Cholesterol particle size matters

As per 2013, more than 1 in 3 adults (81.1 million) live with 1 or more types of cardiovascular disease. According to a government agency, there were 126.0 coronary heart disease deaths per 100,000 population in 2007. In addition to being the first and third leading causes of death, heart disease and stroke result in serious illness and disability, decreased quality of life, and hundreds of billions of dollars in economic loss every year. The statistics are similar for both women and men. A form of cardiac disease may occur at any age, with higher percentages at age 40 than at age 70. It can be a silent killer. Making sure you have cholesterol panel blood tests may help you measure possible ways of reducing your risk. How reliable are the standard lipid panel blood tests? They may not be.

One of the problems associated with the development and study of heart disease and its risk potential in the United States is that there is no national system to collect data on how often cardiovascular events occur or recur, or how often they result in death. Based on smaller studies, many outside the United States, vascular, cardiovascular, and heart disease statistics are astounding. Is the risk of developing heart disease 33%? Are doctors proactive in employing better testing?

A while back, a gastrointestinal specialist told me I had GERD, acid reflux disease. I didn’t seem to be getting upset by the associated risk factors. On a second opinion with a chief physician, she asked me whether I knew the type of GERD. I didn’t know. Obviously there are many types. When it comes to cholesterol and possible heart disease risks, cholesterol has many different subtypes. Some of these go beyond mere lipoprotein levels. Many subtypes and particle sizes come into play when trying to determine risk factors. Many cardiologists proceed with treatments, based on traditional blood test panels, prior to using studies that analyze cholesterol at deeper levels. For some, cholesterol particle size matters and can make a vast difference in a prognosis.

With all the chatter about cholesterol levels, when you check cholesterol particle size, size matters. Some particles of this blood fat are large and buoyant and breeze easily through your circulatory system. But other particles are small and dense — and four times as likely to cause heart disease as they are more likely to gather on your artery walls. So even if you have a low total cholesterol value, you may be at greater risk than you or your doctor might think.

When you are at a risk for cardiovascular diseases, with high LDL, you shouldn’t rely on the results found from a traditional blood test. There are other blood tests that help you get closer to the heart of the problem. Don’t get stressed till you ask your doctor to address this further. The tests are:

One test focuses on cholesterol particle size as well as subclasses or subtypes of LDL (the bad type) and HDL (the good type) levels that aren’t seen in a traditional blood test. The Vertical Auto Profile (VAP) test will analyze your LDL cholesterol and determine if it is made up of predominantly the small, dangerous particles or larger, more benign particles. It will also tell you how much lipoprotein is circulating in your blood. In addition, the VAP test breaks out your HDL cholesterol subtypes, letting you know if you have more of the HDL2 subtype, which is most beneficial. Basically, when it comes to HDL protective qualities, there are black sheep among the different possible HDL. HDL Cholesterol (good guy) is comprised of
different subtypes. HDL2 is a risk factor for cardiovascular disease even in patients whose Total and LDL cholesterol are within the desirable limits established by
the National Cholesterol Education Program (NCEP).

A Lipoprotein Particle Profile (LPP) test also breaks down cholesterol into fractions smaller than LDL and HDL and analyzes the particles comprising each of them, just like the VAP test. It measures the lipoprotein particles directly giving a more precise evaluation of their size. High numbers of small, dense LDL particles can ultimately cause cardiovascular disease. The LPP test has an advantage over the VAP test, because its methodology allows for more precise measurements and because it can also measure remnant lipoprotein (RLP), which is a more threatening type of cholesterol that isn’t singled out by most other cholesterol tests. Elevated remnant cholesterol may cause more artery inflammation that can lead to a heart attack, using a non-fasting test. This leads to a more accurate view than the fasting traditional test. LPP measurements track particles as you live with them.

Another advanced test is the NMR Lipoprotein Test that uses nuclear magnetic resonance (NMR) to deliver a more precise profile of LDL levels in your bloodstream. Test results will outline risk factors. The test from Liposcience was recently approved by the FDA. It only tracks LDL cholesterol particles.

In calculating possible cardiovascular risks, guidelines may differ among those organization that set up risk criteria. Among the oldest is the Framingham Heart Study that was established by the National Heart Association in 1948. The American Heart Association has a heart risk assessment calculator based on the 2010 Framingham study.

