This is a rather bold statement, but experts agree that the vast majority of causes of heart disease relate to negative effects of cholesterol and high blood pressure. Just how these two deliver their deadly effects is quite complex and the science in understanding this is growing rapidly. Heart disease is a condition that occurs over time, not just in an instant. The process is affected by our genes, lifestyle, and vascular (blood vessel) biology. Elevated lipid components of cholesterol and triglyceride accumulate in our bloodstream and penetrate the vessel wall creating the plaque that can result in a heart attack. We can now offer more accurate tests that can identify those patients at risk and either prevent events or reduce the likelihood of repeat events.
First in 1987 National Cholesterol Education Program (NCEP) emphasized measuring and treating Total Cholesterol because it was easy and we knew it ended up in the plaque that causes heart disease. Then in 1993 NCEP focused on LDL-cholesterol as a risk factor as we felt it trafficked or carried the cholesterol into blood vessels. We even measured HDL-cholesterol (referred sometimes as “Healthy”) and tried to raise it, as it is felt to remove cholesterol from the blood stream and return it to the liver for removal from our body.
The evolution of our understanding of lipids/cholesterol changed dramatically around 2000. We now know that it is the LDL Particle number that best predicts risk in individuals. The LDL Particle number is significant because it can identify high risk in patients who have normal numbers in their tradition lipid profile (total cholesterol, LDL-cholesterol, HDL-cholesterol, and Triglycerides). So a patient who has a LDL-cholesterol of 102 (considered good) could have an LDL-particle number of 2002 (which is in the top 95 percentile for risk)!
Nutrition is an essential and often neglected component in reducing the incidence of heart disease. If used properly I believe it can be as effective as medicine, as no drug is a “get out of jail free-card.” In our excessive carbohydrate culture we are working with national and local experts to create livable long term healthy eating lifestyles as opposed to yo-yo fad diets.
Exercise plays a critical role in reducing insulin resistance which is one of the most common mechanisms in creating heart disease. We strive to help create programs for each individual’s needs.
The identification of risk, and development of an individualized program of prevention, takes time and thought. Our goal is to use the best that medicine has to offer, and take the time needed, to provide you a quality filled life.
Also see:
Advanced Testing identifies risk where LDL-cholesterol does not