CHOLESTEROL AND CARDIOVASCULAR DISEASE
Cholesterol is a waxy substance that a human body makes and uses to guard nerves, make cell tissues and create hormones. There are mainly two types of cholesterol low density lipoprotein (LDL) and high density lipoprotein (HDL). LDL cholesterol is also called as bad cholesterol, which is the main source of cholesterol buildup and blockage in the arteries. HDL cholesterol is also called as good cholesterol and helps in protecting the arteries from plaque buildup.
When there is excess cholesterol in the blood, it builds up in the arteries walls. Eventually, this buildup of cholesterol causes hardening of the arteries, which makes the arteries narrowed. With narrowed arteries, flow of blood to the heart is slowed down or obstructed. Oxygen is carried to the heart by blood, and if sufficient oxygen and blood cannot reach the heart, the person may suffer from chest pain. If the supply of blood to a part of the heart is totally cut off by obstruction, the outcome is a heart disease (National Heart, Lung, and Blood Institute 2001).
Cholesterol and Heart Disease
From the past four years, the facts have been gathered that cholesterol is associated with cardiovascular disease, mainly heart attacks and angina. Various studies show that higher the persons average cholesterol level, higher the occurrence of heart disease in that person.There are also indications with animal studies. When rabbits were fed cholesterol, it showed that some of the dietary cholesterol got settled in the arteries. This results in hardening of arteries and narrowing of arteries, which is known as atherosclerosis or arteriosclerosis. This results in reduced flow of blood to the muscles of the heart, which can lead to pain in the chest while exercising or during other stresses and heart attacks (Frohlich 2007). Another relation between cholesterol and cardiovascular disease is noticed in persons with cholesterol inherited disorders like familial hypercholesterolemia. Persons with familial hypercholesterolemia develop cardiovascular disease sooner in life. For example, if the person is inherited with two genes of this order, wide narrowing of arteries can take place as sooner as 5 to 6 years of age. Cardiac problems such as heart attack and angina have been significantly reduced with clinical trials utilising cholesterol lowering regimes like drugs or diet. In the Lipid Research Clinic Study, for every one percent reduction in blood cholesterol, there was two percent reduction in the possibility of a heart attack. In a person, who had angina or had a heart attack, reducing of LDL cholesterol not only reduced the occurrence of succeeding events but also improved the overall survival (Frohlich 2007).
High Cholesterol Levels in Childhood Cardiovascular Disease Risk Factors
The strongest risk factors of cardiovascular disease include increased low density lipoprotein (LDL) or bad cholesterol, reduced high density lipoprotein (HDL) or good cholesterol, type 1 or type 2 diabetes, obesity, high blood pressure and cigarette smoking. A few of these risk factors may be noticed at adolescent ages. Research has revealed that these risk factors should be tackled early. Kids and youngsters are becoming more and more fat and obese. According to a recent study, the occurrence of obesity in children of 12 to 19 years old is 15.5 percent.
Due to the outbreak of childhood obesity, the requirement for pediatric health care specialists to become more familiar about the risk factors for cardiovascular disease and to start employing lifestyle modifications in patients has increased (Cook 2009). With the rise in childhood obesity, there is an increased occurrence of pediatric metabolic syndrome, which is another risk factor for cardiovascular disease. Metabolic syndrome is a collection of risk factors for diabetes and cardiovascular disease that appear to be connected to insulin resistance and obesity. Obesity and metabolic syndrome are connected strongly to abnormalities of lipid metabolism. According to the research, overweight school children, between 2.4 and 7.1 times, are more possibly to have high LDL cholesterol, total cholesterol and triglyceride levels than normal weight children. More number of mechanisms are present, by which insulin resistance can result in dyslipidemias. Hepatic synthesis of VLDL cholesterol, which leads to augmented LDL cholesterol and triglycerides, is increased with overloaded insulin presence in blood.Effects of insulin on lipoprotein lipase, an enzyme that helps in breaking down lipoproteins, increases the levels of LDL cholesterol and triglycerides. Sometimes, HDL cholesterol is degraded more quickly in patients who have metabolic syndrome.
