Cholesterol - Lipids - Hyperlipidemia

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Cholesterol

NIH - What Is Cholesterol?

"Blood is watery, and cholesterol is fatty. Just like oil and water, the two do not mix. To travel in the bloodstream, cholesterol is carried in small packages called lipoproteins (lip-o-PRO-teens). The small packages are made of fat (lipid) on the inside and proteins on the outside. Two kinds of lipoproteins carry cholesterol throughout your body. It is important to have healthy levels of both: -- Low-density lipoprotein (LDL) cholesterol is sometimes called bad cholesterol. High LDL cholesterol leads to a buildup of cholesterol in arteries. The higher the LDL level in your blood, the greater chance you have of getting heart disease. -- High-density lipoprotein (HDL) cholesterol is sometimes called good cholesterol. HDL carries cholesterol from other parts of your body back to your liver. The liver removes the cholesterol from your body. The higher your HDL cholesterol level, the lower your chance of getting heart disease."

Highlighted Article

High-density lipoprotein as a therapeutic target: clinical evidence and treatment strategies.

"Niacin therapy, currently the most effective means for raising HDL levels, should be initiated in patients with isolated low HDL (HDL <40 mg/dL, LDL and non-HDL at or below National Cholesterol Education Program (NCEP) targets based on global cardiovascular risk evaluation). Patients who have both low HDL and elevated LDL should receive a statin or statin-niacin combination therapy, and patients with concomitant low HDL and elevated TGs should receive a fibrate initially, with a statin, niacin, or ezetimibe added thereafter as needed to help attain NCEP lipoprotein targets."

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Cholesterol - Lipids - Hyperlipidemia

General Information

NEWS:

Cholesterol and Stroke: A Paradox

Cholesterol levels may predict dementia "A decline in total cholesterol levels may precede the diagnosis of dementia by at least 15 years, according to a study reported in the Archives of Neurology."

Garlic May Not Lower Cholesterol " Garlic may not improve the cholesterol profiles of people with moderately high levels of "bad" cholesterol, a new study shows. The researchers tested raw garlic and two different garlic supplements on nearly 200 adults with moderately high levels of LDL ("bad") cholesterol. After six months, the patients showed no improvements in their average cholesterol or other blood fats (lipids), no matter what kind of garlic they had consumed."

High Cholesterol Linked With Stroke Even in Healthy Women "A new report from the Women's Health Study confirms that high levels of total cholesterol, low-density lipoprotein–cholesterol (LDL-C), and other lipid levels are significantly associated with an increased risk for ischemic stroke, even in women who are otherwise healthy."

Is Too Much Good Cholesterol, Bad?

Low HDL cholesterol, even when LDL levels are low, is cardiovascular dynamite, new TNT analysis shows "Commenting on the results of the study for heartwire, Dr Monty Krieger (Massachusetts Institute of Technology, Cambridge, MA) said that this is yet another study showing that HDL cholesterol is protective, this time at various LDL levels, and will reinforce the concept that doing something to treat low levels of HDL cholesterol may be beneficial, regardless of the LDL-cholesterol numbers."

Very Low Cholesterol May Bump Up Cancer Risk

When 'Good' Cholesterol Goes Bad

ARTICLES:

Cholesterol "ain't" all bad

Genetics Home Reference: Hypercholesterolemia

High Cholesterol Risks: Top 2 Dangers "LDL is also called "bad cholesterol" -- Sperling suggests that you think of the "L" as standing for lousy. LDL cholesterol can clog your arteries, increasing the risk of heart attackheart attack and strokestroke. Most people should aim for a level of less than 100 mg/dL. However, people who already have heart diseaseheart disease may need to aim for under 70 mg/dL. • HDL is "good cholesterol." Imagine the "H" stands for healthy, Sperling suggests. This type of cholesterol attaches to bad cholesterol and brings it to the liver, where it's filtered out of the body. So HDL cholesterol reduces the amount of bad cholesterol in your system. You should aim for 60 mg/dL or higher. • Triglycerides - Triglycerides are not cholesterol but another type of fat floating in your blood. Just as with bad cholesterol, having a high level of triglycerides increases your risk of cardiovascular problems. Aim for a level of less than 150 mg/dL. "

High Cholesterol (Hypercholesterolemia)

Summaries for patients. Changes in triglyceride levels and risk for coronary heart disease in young men. "In young men, triglycerides are a risk factor for CHD. Increases or decreases in triglyceride levels are associated with increases and decreases, respectively, in CHD risk. Checking for changes in triglyceride levels might help to identify young men at extra high risk for CHD."

