to prevent LDL from depositing in the walls of your blood vessels because sometimes a small portion or clot of this plaque can tear loose from the blood vessel wall and then be carried away by the blood. This clot (or thrombus) can eventually act as a plug in an artery, blocking the flow of blood and oxygen to part of the heart muscle and causing a heart attack or blocking the flow of blood and oxygen to part of the brain, producing a stroke. A high level of LDL reflects an increased risk of heart disease, and that is why LDL is often referred to as “bad” cholesterol. Conversely, scientific and medical research has determined that HDL carries cholesterol away from the arteries and back to the liver, where it is processed, and therefore it removes excess cholesterol from atherosclerotic arteries, slowing the growth of plaque. HDL is therefore known as “good” cholesterol because a high level of HDL seems to protect against heart attack.
Important: To actively manage your risk of developing cardiovascular disease, your first and most important goal must be to frequently monitor your blood LDL HDL levels and Cardiac Risk Ratio (CRR). We suggest that at least once every three months you check your total cholesterol level using a self-test kit, and that at least once a year you ask a qualified health care provider to perform a full test of blood lipids.
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How LDL Cholesterol Obstructs the Circulatory System
LDL cholesterol must be “oxidized” by free radicals before it can form plaque and create artery blockage. A free radical is a molecular fragment that has an unpaired electron. Highly reactive, free radicals search to regain a full complement of electrons. Whenever LDL particles are exposed to these unstable molecules, the LDL particles are oxidized. Immediately the LDL becomes stickier, a quality that increases risk of formation of a blood clot. In the process, an oxidized LDL particle becomes toxic to the human body. Non-oxidized LDL is recognized as “self,” or non-threatening, by the body’s immune system. But oxidized LDL is so changed that our immune system identifies it as “non-self,” or foreign and potentially dangerous. To safeguard the body from this possible hazard, the immune system’s large scavenger cells (called macrophages) engulf and swallow all oxidized LDL. By a process not yet fully understood, the LDL-bloated macrophages are lured into tiny cracks or injuries in artery walls, where they become embedded and protrude, partially occluding the artery and causing atherosclerosis.
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What You Must Know About Cholesterol - A Summary
Cholesterol is a type of fat (lipid) found in the blood, and it comes from two sources. It is produced by an enzyme in our body (a liver enzyme called HMG-CoA reductase), and it also comes from the food we eat. Cholesterol is “transported” in the bloodstream by different types of lipoproteins. The best-researched lipoproteins are HDL and LDL. High levels of LDL (commonly referred to as bad cholesterol) cause the formation of plaque in the arteries. Over time, the buildup of plaque causes narrowing of the arteries and results in reduced flow of blood and oxygen to the brain, heart and other organs. High level of LDL is then considered the main cause of cardiovascular disease (CVD), also known as coronary heart disease (CHD). Other major causes of CHD are: smoking, high blood pressure, poor diet, obesity, lack of exercise and generic predisposition.
Researchers have determined that genetic predisposition—family history of cardiovascular disease represented by the tendency to produce too much cholesterol in the liver—and the arithmetic ratio of total cholesterol (TC) to good cholesterol (HDL) show good predictability of who will develop CVD. The ratio is called the cardiac risk ratio (CRR), and it is obtained by dividing the TC level by the HDL level (TC/HDL). In managing the risk of developing CVD, the main goal should always be to keep the CRR below 5 and ideally under 3.5.
A desirable level of total cholesterol is under 200 milligrams per deciliter (mg/dL) and a desirable level of LDL is under 100 mg/dL. If your total cholesterol level is in the borderline-high range (between 200 and 239 mg/dL), dietary changes, exercise, consumption of specific recommended nutrients and a cholesterol dietary supplement should be enough to bring levels to a desirable range.
Keep in mind that reading and understanding cholesterol levels is very complex, especially since many different types of blood lipids (HDL, LDL, VLDL particles and triglyceride) and lifestyle factors have to be taken into consideration. The most important fact to remember is that if your total cholesterol level is above 200 mg/dL or if your LDL level is above 100 mg/dL, you should be in a cholesterol-reducing regimen supervised by a qualified health care provider. Or, if your total cholesterol level is above 300 mg/dL you must be under treatment by a medical doctor you trust.
If the information presented on this page seems too complicated or overwhelming, just try to remember these simple facts:
To help prevent cardiovascular disease try to maintain: (A) a total cholesterol (TC) level under 200 mg/dL, (B) an LDL level under 100 mg/dL and (C) your Cardiac Risk Ratio (TC/HDL) under 5.
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What Is Triglyceride and How Does It Relate to Cholesterol?
Triglyceride is a major component of very low density lipoprotein (VLDL) and consequently it plays an important role in metabolism as energy source and as a transporter of dietary fat.
High levels of triglyceride in the bloodstream have been linked to atherosclerosis, coronary heart disease and stroke.
There is an inverse relationship between blood triglyceride levels and HDL levels that tends to be confusing. When the triglyceride level rises, the HDL level tends to be lower than normal. Therefore, an elevated triglyceride level—and thus decreased HDL level—may indirectly cause atherosclerosis.
The effects of raised levels of triglyceride, in comparison to raised levels of LDL, are yet to be determined. Of all known lipids, triglyceride is the least studied and understood.
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What Is Familial Hypercholesterolemia (FH)?
