EDUCATIONAL POST - PLEASE SHARE
Total cholesterol, on its' own, is of little value and is not indicative of your cardiovascular health.
Total cholesterol measures LDL (low density lipoproteins), HDL (high density lipoproteins) and VLDL (very low density lipoproteins, which are carried in triglycerides lipids in your bloodstream).
A total cholesterol test will provide you with a numerical value expressed in mmol/l in most countries, for all of its sub-fractions, and for low-risk individuals should have the following values:
LDL-C < 2.59
HDL-C > 1.55
Non-HDL < 3.37
Triglycerides < 1.7
Medium to higher risk individuals (those who smoke, have documented evidence of CVD including revascularization, are overweight, have family history of heart disease, and carry most of their excess weight around their mid-section) should pursue even lower values for non-HDL (<2.6) and triglycerides (<0.79).
LDL particles are atherogenic (they damage the inner lining of arteries, an organ called the endothelium) causing the accumulation of plaque. HDL particles initiate 'reverse cholesterol transport' which scavenges LDL and other VLDL sub-fraction particles and carries them to the liver for elimination by the body. That's why HDL is called 'good cholesterol'. Triglycerides are the fats carried in your blood stream caused by the consumption of sugar and simple carbohydrates such as white flour products in the form of bread, pasta and pizza dough. Other carbs are white rice, white potatoes and any form of sugar whether it be honey, agave, maple syrup, fruit juices, soft-drinks, and alcoholic beverages among others. Packaged foods can be high hidden sugars (sugar identified by different chemical names) as well as unhealthy levels of vegetable oils and salt. It is best to avoid packaged food altogether. Watch this video:
Sugar and simple carbs initiate an inflammatory process in the cardiovascular system that in a complex process, eventually results in plaque accumulation within the arteries, in the endothelium lining, which makes that organ less elastic and cause a restriction in blood flow resulting in a higher blood pressure. You can measure inflammation in your body using a CRP blood test and inflammation in your arteries using a test known as MPO (myeloperoxidase).
If your blood pressure is higher than 120/80 it may be an indication of damage to the endothelium due to plaque accumulation and an early indicator of cardio-vascular disease.
A test for Brachial Artery Responsiveness or reactivity following a 5 minute, proximal arm occlusion of this artery using a blood-pressure cuff, will provide an FMD% score. This value should be 8.7% or greater, otherwise a lower value will indicate endothelial dysfunction. Enthothelial function can be improved with both exercise and diet. Nitric oxide is essential to optimal endothelial function. N.O. production is generated from exercise and consumption of green leafy vegetables, especially spinach and arugula. There is a device called the 'Angiodefender' by Everist Health, that is used in a clinical setting than can provide you with your FMD% score. There's also a competitor called Vendy's by Endothelix, that can provide the same service.
Watch this video:
Recent research has placed less emphasis on the LDL-C value as a measure of risk due to the fact that 50% of heart attack and stroke victims have normal levels of cholesterol volume as measured by LDL-C.
What is more important than cholesterol volume is the number of LDL particles (LDL-P). The more particles in your blood stream, the higher the probability that you will have damage to your endothelium.
Measuring LDL-P is not part of the mainstream medical system's routine process which is still following guidelines established over 25 years ago.
When you get your next blood test, request a measure for the following:
Apolipoprotein 'B' (ApoB) and Apolipoprotein A1 (ApoA1). The former is a good proxy measure for LDL particle number, while the latter measures lipoproteins carrying HDL.
The ratio of ApoB/ApoA1 is the most important measure of cardiovascular risk from a blood test. This ratio should be 0.9 or less, and optimally less than 0.8.
ncbi.nlm.nih.gov/pmc/articl...
Essentially, it measures the balance between endothelial damaging Apo-B, and the scavenging work of Apo-A1 which removes the dangerous LDL-P.
The major cause of heart attacks and strokes are blood clots (thrombosis). These form when your blood platelets are too sticky, or can be caused by endothelial damage. Hypertension (high blood pressure), smoking, and an inflammatory response to poor diet and lifestyle (lack of exercise), are among the major contributors to endothelial damage.
world-heart-federation.org/...
You can measure the stickiness of your platelets with a test called 'fibrinogen' which should be 2.35 g/l or less. How do your platelets get sticky to begin with? It is primarily due to a diet low in folate, vitamin B6, and vitamin B12. A poorly balanced diet will result in these deficiencies which triggers a chemical response in your blood that raises homocysteine (an amino acid) levels. You can measure homocysteine levels with a blood test. Ideally they should be below 7 umol/l. You can buy supplements of those vitamins to resolve this issue.
The other cause of blood clots is when the fibrous cap that covers plaque deposits in your endothelium becomes loose and breaks away from the damaged site, and then floats away, and into your blood stream. If this material gets caught in a narrowing of your arteries it can block blood-flow, triggering a heart attack. A blockage in your carotid artery, the artery that carries blood and oxygen to your brain, triggers a stroke. Risk from a fibrous cap rupture can be measured by a blood test called Lp-pla2 also known as the PLAC test. The resulting value should be 75 or less.
Watch this video:
Whether or not your current diet is healthy is a subjective self-assessment. Compare your diet to the Pritikin diet:
pritikin.com/healthiest-die...
Cardiovascular disease (CVD) is complex and is believed to start in the first decade of life. Although genetics play a role in the development of CVD, diet and exercise have a much greater influence and that's why it is considered a disease of the aged. Since diet and lifestyle are different for everybody, the damage caused to your endothelium accumulates gradually over time, starting in the first decade of life, and will manifest itself eventually in the 6th, 7th, 8th or 9th decade of a person's life.
Other diseases related to CVD are diabetes, kidney disease, fatty liver disease, and inflammatory diseases such as arthritis. Excess body weight, especially when coupled with excess abdominal fat, also causes stress on knees, hips and your lower back which eventually lead to their deterioration and significant pain.
A poor diet can also potentially lead to macular degeneration, a form of blindness, later in life.
The time to deal with cardiovascular risk is as early in life as possible, even in your teens and twenties. A focus on daily exercise of 30 - 60 minutes (a vigorous walk is enough) is essential. Resistance training is also very helpful. A diet focused mostly on plants and legumes (beans, lentils, chick peas) with occasional (2-3 meals per week) consumption of lean chicken or turkey, and 2-3 meals per week of cold-water fish such as salmon or trout, will lead to better health outcomes.
Get educated, then take action. Hold yourself accountable by getting regular blood tests and monitoring your exercise with an activity measuring device like a Fitbit or other such product.
Disclaimer: I am not a doctor. I have CVD and have educated myself since my revascularization in 2015, by reading dozens of medical studies, journals and other credible websites, in order to better understand this disease. There is great disagreement and debate among medical professionals regarding the causes and the optimal treatment of CVD, including the question of the use of statin drugs. Although you should consult a medical professional for your own situation, you should understand that each has an inherent bias based on their own training and education, some of which has been done by pharmaceutical firms that profit from the promotion of their drugs.
In the end, you are responsible for your own health.