JOURNAL ARTICLES:

Association between Depression and Anxiety Symptoms and Major Atherosclerosis Risk Factors in Patients with Chest Pain. (Tohoku J Exp Med. 2007) "Thus, DM and hypercholesterolemia are associated with depression and anxiety, while hypertension is only related to anxiety. In contrast, smoking and family history of atherosclerosis are not related to depression and anxiety scores. These results suggest depression and anxiety symptoms may contribute to the development and progression of CAD, especially in patients with DM or hypercholesterolemia."

Cerebral Vascular Dysfunction During Hypercholesterolemia. (Stroke. 2007) "CONCLUSIONS: Hypercholesterolemia is associated with oxidative stress and endothelial dysfunction in cerebral arterioles, despite the absence of atherosclerotic lesions."

Contemporary diagnosis and management of hypercholesterolemia in elderly acute myocardial infarction patients: a population-based study. (Am J Geriatr Cardiol. 2007)

Diagnosis and treatment of dyslipidemia are neglected in patients with peripheral artery disease. (Scand Cardiovasc J. 2007) "Conclusions. Dyslipidemia was highly under-diagnosed among PAD patients. Serum lipids were measured only in a minority and among them serum lipid values and the use of hypolipidemic drugs were not optimal according to guidelines."

Dietary supplementation with flaxseed oil lowers blood pressure in dyslipidaemic patients. (Eur J Clin Nutr. 2007) "Conclusions:We observed a hypotensive effect of ALA, which may constitute another mechanism accounting in part for the apparent cardioprotective effect of this n-3 fatty acid."

Dyslipidemia as a risk factor for erectile dysfunction. (Curr Med Chem. 2007)

Elevation of Low-Density Lipoprotein Cholesterol Concentration with Over-the-Counter Fish Oil Supplementation (July/August). (Ann Pharmacother. 2007) "CONCLUSIONS: This case documents a much higher LDL-C elevation associated with OTC fish oil supplementation than has been previously identified in the literature. Healthcare providers should be advised that LDL-C levels may increase with use of OTC fish oil and should monitor patients periodically for such elevations. The significance of this increase on clinical outcomes is not known."

Fructose intake is a predictor of LDL particle size in overweight schoolchildren. (Am J Clin Nutr. 2007) "CONCLUSIONS: In school-age children, greater total and central adiposity are associated with smaller LDL particle size and lower HDL cholesterol. Overweight children consume more fructose from sweets and sweetened drinks than do normal-weight children, and higher fructose intake predicts smaller LDL particle size."

HDL Cholesterol, Very Low Levels of LDL Cholesterol, and Cardiovascular Events (NEJM 2007) "Conclusions In this post hoc analysis, HDL cholesterol levels were predictive of major cardiovascular events in patients treated with statins. This relationship was also observed among patients with LDL cholesterol levels below 70 mg per deciliter."

Higher Total Serum Cholesterol Levels Are Associated With Less Severe Strokes and Lower All-Cause Mortality. Ten-Year Follow-Up of Ischemic Strokes in the Copenhagen Stroke Study. (Stroke. 2007) "BACKGROUND AND PURPOSE: Evidence of a causal relation between serum cholesterol and stroke is inconsistent. We investigated the relation between total serum cholesterol and both stroke severity and poststroke mortality to test the hypothesis that hypercholesterolemia is primarily associated with minor stroke. … CONCLUSIONS: The results of our study support the hypothesis that a higher cholesterol level favors development of minor strokes. Because of selection, therefore, major strokes are more often seen in patients with lower cholesterol levels. Poststroke mortality, therefore, is inversely related to cholesterol."

