UPDATE ON CHOLESTEROL THE GOOD THE BAD AND THE UGLY LDL HDL TRANS FATS AND NATURAL DIETS TO LOWER CHOLESTEROL PART TWO
Trans Fat Acts to Increase Bad Cholesterol: What is Cholesterol and Why The Body Manufactures Cholesterol
Cholesterol is not all bad. The body enlists cholesterol to synthesize important molecules that it needs, molecules like the male and female hormones testosterone and estrogen, not to mention Vitamin D as well as constituents of the body's cell membranes. Cholesterol is also involved with the bile that is released to help digest a meal. Because cholesterol is a lipid, it is soluble in oil but not very soluble in water so it is transported in the relatively watery blood aboard a transport molecule. Cholesterol is manufactured in the liver and travels out of the liver aboard lipoprotein particles called VLDL which are then converted to LDL, short for Low Density Lipoproteins. Our body makes most of our cholesterol but we also get cholesterol from food we eat. Foods high in animal fat and foods that are high in saturated fats, cholesterol and trans fats are likely to raise LDL, the "bad cholesterol". As of January, 2006 food labels are mandated to list trans fats. See What Trans Fat Labels Mean: Read Them and Get Healthy
Meds for Cholesterol: Statins The 500 Pound Gorilla of Cholesterol Meds and Zetia the (Not So) New Kid on the Block
Right now the most "popular" class of cholesterol meds are the statins. There are six statins on the market with the newest contender being Crestor (rosuvastatin). The others include:
Statins reduce the quantities of LDL Cholesterol. Statins block the manufacture of cholesterol in the liver by interfering with an enzyme that orchestrates cholesterol production,HMGCoa Reductase. That's why statins are called HMGCoa Reductase Inhibitors. Enzymes are chemicals called proteins that act all over the body to speed up chemical reactions. Statins work in the liver. That's why they get a blood test to check liver function when someones starts a statin and why they monitor liver function.A rare but dangerous possible side effect of statins is rhabdomyolysis characterized by muscle pain and weakness. One statin, cervistatin, was removed from the market because of problems with this phenomenon. It's the breakdown of muscle tissue and requires immediate emergency intervention. It may be the result of drug interactions between statins and other medications which result in high concentrations of the drug.
Vytorin and Zetia Ezetimibe: They Were Touted as a Cholesterol Reducer With Less Side Effects but Questions about Ability to Reduce Plaque Cloud Picture
Ezetimibe is a whole different ball game when it comes to lowering cholesterol. Zetia works in the intestine to block cholesterol absorption, not in the liver like statins. So potentially it may have fewer side effects. The downside is that so far it seems to be a mild cholesterol reducer and recent studies of it as well as the combination drug Vytorin which is a statin drug plus ezetimibe have questioned the value of it to reduce artery plaque.
Niacin
Niacin is a B vitamin. It can lower cholesterol and triglycerides and raise HDL. The trouble with niacin is the side effects. Hot flashes are a big problem for niacin users and sometimes they are so unpleasant that people just won't use niacin.
Niacin can also interact with other drugs and it can raise blood sugar. Always talk with your doctor if you are contemplating using niacin.
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David A. Jenkins, of the University of Toronto and colleagues tested a vegetarian or "natural" diet to lower cholesterol. Plant sterols are molecules found in plants that resemble cholesterol and compete in the intestine with cholesterol for absorption. The Jenkins Toronto has claimed capabilty to lower cholesterol possibly as much as 20% something akin to a low dose statin drug.
Plaque in Coronary Artery Wall Seems to be Linchpin of Coronary Artery Disease: Inflammation
In the classic explanation of the dangers of high cholesterol, high cholesterol leads to the narrowing of the coronary arteries and a plaque may break off and block or occlude the artery. The result is little or no blood flow to the part of the heart being supplied by that artery and a heart attack. As Dr. Peter Libby points outsometimes a plaque grows so large that it virtually halts the blood flow in an artery and generates a heart attack or stroke. (he means a stroke caused by a blockage, a thrombotic stroke, but there's also another kind called a hemorrhagic stroke which is due to bleeding) Yet only 15% of heart attacks happen in this way. By carefully examining vessel walls of people who died from heart attacks, pathologists have demonstrated that most attacks occur after a plaque's fibrous cap breaks open"
attracting a blood clot that leads to the blockage of the artery. See the fascinating and instructive article by Dr. Libby Atherosclerosis The New View.
Dr. Libby, a professor at Harvard Medical School, has pointed out that the cholesterol lowering drugs seem to decrease the number of coronary events such as heart attacks even though angiograms don't necessarily show a decrease in the stenosis or narrowing of the artery. See the more technical article Molecular Bases of the Acute Coronary Syndromes
Risk factors for heart disease include
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