Stanway Health

Most health professionals agree that heart disease, commonly also referred to as cardiovascular disease, is primarily a problem of blocked arteries or “pipes” as they are sometimes called. However, this is not the complete picture. There are many things which contribute to the development of heart disease and problems such as a heart attack. Some factors that have been implicated include:

• cholesterol and other blood fats (although this appears to have been over emphasized),
• coronary inflammation (homocysteine and C-reactive protein),
• blood clotting,
• excess body weight,
• blood pressure,
• diabetes,
• syndrome X (believed to be a product of insulin resistance),
• aerobic capacity,
• smoking and
• personality.

As well as these there are genetic factors. This is a variable over which we have no control. If you do have a family history of heart disease this does not necessarily mean that you will develop heart disease yourself. There are many factors, besides genetics, that go into the development of heart disease. It is these factors that can be changed and thereby reduce your risk of developing heart disease. Cholesterol and other blood fatsIn recent years cholesterol levels have become closely identified with heart disease. Too much cholesterol in the blood tends to clump together in the walls of arteries - combining with fibrous tissue to form a “bump” which thickens the artery walls and reduces the blood flow. However, cholesterol levels are not the be-all and end-all of heart disease. It is a natural, non toxic soft waxy substance that is in all cells and is necessary for good health. It is only when it is excessive that we have a problem. So how much cholesterol is too much? The National Cholesterol Education program in collaboration with the American Heart Association has provided the following guidelines for total cholesterol (milligrams of cholesterol in one deciliter (dl) of blood).

Below 200 - desirable

200 to 239 - borderline high

240 and above - high

If you have a total cholesterol above 200 you are not alone - the American Heart Association estimates that 98 million Americans have a high blood cholesterol level.

Total cholesterol, however, is not a single unit, it is made up of LDL (Low Density Lipoprotein) and HDL (High Density Lipoprotein). Cholesterol needs to be combined with fat and protein for it to be transported in the blood - the result is a lipoprotein. Various types of lipoproteins have different sizes, shapes and functions and are classified on the basis of their density (compactness).

LDL (Low Density Lipoprotein)

One of the most important is the LDL. It transports about 60 - 80 % of the cholesterol through the blood stream and it is taken up by the cells as a building block for hormones and cell parts. However the cells may not need all of the cholesterol that is produced and LDL is unstable and will “unravel”. It can penetrate the artery walls. LDL is sometimes referred to as “bad cholesterol” because of its role in the clogging of arteries. Because of this it is seen as a better marker of the potential for heart disease than total cholesterol levels. The higher your LDL levels the greater the risk of artery build up.

The National Cholesterol Education Program has created the following as a guideline of cardiac risk from LDL cholesterol (milligrams of LDL in one deciliter (dl) of blood).

Below 100 - optimal

100 to 129 - near optimal

130 to 159 - borderline high

160 - 189 - high

190 and above - very high

HDL (High Density Lipoprotein)

HDL is often known as the “good” cholesterol. It forms a stable package of cholesterol fats and proteins that do not unravel when it comes in contact with the artery wall and the cholesterol it carries does not deposit on the artery walls. HDL can also be used by the body to undo the damage that is caused by the LDL - it collects the unravelled LDL and transports it back to the liver for removal from the body. HDL is therefore considered to be cardio protective.

The National Cholesterol Education Program has created the following as a guideline of cardiac risk from HDL cholesterol (milligrams of HDL in one deciliter (dl) of blood).

60 and above - low

40 to 59 - moderate

below 40 - high

If your cholesterol levels are not what they should be then you need to take action - so that you don’t become another heart disease statistic.

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