A set of statistics indicate that about 50% of people who have suffered heart attacks have “normal” cholesterol numbers according to NHLBI The National Heart, Lung and Blood Institute of the National Institute of Health. In many cases the cholesterol particle size mattered upon further investigation. Using cholesterol particle size as part of routine measurement may reduce cholesterol level risk or increase it. According to the NHLBI calculator, my risk potential is 10% over the next 10 year period. The calculator factors age, gender, traditional total cholesterol, HDL cholesterol, whether I smoke, and my systolic blood pressure reading. A 10% risk sounds pretty good, although I’d sit more comfortably with 5% or less as a probability.

Being statin treatment intolerant, that 10% number is kind of okay. I do take other cholesterol reducing drugs and supplements, follow a strict diet, and exercise regularly. Also having Myotonic dystrophy (a degenerative muscle disease) may mean more frequent cardiograms and cardiac muscle tests to keep my risk factor as low as possible.

According to a large 1999 life risk study of developing heart disease experiment in the United Kingdom, the findings were alarming. The 7733 patients were followed up for a total of 109,948 person-years. Overall, 1157 participants developed coronary heart disease. 1312 died from non-coronary heart disease causes. Lifetime risk of coronary heart disease at age 40 years was 48.6% (95% CI 45.8-51.3) for men and 31.7% (29.2-34.2) for women. At age 70 years, lifetime risk was 34.9% (31.2-38.7) for men and 24.2% (21.4-27.0) for women. After researchers excluded isolated angina pectoris as an initial event, the lifetime risk of coronary artery disease events at age 40 years was 42.4% for men and 24.9% for women.

Hypertension and high triglycerides factor greatly in the mortality rates of heart disease risks.

The lifetime risk of developing or dying From Cancer is 43% for males and 38% for females, all inclusive cancers according to the American Cancer Society. The National Safety Council releases a book on risk statistics in virtually every aspect of life.

Fortunately, we don’t live trying to assess our risks of dying inside or outside our home. Yet nearly everyone knows or has known someone living with the threat of heart disease or cancer. It’s very disconcerting. Cardiovascular risks, one or more, are like driving a car. You need to know more about the road ahead and around you. Use your mind and be proactive about risks. While there’s no guarantee against accidents, be diligent in aiming for safety.

Knowing your serum cholesterol levels, your cholesterol particle size and constituency of the subclasses help you assess and act toward reducing your risks of athesclerosis and heart disease. The media surrounds us with what steps to take. You should know them. Pursue your doctor for more thorough testing. Become proactive at being your personal wellness advocate. Live better, hearty, and prosper towards longer, healthier living.

New 2013 cholesterol guidelines

Sometimes it may be the binge eating you had before your medical exam. Other times it may be the dietary recommendations that eating chicken and fish are healthier than red meat. Any animal-source food has cholesterol. According to the Center of Disease Control, 71 million Americans or 1 in 3 have high LDL or bad cholesterol levels. LDL cholesterol is associated with lining arteries with plaque that may lead to organ damage, particularly leading to heart attacks and strokes. For some people, it is dietary, and is easily controlled. For others, these may be familial, chronic conditions. There’s no wonder why cholesterol management is a big topic and essential indicator examined on general blood tests. When the American Heart Association announces new guidelines for cholesterol management, doctors listen. The new report promotes high statin dosage to control high LDL levels.

A group of researchers from the American College of Cardiology and the American Heart Association put their weight on new cholesterol management guidelines. Their emphasis is to increase statin treatments to more people who might be at risk of having a heart attack. The origin of these reports were designed to effectively care for those who already had some level of a cardiovascular episode.

As with all cases, the panel took a traditional approach. As with all patients, they emphasized lifestyle guidelines (i.e., adhering to a heart healthy diet, regular exercise
habits, avoidance of tobacco products, and maintenance of a healthy weight). They cited that use of one of the 4 statin groups would help those who can’t manage to keep their LDL at a normal range. They did not discuss HDL/LDL ratios.

Establishing a target range under real circumstances still remains vague but they deemed that an LDL-C of 190 is considered threatening.