Even, obesity obviously adds to dyslipidemias and cardiovascular disease, a significant genetic component is also added to the risk. If any of the family members is having cardiovascular disease, there is an increased risk for children or youngsters to develop the disease at some phase of their life. The family member can include a parent or a grandparent of age less than 55 who have cerebrovascular disease, peripheral vascular disease, coronary atherosclerosis, or myocardial infarction, coronary artery procedure or unexpected cardiac death. Children, who have high cholesterol levels or their parents with high cholesterol levels, are believed to be at risk. Diagnosis is suggested for them (Cook 2009).
Cook, W. B. (2009) High Cholesterol in Childhood Risk Factors for Cardiovascular Disease. Medscape Today online 34, (3) 27-32.
Statins, Cholesterol Levels, and Coronary Heart Disease Prevention
Statin is one of the most commonly prescribed drugs in the world. Before 20 years back, patients with high serum cholesterol levels, and those who had earlier experienced a heart attack, were not given any cholesterol lowering drugs. At that period, most of the Americans did not even hear about LDL and HDL cholesterols and very few have gone for measurements of cholesterol levels. With the innovation and progress of the statins, the obstruction was demolished, which blocked extensive cholesterol lowering treatment. Several studies regarding statins were published in the early and late 1900s. Those studies revealed that these drugs can decrease cardiovascular disease death and heart attack rates by 20 to 50 percent, based on the initial blood cholesterol levels and existence or non-existence of heart disease risk factors. The drug, statin, was shown to work effectively in women and men, middle aged people and old, and in patients with or without pre-existing diabetes or heart disease (Freeman 2006). After the beginning of 21st century, the atherosclerosis problem is not solved, however. Statin therapy noticeably decreases future cardiovascular events in people who have had an earlier heart attack, but it is short of providing ultimate cure.
The science advancement from the past twenty years have demonstrated a significant task of the immune system, mainly the macrophage and T lymphocyte, in encouraging the progress and coronary plaque catastrophic rupture that results in heart attacks or unexpected coronary death. The immunological responses look to be started by high cholesterol levels penetrating into the artery wall. But, once the procedure has started, even remarkable decrease in blood cholesterol appears to be incompetent of totally stopping it. HDL cholesterol has been exposed to alter immune responses and to take part in a path that is intended to eliminate cholesterol from the walls of the artery. According to the animal data, we can efficiently and cleverly interrupt immune processes straightly, or through the improvement of HDL functioning, but if we would have extra, important therapeutic methods in preventing cardiovascular disease. These approaches when combined with statins could radically decrease the atherosclerosis. We do not have enough tools to reduce the cholesterol levels, but those tools and their demonstration are possibly followed in the coming decade (Freeman 2006).
Freeman, M. W. (2006) Statins, Cholesterol, and the Prevention of Coronary Heart Disease. The FASEB Journal online 20, (2) 200-201. Available from httpwww.fasebj.orgcgicontentfull202200 2006
Importance of Cholesterol, Blood Pressure and Smoking for Coronary Heart Disease
Epidemiological studies conducted over the last five decades have shown that increased blood pressure, dyslipidemia, and cigarette smoking raise cardiovascular disease risks and randomised experiments have shown that reducing cholesterol and blood pressure prevents cardiovascular disease risks. However, there are popular fallacies about the significance of these traditional risk factors, including the extensively held belief that these risk factors account for only half of all coronary heart diseases. The Population Attributable Risk Fractions (PARF) method is a helpful way of measuring the combined impact of cholesterol, smoking and blood pressure for ischemic heart disease (IHD) mortality, but it emphasises the restrictions of using threshold values to decide the risk. Epidemiological studies have showed the log-linear relations between total cholesterol and ischemic heart disease risk, so that for each change in cholesterol unit, there is similar proportional modification in risk, in spite of early cholesterol levels with no noticeable value of threshold below which lesser total cholesterol value is not related to lesser IHD risk (Lewington 2003).