High-density lipoprotein-cholesterol and risk of stroke and carotid atherosclerosis: A systematic review. (Atherosclerosis. 2007) "BACKGROUND AND PURPOSE: Epidemiological studies have found no relationship between total cholesterol and stroke risk, but little attention has been paid to high-density lipoprotein-cholesterol (HDL-C). … CONCLUSIONS: The weight of evidence in the literature supports an inverse association between HDL-C level and stroke or carotid atherosclerosis, but more data are needed to firmly establish this protective effect."

Hypertriglyceridemia: its etiology, effects and treatment. (CMAJ. 2007)

Lifetime risk for developing dyslipidemia: the Framingham Offspring Study. (Am J Med. 2007) "RESULTS: Over a 30-year period, approximately 6 of 10 participants developed borderline-high LDL, 4 of 10 people developed high LDL, and 2 (women) to 4 (men) of 10 individuals developed low HDL levels; estimates were generally similar for different age groups. Adjustment for baseline prevalence of dyslipidemia increased these estimates: 30-year risks exceeded 80% for borderline-high LDL, 50% for high LDL, and 25% (women) to 65% (men) for low HDL; 20-50% had or developed a low HDL along with a high LDL level. The 30-year estimates approximate the lifetime risk in 50-year-olds."

Lipoprotein (a) and Stroke. A Meta-Analysis of Observational Studies. (Stroke. 2007) "CONCLUSIONS: This meta-analysis suggests that elevated Lp(a) is a risk factor for incident stroke."

Low density lipoprotein triglycerides and lipoprotein(a) are risk factors for retinal vascular occlusion. (Clin Chim Acta. 2007) "CONCLUSION: These findings suggest that disorders in lipoprotein metabolism may contribute to the etiology of retinal vascular occlusions."

Postprandial hyperglycemia/hyperlipidemia (postprandial dysmetabolism) is a cardiovascular risk factor. (Am J Cardiol. 2007) "Diet, exercise, and various pharmacologic agents can improve postprandial dysmetabolism. Using these strategies may help improve the prognosis for patients with diabetes mellitus and/or coronary heart disease."

Prevalence and determinants of coronary artery disease in males and females with familial combined hyperlipidaemia. (Atherosclerosis. 2007) “CONCLUSIONS: In FCH patients, the prevalence of CAD is higher in males than in females, independent of lipidaemic profile and other risk factors. Among lipid variables, Lp(a) and cholesterol level are predictors of CAD in males and females respectively.”

Relation between hypercholesterolaemia and vascular endothelial microinflammation. (East Mediterr Health J. 2007) "Hypercholesterolaemia causes endothelial microinflammation, and P-selectin and IL-6 may also be risk factors for cardiovascular disease. "

Self-rated health showed a consistent association with serum HDL-cholesterol in the cross-sectional Oslo Health Study. (Int J Med Sci. 2007)

Serum cholesterol changes after midlife and late-life cognition: twenty-one-year follow-up study. (Neurology. 2007) "CONCLUSIONS: The relationship between serum total cholesterol (TC) and dementia seems to be bidirectional. High midlife serum TC is a risk factor for subsequent dementia/Alzheimer disease, but decreasing serum TC after midlife may reflect ongoing disease processes and may represent a risk marker for late-life cognitive impairment."

The prevalence of newly diagnosed hyperlipidaemia in men with erectile dysfunction. (BJU Int. 2007) "CONCLUSION This study shows the high prevalence of undiagnosed hypercholesterolaemia and hypertriglyceridaemia in men presenting with ED. The opportunity to screen for and treat these risk factors has long-term benefits in preventing cardiovascular disease in this group of patients."

The two faces of the 'good' cholesterol. (Cleve Clin J Med. 2007)

Update on Dyslipidemia. (J Clin Endocrinol Metab. 2007)

Virgin olive oil may help keep blood clot-free "Eating foods prepared with olive oils that are rich in phenols, substances though to have beneficial effects on the heart, may help ward off harmful blood clots in people with high cholesterol, Spanish researchers report. … In the early stages of atherosclerosis, the balance between clot-promoting and clot-dissolving factors in the blood vessels shifts in favor of clot formation and having high levels of fat in the blood can worsen this imbalance …"

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