The new guideline recommends moderate- or high-intensity statin therapy for these four groups:

1) Patients who have cardiovascular disease;
2) Patients with an LDL, or “bad” cholesterol level of 190 mg/dL or higher;
3) Patients with Type 2 diabetes who are between 40 and 75 years of age
4)Patients with an estimated 10-year risk of cardiovascular disease of 7.5 percent or higher who are between 40 and 75 years of age (the report provides formulas for calculating 10-year risk).

Chronic use of statins may have negative effects on neuromuscular systems, particularly peripheral myopathies. While Cleveland University research cites that 72.5% of statin-intolerant patients may be treated with statins. There are those that have diseases like muscular dystrophy or multiple sclerosis for which statin use may be almost fatal. Recommendations of high stain dosages may be more dangerous holistically than cardiology specialists realize.

For example, many people suffer from rheumatism and fibromyalgia. These involve muscle pains, affecting over 10 million people, that have no succinct etiology to infer causality and results. There is little data to support that high-dose statins may induce more extreme pain or inflammation. While cholesterol management is vital, average cardiologists may not take these other common diseases into consideration when prescribing statin drugs.

Specialists that read these guidelines may take easier approaches at high-dosing statins to force cholesterol management to those that may not need it. The November 2013 guidelines of the American College of Cardiologists and the American Heart Association seems to sanction this. Most cardiologists adhere to the average and this report definitely targets the average. Patients are then forced to seek out cardiologists that see patients as individuals instead of group numbers. Groupings are attractive at writing presentations. Patients as clients require more specific attention.

Yet statins are touted well beyond cholesterol management with research demonstrating efficacy in treating cancer and other diseases. It’s as if all the leading drug companies that produce cholesterol are behind all the experiments. In some respects, companies like Merck and Pfizer are using cardiologists as drug pushers, especially when two major heart organizations sanction high dosages of statin medications to help lower LDL cholesterol.

I have genetic cholesterol and management requires an almost vegan diet along with exercise. Because of a form of muscular dystrophy, all statins have been proven toxic. I use Source Natural Cholesterol Complex on a daily basis, along with non-statin prescription Zetia and Lopid. Policosanol is a key ingredient in my supplement mix and policosanol research shows that 20mg can help reduce LDL cholesterol by nearly 30%. For people that suffer from statin intolerance, statins are not the conclusive treatment.

Cholesterol is only one of many indicators that may lead to heart disease. Relying on statins to lower LDL cholesterol levels may be great for many people. For those that exhibit statin intolerance, there are other routes and physicians should understand and study these.

Sifting through this 80 page document from November, it’s a rather unimpressive work and further extends that the two leading organizations continue to fail at examining holistic approaches to cholesterol management. Cholesterol levels correlate differently with age and this report didn’t cover that well. As people rise over 70, 190 to 200 LDL is more tolerable than that of a 25 year old.

Prescribing high intensity statins as a rule instead of an exception, may actually harm some patients in those groups due to side-effects. The fervent faith in statins for cholesterol management that seems to be shared by traditional cardiologists may be taking cardiovascular care in wrong directions. There must be more exploration into alternative approaches that place responsibilities on both doctor and patient.

Finding a reasonable target that I can maintain without statins is my goal. In the overall wellness mix, I prefer to be in control. Control requires an active goal-oriented approach. That control persists between routine visits to my practitioner.

Patients, as drug consumers, will accept statins and will likely not report intolerances. While statins for lowering cholesterol may be beneficial, the overall goal is to help patients (as clients) pursue healthy lifestyles and feel well. On the patient’s side, you must be willing to take necessary drug-free steps to improve your heart and cardiovascular health. Ultimately your health is your responsibility!

As to the new stricter standards proposed by the ACC and AHA regarding cholesterol borderlines and statin medications, everything and anything is subject to change. Each year new studies and interventions lead to new perspectives of how to approach cardiovascular conditions. The ACC and AHA are traditionalists and are likely to follow Statins as a holy sword. Statins are not exclusive. Seek out other options and, if possible, find integrative health centers that offer more holistic and educational approaches to help resolve what may be a chronic condition. There are lifestyle choices that can help you manage your LDL cholesterol levels.