The Heart Protection Study showed that statin therapy use to reduce levels of total cholesterol is linked to a like proportional decrease in cardiovascular disease risk, in spite of whether the previous total cholesterol treatment level is above or below 5.5mmoll.The Prospective studies meta-analysis demonstrated that the relations of general systolic blood pressure with IHD and stroke mortality are log-linear below to at least 11575 mmHG. Generally, a 200mmHg variation in normal systolic blood pressure is related to a two-fold variation in cardiovascular risk. However, there is a threat that results could be misunderstood to support the significance of 5.5mmoll as a value of threshold for total cholesterol. An even enhanced method to evaluate the significance of these identified vital risk factors can be to estimate the impact on risk of ending smoking and of modest and practical decline in blood pressure and cholesterol that could be attained, for example, by lessening the intake of salt in processed food and promoting the substitution of saturated fat in cooking with monounsaturated fats or polyunsaturated fats (Lewington 2003).
Lewington, S. (2003) The Importance of Cholesterol, Blood Pressure and Smoking for Coronary Heart Disease. European Heart Journal online 24, (19) 1703-1704.
Patients awareness of cholesterol, cardiovascular disease risk, and risk communication strategies
In spite of some latest developments in familiarity about cholesterol in U.S., patient obedience to cholesterol treatment suggestions are below the optimum level.
A study is conducted that discovered patients awareness of cholesterol and cardiovascular disease and their responses to three strategies for communicating cardiovascular disease risk. Researchers conducted seven focus groups in New England by means of open ended questions and visual threat communication prompts. The multidisciplinary study group carried out an in-depth analysis using immersioncrystallisation methods. The coded reports were analysed with the help of qualitative coding software NVivo (Goldman 2006).Participants from the groups were all conscious that high cholesterol levels negatively affect health. However, many participants had insufficient awareness about hypercholesterolemia and cardiovascular disease risk, and few were familiar with their cholesterol numbers. Many participants thought that their cholesterol levels were healthy, even if the doctor had not stated it. An approach that offers a cardiovascular risk adjusted age was estimated as apparent, impressive, appropriate, and potentially capable of inspiring people to formulate healthy changes. Few participants in every group were worried that a cardiovascular risk-adjusted age that was larger than chronological age would scare patients.
Difficult explanations about cholesterol levels and cardiovascular disease risk look to be inadequate for inspiring behaviour change. A cardiovascular risk-adjusted age calculator is a method that may keep patients in identifying their cardiovascular disease risk and, when combined by information about reduction of risk, it may be supportive in communicating cardiovascular disease risk to patients (Goldman 2006).
Goldman, R. E. et al. (2006) Patients Perceptions of Cholesterol, Cardiovascular Disease Risk, and Risk Communication Strategies.
Treating High Cholesterol
The main aim of the cholesterol treatment is to decrease the LDL cholesterol levels as much as necessary to decrease the risk of developing cardiovascular disease or heart attack. The greater the risk, the lesser the LDL cholesterol objective will be. There are two ways to reduce cholesterol levels Therapeutic Lifestyle Changes (TLC) TLC includes diet that lowers cholesterol, exercise, and weight management. TLC diet TLC diet is a low saturated fat and low cholesterol intake plan that contains less than seven percent of calories from saturated fat and less than 200 milligrams of dietary cholesterol per day. This diet suggests only sufficient calories to sustain a wanted weight and prevent weight gain (National Heart, Lung, and Blood Institute 2001). Weight management losing weight if a person is overweight can help decrease LDL cholesterol and it is particularly important for those with a group of risk factors that includes low HDL levels and high triglyceride levels and being obese with a large measurement of waist.Exercise Regular exercise is suggested for everyone. It helps in raising HDL levels and lowering LDL levels and is particularly important for those with low HDL levels and high triglyceride and being obese with a large measurement of waist. Drug treatment If drugs that reduce cholesterol are required, they are used with TLC treatment to lower the LDL cholesterol levels.