FH patients have high blood concentrations of LDL cholesterol due to a genetic disorder that prevents proper metabolism of LDL particles. These patients experience a markedly increased risk of premature cardiovascular diseases (CVD) and CVD-related death. Familial hypercholesterolemia can be present in two forms: homozygous (hoFH), where the same defective gene is inherited from both parents, or heterozygous (heFH), where the defective gene is inherited from only one parent so that some function is preserved. The homozygous form is a very rare condition estimated to affect approximately one in a million people. Children with hoFH are at high risk for early coronary events and sudden death as young as age 1. HeFH is more common, with a prevalence of approximately one in 500. Patients with heFH also experience elevated LDL cholesterol and are at high risk for early coronary events. For undiagnosed or untreated heFH, the cumulative risk of a coronary heart disease (CHD) by age 60 is 60-85% among men and 30-50% among women, with a mean age of early-stage diagnosis of approximately 47 years.
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Traditional Prescription (Statin) Drug Treatments and Potential Side Effects
Millions of patients are taking prescription drugs to lower cholesterol without being fully aware of their potential side effects. If you are considering a prescription drug treatment for lowering your cholesterol, we recommend you read the article Lower Cholesterol Without Drugs [PDF] by Dean Ornish, M.D.
Following you will find an overview of a few prescription drugs commonly used by medical doctors to treat high cholesterol and a summary of their potentially serious side effects.
In the past, the prescription drug choices to treat cholesterol were: fibric acids, cholesterol absorption inhibitors, bile acid sequestrants (cholestyramine and colestipol) and nicotinic acid (niacin). Niacin in particular is still used to treat HDL cholesterol but it has troublesome side effects (e.g., itching, flushing) and therefore requires considerable patient education in order to achieve adherence. Other prescription drugs—gemfibrozil, probucol, and clofibrate—have proven to moderately reduce LDL cholesterol levels and effectively reduce other blood lipids (i.e., triglyceride).
Nowadays other types of "more friendly” prescription drugs are being used for treating high cholesterol. They are synthetically produced HMG-CoA reductase inhibitors, which control the production of cholesterol in the liver and are commonly known as “statin” drugs. Examples of these commonly prescribed—hundreds of millions of patients are taking them—statin drugs are: Lipitor/atorvastatin, Baycol/cerivastatin, Lescol/fluvastatin, Mevacor/lovastatin, Pravachol/pravastatin, Crestor/rosuvastatin, Vytorin/simvastatin and Zocor/simvastatin.
Although statin drugs have proven effective for lowering LDL cholesterol levels, they have shown serious short-term side effects. It is also important to understand that statins' long-term side effects are still unknown—data is still being compiled, analyzed and studied on a worldwide basis.
Despite the fact that it is still under study, loss of memory and loss of cognitive function is one of the most recent side effects associated with statin drugs. Another of the statin's short-term side effects that has been more clearly identified and studied is muscle pain. People taking statin prescription drugs must be very alert to the possibility of developing muscle pain, especially in the legs. Muscle pain is a well-known side effect of statin drugs and might be an indication that more serious long-term health problems will develop. If you are under a cholesterol-lowering prescription drug treatment and you are feeling muscle pain, particularly in your legs, ask a qualified health care provider to perform a blood test to check your muscle enzymes and liver function.
Due to the potentially serious side effects of statin drugs, you should discuss with a health care provider you trust—especially if your cholesterol is only borderline-high—alternative ways to promote healthier cholesterol levels, the subject of our next section.
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Natural Alternatives to Promote Healthy Levels of Cholesterol
David Heber, M.D., Ph.D., states in his book Natural Remedies for a Healthy Heart:
"It has been estimated that 25 percent of the patients who take cholesterol lowering prescription drugs and follow a low-fat, low cholesterol diet do not achieve adequate reductions in their cholesterol levels. In many patients, this is due to the presence of elevated triglyceride levels, so physicians must add a second or third drug to lower triglyceride as well. Every day, cardiologists are discovering new treatments for patients with severe heart disease. These new treatments are not an argument against prevention. On the contrary, both are needed. I believe that prevention can be both highly technical and natural by combining a scientific understanding of what is going on in each patient with the use of natural therapies."
Penny M. Kris-Etherton, Ph.D., of Pennsylvania State University, stated:
"Clearly we are entering an exciting era in which we will likely identify novel ways to lower risk of cardiovascular disease and other chronic diseases with diet."
There are several divergent views on how to effectively promote and maintain healthy cholesterol levels in your blood stream and reduce the risk of heart disease. However, most experts agree that nature provides ways to complement dietary and lifestyle changes to improve cardiovascular health.
Now that you've read important concepts related to blood lipids, we recommend that you consider expanding your knowledge on the subject by completing a brief, 5-questions survey that will let you obtain the easy-to-read (23-pages) free book "Chinese Red Yeast Rice" by Rita Elkins. The book will help you further understand "how to control cholesterol and promote cardiovascular health." Alternatively, if you don't have the time to fill-out the brief survey, you can also purchase a copy of the book by visiting the products page of our Web site.
Important Note
No prescription drugs, herbs or dietary supplements that affect cholesterol can be a substitute for a healthy diet and regular exercise. In the words of Dr. Heber, "Supplements are not magic pills, but they play an important role for people with high cholesterol after they have changed their diet and lifestyle." You should never substitute a dietary supplement for a cholesterol-reducing prescription drug—or start taking a dietary supplement while taking a cholesterol lowering prescription drug—without the approval of a qualified health care provider.
The bottom line is this: (a) if your total blood cholesterol level is between 200-299 mg/dL, you should act immediately and start lifestyle and diet changes and consult with a qualified healthcare provider who most likely will also recommend a dietary supplement, or (b) if your total blood cholesterol level is 300 mg/dL or above, you must be in a strict cholesterol reduction treatment under the supervision of a medical doctor who most likely will prescribe cholesterol reducing drugs. If the later is your case, no basic nutrients, herbs or dietary supplements that affect cholesterol should be taken without your doctor's approval.
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