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Testing For High & Low Cholesterol
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Unfortunately, most people aren’t even aware they have
atherosclerosis until they have a heart attack or stroke. It is
possible to have up to 80 percent closure of the arteries without
ever feeling a single symptom!
Most people begin to develop cholesterol driven atherosclerosis
as children and it’s unusual if you find an adult in the United
States who does not have some degree of atherosclerosis.
Diagnosing cholesterol levels require a simple blood test to
determine the levels of LDL and HDL. Cholesterol tests can be
tricky, however. Simple screening that is done without “fasting,”
measures only the total cholesterol and the HDL, the “good”
cholesterol. It will give you a ballpark figure, but far from
accurate.
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The complete test is called a “lipid profile,” and even that can
vary from test to test. This test will measure total cholesterol,
HDL, LDL and triglycerides.
For truly accurate numbers, you should not eat, or drink anything
other than water for 12 hours before testing. Vigorous exercise
should be avoided for 24 hours before testing and you need to make
certain that whoever tests you is made aware of any medications you
may be taking as they will also affect the results.
Okay, now that you have accurate numbers, what do they mean?
Before we discuss the numbers and their meanings, we need to clarify
some terminology.
Dietary cholesterol means the cholesterol that you eat. The
American Heart Association recommends no more than 300 milligram per
day. Most food labels in the United States list cholesterol. The
three terms, blood cholesterol, serum cholesterol and total
cholesterol mean the same thing – the total cholesterol in your
body. This is what is measured when you have a cholesterol test.
Your test results will come in with three numbers:
1. HDL Cholesterol
2. LDL Cholesterol
3. Total Cholesterol
For total cholesterol the National Cholesterol Education Program
classifies levels below 200 milligrams/dl (milligrams per deciliter)
as “desirable.” A level between 200 and 239 is “borderline high.”
Anything over 240 is “high.”
Triglyceride levels over 400 milligrams/dl are considered “high”
and levels over 1,000 milligrams/dl are considered “very high.”
For LDL, the desirable level is less than 130 milligrams/dl. The
“borderline high” level is 130 to 159. the “high risk” level is 160
and above.
Higher is better for HDL. For HDL, the numbers are lower because
there is less HDL in the blood. Anything lower than 35 milligrams/dl
is considered “high risk.” If your HDL is very high, say over 60,
your risk of heart disease is reduced.
The LDL, however, is the “bad” cholesterol and the most important
factor in predicting heart attack. For LDL, lower is better
preferably less than 160. It’s best to keep the level around 130.
CAUSES
If you recall, we mentioned that cholesterol can only attach to the
inner lining of the artery if it has been damaged. How does that
damage occur?
Evidence points to “free radical” damage as being one of the
culprits of arterial wall damage. Free radicals are found all around
us. They are highly reactive substances like polluted air,
radiation, tobacco smoke, herbicides, and naturally within our own
bodies as an offshoot of regular metabolic processes.
Free radicals attack and damage cells altering normal cell
activity. You see it around you every day causing metal to rust and
fruit to spoil. This is why we take anti-oxidants like vitamins C,
E, beta-carotene and selenium, to combat the attack of free
radicals.
Heredity plays a role in high cholesterol. Your genes can
influence your LDL by affecting how fast it is made and removed from
your blood. There is one particular form of inherited high
cholesterol that will often lead to early heart disease. It is
called familial “hypercholesterolemia” and can play a role in 1 of
500 people.
Weight is a factor in determining your LDL. If you have a high LDL
level and are overweight, losing those pounds may help you to lower
it. Additionally, losing weight also helps to lower triglycerides
and raise your HDL.
Age and sex should be considered as well. Women, before
menopause, usually have total cholesterol levels that are lower than
men. This changes as men and women age. Levels will rise until
reaching age 60 to 65. For women, menopause can cause an increase in
LDL and a decrease in HDL. After the age of 50 women often have
higher total cholesterol levels than men of the same age.
Alcohol plays an odd role in cholesterol levels. It increases HDL
but at the same time it does not lower LDL. The medical community
does not know for certain whether alcohol reduces the risk of heart
disease. We know that too much alcohol can damage the liver and
heart muscle, lead to high blood pressure and raise triglycerides.
There are just too many other risks to even consider the use of
alcoholic beverages used as a way to prevent heart disease just
because it increased the HDL.
Stress and personality may contribute to heart disease.
Associating a certain type of personality and heart disease has been
suggested for many years. This goes back to the “Type A” and “Type
B” personality study conducted in 1959.
Type A behavior generally manifests in a chronic sense of time,
urgency, aggressiveness and striving for achievement. Type A people
will drive themselves to meet specific deadlines which are most
often self-imposed.
They have feelings of being constantly under pressure and often
multi-task to the point of doing two or three things at one time. To
say that Type A people are “driven” is an understatement. They
consider themselves indispensable. All of these traits add up to a
state of constant stress.
Over the long term, stress has shown to raise blood cholesterol
levels. The way it does this is by affecting habits. An example is
over indulging in fatty foods as a way of consoling themselves when
people are under stress. The saturated fat and cholesterol in these
foods contribute to high levels of blood cholesterol. We will
explore dietary factors in a later chapter.
Type B behavior is characterized by just the opposite set of
traits. Type B people are less preoccupied with achievement, less
rushed and generally more easygoing people.
They don’t allow themselves to be rushed nor have any particular
pressure regarding deadlines. They are less prone to angry outbursts
and seem to be better equipped to making distinctions between work
and play.
Studies completed over a period of eighteen months to two years
with a group of both Type A and Type B people, indicated that Type A
participants had a 31 percent increased risk of developing heart
disease.
This was further substantiated by the discovery of more deposits
of plaque in the coronary arteries of Type A people. Type A behavior
also appears to show an association with other risk factors like
smoking, higher fat levels, increased secretion of adrenaline. All
of which increases the oxygen requirement of the heart muscles and
releasing fatty acids from the body fat.
It is important to note that there are not two different types of
people. Each person is an individual and sorting them into specific
categories do not properly identify them.
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