When there is excess cholesterol in the blood, it builds up in the arteries walls. Eventually, this buildup of cholesterol causes hardening of the arteries, which makes the arteries narrowed. With narrowed arteries, flow of blood to the heart is slowed down or obstructed. Oxygen is carried to the heart by blood, and if sufficient oxygen and blood cannot reach the heart, the person may suffer from chest pain. If the supply of blood to a part of the heart is totally cut off by obstruction, the outcome is a heart disease (National Heart, Lung, and Blood Institute 2001).
Cholesterol and Heart Disease
From the past four years, the facts have been gathered that cholesterol is associated with cardiovascular disease, mainly heart attacks and angina. Various studies show that higher the persons average cholesterol level, higher the occurrence of heart disease in that person.There are also indications with animal studies. When rabbits were fed cholesterol, it showed that some of the dietary cholesterol got settled in the arteries. This results in hardening of arteries and narrowing of arteries, which is known as atherosclerosis or arteriosclerosis. This results in reduced flow of blood to the muscles of the heart, which can lead to pain in the chest while exercising or during other stresses and heart attacks (Frohlich 2007). Another relation between cholesterol and cardiovascular disease is noticed in persons with cholesterol inherited disorders like familial hypercholesterolemia. Persons with familial hypercholesterolemia develop cardiovascular disease sooner in life. For example, if the person is inherited with two genes of this order, wide narrowing of arteries can take place as sooner as 5 to 6 years of age. Cardiac problems such as heart attack and angina have been significantly reduced with clinical trials utilising cholesterol lowering regimes like drugs or diet. In the Lipid Research Clinic Study, for every one percent reduction in blood cholesterol, there was two percent reduction in the possibility of a heart attack. In a person, who had angina or had a heart attack, reducing of LDL cholesterol not only reduced the occurrence of succeeding events but also improved the overall survival (Frohlich 2007).
High Cholesterol Levels in Childhood Cardiovascular Disease Risk Factors
The strongest risk factors of cardiovascular disease include increased low density lipoprotein (LDL) or bad cholesterol, reduced high density lipoprotein (HDL) or good cholesterol, type 1 or type 2 diabetes, obesity, high blood pressure and cigarette smoking. A few of these risk factors may be noticed at adolescent ages. Research has revealed that these risk factors should be tackled early. Kids and youngsters are becoming more and more fat and obese. According to a recent study, the occurrence of obesity in children of 12 to 19 years old is 15.5 percent.
Due to the outbreak of childhood obesity, the requirement for pediatric health care specialists to become more familiar about the risk factors for cardiovascular disease and to start employing lifestyle modifications in patients has increased (Cook 2009). With the rise in childhood obesity, there is an increased occurrence of pediatric metabolic syndrome, which is another risk factor for cardiovascular disease. Metabolic syndrome is a collection of risk factors for diabetes and cardiovascular disease that appear to be connected to insulin resistance and obesity. Obesity and metabolic syndrome are connected strongly to abnormalities of lipid metabolism. According to the research, overweight school children, between 2.4 and 7.1 times, are more possibly to have high LDL cholesterol, total cholesterol and triglyceride levels than normal weight children. More number of mechanisms are present, by which insulin resistance can result in dyslipidemias. Hepatic synthesis of VLDL cholesterol, which leads to augmented LDL cholesterol and triglycerides, is increased with overloaded insulin presence in blood.Effects of insulin on lipoprotein lipase, an enzyme that helps in breaking down lipoproteins, increases the levels of LDL cholesterol and triglycerides. Sometimes, HDL cholesterol is degraded more quickly in patients who have metabolic syndrome.
