High Cholesterol

HIGH CHOLESTEROL


Medically speaking: “Dyslipidemia”, literally abnormal forms and quantities of several kinds of fatty molecules that can be found in your blood stream. The usual determinants include: HDL, LDL and Triglycerides*. But there are actually several more that can be measured, and have clinical significance including, VLDL and VLDL ‘remnants’.

These fats have varying capability of entering the wall of the blood vessels and forming deposits that can eventually become blockages that lead to heart attacks, strokes and vascular disease. Although there is a strong genetic component to these values, they can be heavily influenced by diet and exercise. By example, more than 80% of Americans over age 50 have unhealthy levels of these fats compared to 10% of Japanese with most of the difference accounted for by diet.

Fats enter your system via diet and are converted by your liver into the variety of forms mentioned. Genetic differences account for differences in the rates of absorption from the gut and rates of conversion. Diet and medication can affect both of these processes and picking the right treatment is critical to the outcome. Traditional determinations of these values can miss certain subtle abnormalities, which can lead to under or over treatment. Complete lipid profiles by NMR (Nuclear Magnetic Resonance) can address these shortcomings and lead to more precise treatment. In certain patients, NMR is critical to the correct diagnosis.

Dietary changes and exercise can be as effective as many of the more than 10 drugs available. These changes are more related to the kind of foods eaten than the quantity. Reductions in certain types of fats and carbohydrates can be more effective than caloric restriction. Additionally, dietary supplements such as niacin, fish oil and red yeast can be useful in reducing risk. Occasionally, there needs to be several attempts to get the right combination of therapy that is both well tolerated and effective. Our lipid clinic staff has more than 8 years experience with these measurements and treatments.


*Since blood is mostly water, cholesterol, a long chain fatty alcohol found only in animal products doesn’t mix well and has to be attached to a protein molecule that is miscible (dissolved) in water. The resultant combination is called a Lipo-Protein. The size of the protein molecule determines the density of the combined structure. Large protein molecules result in HIGH Density Lipoproteins (HDL) whereas smaller proteins result in LOW Density Lipoprotein (LDL). Triglycerides are a combination of three fatty acids and represent most of the fats found in plants and animals (the white streaks in the meat). The vast majority of ingested fats are in the form of triglycerides. Your liver converts ingested cholesterol and triglycerides into the various lipoproteins.

HDL is beneficial and acts as a transport mechanism to take cholesterol back from the blood vessel walls to the liver. LDL in its oxidized form tends to deposit in arteries. Either having a LOW HDL or HIGH LDL is likely to cause arterial blockages. Having a low HDL is actually the most common abnormality in patients with vascular disease and puts you at significant risk even if your total cholesterol is in the recommended range.