Foods to Improve your Cholesterol



If You Think Lowering Your Cholesterol Is The Best Way Prevent Heart Disease, You Need To Read This

Dawn Blatt didn't seem like a typical . The 46-year-old physical therapist from Long Island, NY, didn't smoke, exercised regularly, and had just had a routine checkup the week before and been told by her doctor that everything was normal, including her cholesterol levels. But while visiting Los Angeles on vacation, she began feeling pressure in her chest. She knew the signs of a heart attack but didn't believe she could be having one. So she sat down, and after about 20 minutes the feeling went away.I'll get that checked when I'm home, she thought.

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Two hours later, back at the hotel with her husband, the sensation returned, stronger this time, and began radiating down her left arm. She became short of breath and started to tell her husband she wasn't feeling well. "But I must not have looked very good," she says, "because he was already calling 911." Even as EMTs rushed into the room, administering nitroglycerin and aspirin and yelling out EKG readings that Blatt knew indicated a heart attack, she was still in denial. The reality didn't hit her until later, when she was admitted to the hospital to have a stent inserted to relieve a blockage in her left anterior descending coronary artery. "That's what they call the widow-maker," she says.

In recent years, cases like Blatt's have challenged what experts thought they knew about cholesterol. One analysis of more than 136,000 patient records from over 500 US hospitals by researchers at the David Geffen School of Medicine at the University of California, Los Angeles, found that almost three-quarters of heart attack patients didn't have cholesterol levels high enough to indicate increased risk. In fact, almost half had levels of "bad" LDL that are considered optimal (below 100 mg/dL).

"Having cholesterol levels that don't suggest a risk of a heart attack or stroke is false reassurance," says lead study author Gregg Fonarow, codirector of the preventive cardiology program at UCLA. Doctors now realize that many people with normal levels, like Blatt, are nevertheless at risk. "Cholesterol is still important," says Fonarow, "but evidence suggests that LDL cholesterol interacts with other risk factors and that your absolute risk depends on all of them taken together."

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A DEADLY COMBINATION

For decades, doctors considered high cholesterol the equivalent of a plumbing problem. A waxy, fatty substance circulating in the blood, cholesterol is used by the body to help digest food and make hormones and vitamin D. But when levels of LDL cholesterol get too high, the substance can accumulate in the arteries, along with other materials like calcium, and can then harden into plaque. Eventually, the plaque blocks blood flow enough to cause a heart attack. HDL ("good") cholesterol, on the other hand, was considered beneficial because it removes LDL cholesterol from the blood.

MORE: Top 10 Cholesterol-Fighting Foods

But as it turns out, this plumbing model doesn't explain most heart attacks. Not only do many people with relatively low LDL still have coronary "events," as doctors call them, but only about 15% of heart attacks in the UCLA study could be attributed to slow plaque buildup. So what's causing the other 85% of heart attacks?

Research now suggests that the plumbing model provides only a partial explanation. That theory assumes that the arteries are just passive pipes that do nothing as plaque accumulates.

In fact, the arteries are composed of dynamic tissue that communicates with blood. "Plaque, too, is teeming with active cells," says Peter Libby, Mallinckrodt Professor of Medicine at Harvard Medical School's Brigham and Women's Hospital. The arteries' attempt to deal with encroaching plaque, and the plaque's response to that attempt, may set off a reaction that eventually leads to a heart attack. In this scenario, a person's LDL cholesterol still matters, since it's responsible for starting the whole process of plaque production. But the plaque then triggers inflammation that further damages the heart muscle. (Watch out for these 3 signs you have chronic inflammation.)

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The new theory goes like this: When the body senses irritations in an artery wall, such as the start of cholesterol buildup, it sends in white blood cells to attack the troublemakers. This inflammation is the same kind of immune response that heals wounds and protects against infection. But, as with autoimmune diseases like lupus or rheumatoid arthritis, the friendly fire does more harm than good, increasing the plaque and weakening the structure that holds it in place. Eventually, the plaque can crack or rupture. "When it does, it can trigger blood clots," Libby says. Usually it's the blood clot, not the plaque, that obstructs the artery. Clots can form quickly, which is why heart attacks can come on so suddenly.

Not all experts are convinced that inflammation causes heart disease. But many now accept that cholesterol and inflammation interact with each other and with additional risk factors to cause a heart attack. High blood pressure, obesity, diabetes, and lifestyle factors like smoking all seem to contribute to inflammation. And studies have shown that reducing inflammation—even in people who have low cholesterol—can bring cardiovascular risks down.

MORE: The 10 Best Anti-Inflammatory Foods To Keep On Hand

THE STATIN DEBATE

Taking lifestyle steps to lower LDL and raise HDL cholesterol is still considered smart. Eating a nutritious diet and getting plenty of exercise, two of the most effective ways to achieve this, are healthy for the entire body, not just the heart. Another way a growing number of people get their cholesterol into an optimal range is by taking statins, prescription drugs that work by blocking an enzyme the body needs to form cholesterol. These drugs have been shown to lower LDL levels by as much as 50% and were recently found to lower inflammation as well. "Statins are a twofer," Libby says.

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Researchers have known for many years that statins are remarkably effective at preventing heart attacks in people who already have cardiovascular disease. But the tide began to turn in favor of using statins preventively, in people without heart disease, when the results of a 26-country clinical trial known as JUPITER (Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin) were published in 2009. This trial tested statins' benefits for people who did not have high LDL cholesterol or heart disease but did have elevated levels of a substance in the blood called C-reactive protein, which is associated with inflammation. The largest trial to date that has assessed using statins preventively, JUPITER found that inflammation does matter and that statins reduce the risk of heart disease by about 45% in both men and women. Some doctors now say that statins amount to cheap insurance, since serious side effects are fairly rare and many statin drugs are available as inexpensive generics.

MORE: Should You Take Statins?

But questions remain about statins' long-term benefits and the wisdom of vastly expanding the number of healthy people taking them, as both the American Heart Association and American College of Cardiology have recommended. Some scientists noted that the number of heart attacks in the JUPITER trial was small: Only 18 women in the control group had one, compared with 10 in the drug group. And the study didn't look at whether statins actually saved any lives over many years, which is a factor doctors consider before prescribing.

One analysis that did look at mortality almost 2 years after the trial ended found that about twice as many subjects in the JUPITER trial had died—of any cause—than would be expected in this type of prevention study. The researchers, publishing in the journalCardiology, called the results "alarming" and stated that if their results were verified, "millions of patients may find better and safer options for primary prevention of vascular events."

Side effects are also a concern. Relatively minor ones, such as weakness and muscle stiffness, are fairly common, but a more serious one is an increased risk of diabetes in postmenopausal women, documented by the Women's Health Initiative in 2012.

Until further studies provide more answers, the important message about preventing heart attacks is that you can't rely on a specific number on a single test to determine your risk. Cholesterol is now considered one risk factor among many, and experts agree that addressing many threats is what will help prevent heart attacks like Dawn Blatt's.

As a volunteer for the advocacy organization WomenHeart: The National Coalition for Women with Heart Disease, Blatt speaks to women's groups and recently to legislators on Capitol Hill about heart disease. "Every health care provider I go to says, 'Oh, you're so young for a heart attack,' " Blatt says. "It made me angry after a while. I'm obviously not too young—because I had one."

Richard Laliberte Richard Laliberte is an award-winning veteran health journalist and former senior writer at Men's Health who writes for some of the nation's best-known magazines, blogs for WeightWatchers.com, and has authored several books.





Video: Lowering LDL Cholesterol With Statins [Healthy Hangouts]

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Date: 15.12.2018, 10:08 / Views: 44481