Even, obesity obviously adds to dyslipidemias and cardiovascular disease, a significant genetic component is also added to the risk. If any of the family members is having cardiovascular disease, there is an increased risk for children or youngsters to develop the disease at some phase of their life. The family member can include a parent or a grandparent of age less than 55 who have cerebrovascular disease, peripheral vascular disease, coronary atherosclerosis, or myocardial infarction, coronary artery procedure or unexpected cardiac death. Children, who have high cholesterol levels or their parents with high cholesterol levels, are believed to be at risk. Diagnosis is suggested for them (Cook 2009).
Cook, W. B. (2009) High Cholesterol in Childhood Risk Factors for Cardiovascular Disease. Medscape Today online 34, (3) 27-32.
Statins, Cholesterol Levels, and Coronary Heart Disease Prevention
Statin is one of the most commonly prescribed drugs in the world. Before 20 years back, patients with high serum cholesterol levels, and those who had earlier experienced a heart attack, were not given any cholesterol lowering drugs. At that period, most of the Americans did not even hear about LDL and HDL cholesterols and very few have gone for measurements of cholesterol levels. With the innovation and progress of the statins, the obstruction was demolished, which blocked extensive cholesterol lowering treatment. Several studies regarding statins were published in the early and late 1900s. Those studies revealed that these drugs can decrease cardiovascular disease death and heart attack rates by 20 to 50 percent, based on the initial blood cholesterol levels and existence or non-existence of heart disease risk factors. The drug, statin, was shown to work effectively in women and men, middle aged people and old, and in patients with or without pre-existing diabetes or heart disease (Freeman 2006). After the beginning of 21st century, the atherosclerosis problem is not solved, however. Statin therapy noticeably decreases future cardiovascular events in people who have had an earlier heart attack, but it is short of providing ultimate cure.
The science advancement from the past twenty years have demonstrated a significant task of the immune system, mainly the macrophage and T lymphocyte, in encouraging the progress and coronary plaque catastrophic rupture that results in heart attacks or unexpected coronary death. The immunological responses look to be started by high cholesterol levels penetrating into the artery wall. But, once the procedure has started, even remarkable decrease in blood cholesterol appears to be incompetent of totally stopping it. HDL cholesterol has been exposed to alter immune responses and to take part in a path that is intended to eliminate cholesterol from the walls of the artery. According to the animal data, we can efficiently and cleverly interrupt immune processes straightly, or through the improvement of HDL functioning, but if we would have extra, important therapeutic methods in preventing cardiovascular disease. These approaches when combined with statins could radically decrease the atherosclerosis. We do not have enough tools to reduce the cholesterol levels, but those tools and their demonstration are possibly followed in the coming decade (Freeman 2006).
Freeman, M. W. (2006) Statins, Cholesterol, and the Prevention of Coronary Heart Disease. The FASEB Journal online 20, (2) 200-201. Available from httpwww.fasebj.orgcgicontentfull202200 2006
Importance of Cholesterol, Blood Pressure and Smoking for Coronary Heart Disease
Epidemiological studies conducted over the last five decades have shown that increased blood pressure, dyslipidemia, and cigarette smoking raise cardiovascular disease risks and randomised experiments have shown that reducing cholesterol and blood pressure prevents cardiovascular disease risks. However, there are popular fallacies about the significance of these traditional risk factors, including the extensively held belief that these risk factors account for only half of all coronary heart diseases. The Population Attributable Risk Fractions (PARF) method is a helpful way of measuring the combined impact of cholesterol, smoking and blood pressure for ischemic heart disease (IHD) mortality, but it emphasises the restrictions of using threshold values to decide the risk. Epidemiological studies have showed the log-linear relations between total cholesterol and ischemic heart disease risk, so that for each change in cholesterol unit, there is similar proportional modification in risk, in spite of early cholesterol levels with no noticeable value of threshold below which lesser total cholesterol value is not related to lesser IHD risk (Lewington 2003).
