In the last article we discovered myths relative to cholesterol and its roll in heart disease, statins perceived roll in heart disease, and “normal” stress tests and their effectiveness (or lack thereof) in predicting cardiac disease.
Back to cholesterol: The lipid with the bad reputation.
Hyperlipidemia refers to elevated levels of lipids (fats) including cholesterol and triglycerides. Most people with hyperlipidemia have no symptoms. However, hyperlipidemia is a contributing factor with an increased risk of coronary artery disease (CHD), a thickening or hardening of the arteries that supply blood to the heart muscle. CHD in turn can result in angina pectoris (chest pain), a heart attack, or both. Although hyperlipidemia is considered a risk factor to heart disease, it is one of many risk factors and what actually causes hyperlipidemia is a debatable issue. It’s not as simple as foods that contain cholesterol elevating lipids.
Another important risk factor, which has been largely over-looked, is the oxidation of low-density lipoprotein (LDL) cholesterol caused from a lack of antioxidant rich foods, herbs, and nutrients and/or a large intake of foods and chemicals that contain damaging free radicals. Chronic inflammation also contributes to oxidative stress (which breaks down your cell walls) and an increase in CHD. When LDL oxidizes, it promotes atherosclerosis (plaqueing of the arteries) by promoting a process which causes damage to the artery wall – especially in the presence of stress and high blood sugar conditions (insulin resistance, Syndrome X, Diabetes I and II). Inflammation is also involved in the process of damaging the cell wall, causing your cholesterol to attempt to patch up the damage. Cholesterol is the good guy. It’s trying to fix you. Chronic inflammation, oxidative stress, high cortisol (stress) and insulin are the real underlying cause of chronic disease and particularly CHD.
The production of C-reactive protein (CRP) is an essential part of the inflammatory process. The measurement of C-reactive protein reflects the level of inflammatory activity deep within the body. It appears that certain conditions create a state of excessive inflammation within the circulatory system. High C-reactive protein levels are evidence of this cardiac related type of inflammation.
Multiple risk markers for atherosclerosis and cardiovascular disease act together to create havoc in your heart’s inflammatory pathway. The following is a list of the different factors that have been identified as risk factors for CHD and arterial damage.
Elevated CRP, elevated LDL, excess insulin, low LDL, high glucose (high blood sugar), nitric oxide deficit, excess triglycerides, low testosterone (men), high testosterone (women), excess homocysteine, increased blood pressure, low Vitamin K, and, oh yes, excess cholesterol.
So it’s more about cardiovascular disease and inflammation. There are many key inflammatory biochemical risk markers for cardiovascular disease which is beyond the scope of this article to detail. But, inflammatory mediators such as nitric oxide balance and the use of nutrients (flavanoids, carotenoids, sterols [Vitamin D], Vitamin C and E, Omega 3 fatty acids, etc.) are very powerful in circumventing the body’s cardiovascular inflammatory pathway and rendering “high cholesterol” to doing what is does best – create healthy cell walls and hormones.
Most of the above listed risk factors for cardiovascular disease have pro-inflammatory components. They all contribute to the atherosclerotic plaquing process. Nitric Oxide plays a pivotal role in preventing the progression of atherosclerosis by dilating your heart’s arteries and not allowing the damage to the arteries that triggers cholesterol (plaquing) to patch them up. Nutrients such as arginine, antioxidants (Vitamin C and E, liporic acid, selenium, glutathione), and enzyme co-factors (Vitamin B2, B3, B6, B12 folate, zinc) help to elevate nitric oxide levels and play an important role in management of cardiovascular disease.
Within the broad range of cholesterol levels from 180 to 240, there is little to no evidence that this alone correlates with heart disease. In fact, below 180 there is an increased risk of hemmorhagic stroke, depression and suicide. Above 240 there may be an increased risk of cardiovascular disease and stroke. Over age 70, elevated cholesterol and cardiovascular events no longer correlate. All told, total serum cholesterol alone is a poor indicator of cardiovascular disease. Half of all heart attack patients have normal cholesterol levels.
So, not only do statin drugs have their inherent drawbacks (see part 1 of this article), but in some ways they are treating a fabricated problem based on misunderstood and misrepresented “research”. As a health care “consumer” one must be wary of the current cholesterol hysteria. One needs to investigate the facts so as a consumer you can make more educated health care choices.
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Aug: 13 (4): 383-9
Bermudez EA, Ridker PM, C-reactive protein, statins and the primary prevention of atherosclerotic cardiovascular disease. Prev Cardiol 2002 Winter; 5 (1) : 42-6
Osiecki HE The role of chronic inflammation in cardiovascular disease and its regulation by nutrients
Altern Med Rev 2004 Mar 9 (1) 32-53