The Heart Protection Study showed that statin therapy use to reduce levels of total cholesterol is linked to a like proportional decrease in cardiovascular disease risk, in spite of whether the previous total cholesterol treatment level is above or below 5.5mmoll.The Prospective studies meta-analysis demonstrated that the relations of general systolic blood pressure with IHD and stroke mortality are log-linear below to at least 11575 mmHG. Generally, a 200mmHg variation in normal systolic blood pressure is related to a two-fold variation in cardiovascular risk. However, there is a threat that results could be misunderstood to support the significance of 5.5mmoll as a value of threshold for total cholesterol. An even enhanced method to evaluate the significance of these identified vital risk factors can be to estimate the impact on risk of ending smoking and of modest and practical decline in blood pressure and cholesterol that could be attained, for example, by lessening the intake of salt in processed food and promoting the substitution of saturated fat in cooking with monounsaturated fats or polyunsaturated fats (Lewington 2003).
Lewington, S. (2003) The Importance of Cholesterol, Blood Pressure and Smoking for Coronary Heart Disease. European Heart Journal online 24, (19) 1703-1704.
Patients awareness of cholesterol, cardiovascular disease risk, and risk communication strategies
In spite of some latest developments in familiarity about cholesterol in U.S., patient obedience to cholesterol treatment suggestions are below the optimum level.
A study is conducted that discovered patients awareness of cholesterol and cardiovascular disease and their responses to three strategies for communicating cardiovascular disease risk. Researchers conducted seven focus groups in New England by means of open ended questions and visual threat communication prompts. The multidisciplinary study group carried out an in-depth analysis using immersioncrystallisation methods. The coded reports were analysed with the help of qualitative coding software NVivo (Goldman 2006).Participants from the groups were all conscious that high cholesterol levels negatively affect health. However, many participants had insufficient awareness about hypercholesterolemia and cardiovascular disease risk, and few were familiar with their cholesterol numbers. Many participants thought that their cholesterol levels were healthy, even if the doctor had not stated it. An approach that offers a cardiovascular risk adjusted age was estimated as apparent, impressive, appropriate, and potentially capable of inspiring people to formulate healthy changes. Few participants in every group were worried that a cardiovascular risk-adjusted age that was larger than chronological age would scare patients.
Difficult explanations about cholesterol levels and cardiovascular disease risk look to be inadequate for inspiring behaviour change. A cardiovascular risk-adjusted age calculator is a method that may keep patients in identifying their cardiovascular disease risk and, when combined by information about reduction of risk, it may be supportive in communicating cardiovascular disease risk to patients (Goldman 2006).
Goldman, R. E. et al. (2006) Patients Perceptions of Cholesterol, Cardiovascular Disease Risk, and Risk Communication Strategies.
Treating High Cholesterol
The main aim of the cholesterol treatment is to decrease the LDL cholesterol levels as much as necessary to decrease the risk of developing cardiovascular disease or heart attack. The greater the risk, the lesser the LDL cholesterol objective will be. There are two ways to reduce cholesterol levels Therapeutic Lifestyle Changes (TLC) TLC includes diet that lowers cholesterol, exercise, and weight management. TLC diet TLC diet is a low saturated fat and low cholesterol intake plan that contains less than seven percent of calories from saturated fat and less than 200 milligrams of dietary cholesterol per day. This diet suggests only sufficient calories to sustain a wanted weight and prevent weight gain (National Heart, Lung, and Blood Institute 2001). Weight management losing weight if a person is overweight can help decrease LDL cholesterol and it is particularly important for those with a group of risk factors that includes low HDL levels and high triglyceride levels and being obese with a large measurement of waist.Exercise Regular exercise is suggested for everyone. It helps in raising HDL levels and lowering LDL levels and is particularly important for those with low HDL levels and high triglyceride and being obese with a large measurement of waist. Drug treatment If drugs that reduce cholesterol are required, they are used with TLC treatment to lower the LDL cholesterol levels.
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