What you need to know about Cholesterol, Blood Pressure
Homocysteine, C Reactive Protein and Your Heart
Why Is Cholesterol Important?
Your blood cholesterol level has a lot to do with your chances of getting heart disease. High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases your chance of getting a disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack. Heart disease is the number one killer of women and men in the United States. Each year, more than a million Americans have heart attacks, and about a half million people die from heart disease.
How Does Cholesterol Cause Heart Disease?
When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes "hardening of the arteries" so that arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.
High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone--younger, middle age, and older adults; women and men; and people with or without heart disease.
Know your cholesterol numbers!
A simple blood test checks for high cholesterol. Simply knowing your total cholesterol level is not enough. A complete lipid profile measures your LDL (low-density lipoprotein [the bad cholesterol]), total cholesterol, HDL (high-density lipoprotein [the good cholesterol]), and triglycerides-another fatty substance in the blood. Government guidelines say healthy adults should have this analysis every 5 years, however, most healthcare providers recommend having your cholesterol levels checked yearly.
HDL (good) Cholesterol
About one-fourth to one-third of blood cholesterol is carried by high-density lipoprotein
(HDL). HDL cholesterol is known as “good” cholesterol, because high levels of HDL seem to protect against heart attack. Low levels of HDL (less than 40
mg/dL) also increase the risk of heart disease. Medical experts think that HDL tends to carry cholesterol away from the arteries and back to the liver, where it's passed from the body. Some experts believe that HDL removes excess cholesterol from arterial plaque, slowing its buildup.HDL levels below 40
mg/dL result in an increased risk of coronary atery disease, even in people whose total cholesterol and LDL cholesterol levels are normal. HDL levels between 40 and 60
mg/dL are considered "normal." However, HDL levels greater than 60 mg/dL may actually protect people from heart disease. Indeed, for several years, doctors have known that when it comes to HDL levels, the higher the better.
Cholesterol Level Guideline
Less than 100 mg/dL
100 to 129 mg/dL
Near Optimal/ Above Optimal
130 to 159 mg/dL
160 to 189 mg/dL
190 mg/dL and above
What is LDL cholesterol (low density lipoproteins)?
Low-density lipoprotein (LDL or "bad") cholesterol is necessary for important body functions, but in excessive, it can accumulate in artery walls. LDL is the major cholesterol carrier in the blood. When there is too much LDL circulating in the blood, the cholesterol can be deposited in artery walls, contributing to
atherosclerosis. LDL cholesterol is the most abundant cholesterol carrier in the body and contributes greatest to the build up of plaque on artery walls. Plaque forms when LDL combines with other substances and sticks to the walls of arteries. Decreasing the amount of LDL cholesterol in the blood is an important part of decreasing risk of heart disease.
Low-density lipoprotein (LDL) refers to a type of lipoprotein which carry cholesterol in the blood and around the body. There is a link between high LDL levels and cardiovascular disease. Generally, LDL transports cholesterol and triglycerides away from cells and tissues that produce more than they use and towards cells and tissues which are taking up cholesterol and triglycerides.
Increasing evidence suggests that the concentration and size of the LDL particles has a stronger relation to the progression of atherosclerosis than the concentration of cholesterol contained within all the LDL particles. Having low concentrations of large LDL particles is considered a healthy pattern while high concentrations of small LDL particles, despite the same total cholesterol content, is considered an unhealthy pattern indicating a much more likely and faster growth of atheroma and progression of
atherosclerosis. LDL is formed as VLDL lipoproteins lose triglycerides through the action of lipoprotein lipase (LPL) becoming smaller, denser and contain a higher proportion of cholesterol. Notable medical terms for a high LDL count are hyperlipoproteinemia and familial hypercholesterolemia
Reducing low-density lipoprotein (LDL) cholesterol has long been the goal of medications and other cholesterol-lowering treatments, but researchers are finding that other lipoproteins appear to be involved in developing heart disease. These include some very low-density lipoproteins
(VLDL) and intermediate-density lipoproteins (IDL) - which are types of non-HDL cholesterol. Studies have shown that the general category of
"non-HDL" cholesterol, is a strong predictor of heart disease in people who have not yet developed signs of heart problems
What is VLDL (Very Low Density Lipoproteins) Cholesterol?
VLDL Cholesterol (very low density lipoprotein) is a lipoprotein subclass assembled in the liver from cholesterol and
apolipoproteins. It is then converted in the bloodstream to low density lipoprotein (LDL). VLDL is prone to accelerate
atherosclerosis, and is elevated in a number of diseases and metabolic states. It is composed mostly of cholesterol, with little protein. VLDL (and LDL) is often called "bad cholesterol" because it deposits cholesterol on your artery walls. VLDL transports endogenous triglycerides,
phospholipids, cholesterol and cholesteryl esters. It functions as the body's internal transport mechanism for lipids.
It is important to know your VLDL cholesterol level. However, there is no simple, direct way to measure VLDL cholesterol. So VLDL cholesterol is usually estimated as a percentage of your triglyceride value. A normal VLDL cholesterol level is between 5 and 40 milligrams per deciliter.
By lowering your triglyceride levels, you also lower your VLDL cholesterol levels. Healthy lifestyle changes such as losing excess weight and exercising regularly can help lower triglyceride levels. Also, avoid sugary foods and alcohol, which have a particularly potent effect on increasing triglycerides.
Triglyceride is a form of fat. People with high triglycerides often have a high total cholesterol level, including high LDL (bad) cholesterol and low HDL (good) cholesterol levels.
Your triglyceride level will fall into one of these categories:
- Normal : less than 150 mg/dL
- Borderline-High: 150–199 mg/dL
- High: 200–499 mg/dL
- Very High: 500 mg/dL
Many people have high triglyceride levels due to being overweight/obese, physical inactivity, cigarette smoking, excess alcohol consumption and/or a diet very high in carbohydrates (60 percent of more of calories). High triglycerides are a lifestyle-related risk factor; however, underlying diseases or genetic disorders can be the cause.
The main therapy to reduce triglyceride levels is to change your lifestyle. This means control your weight, eat a heart-healthy diet, get regular physical activity, avoid tobacco smoke, limit alcohol to one drink per day for women or two drinks per day for men and limit beverages and foods with added sugars.
Other Heart Disease Indicators and what you should look for
What Is Homocysteine?
Homocysteine (say: ho-mo-sist-een) is an amino acid (a building block of protein) that is produced in the human body. Epidemiological studies have shown that too much homocysteine in the blood (plasma) is related to a higher risk of coronary heart disease, stroke and peripheral vascular disease.
Other evidence suggests that homocysteine may have an effect on atherosclerosis by damaging the inner lining of arteries and promoting blood clots. However, a direct causal link hasn’t been established.Plasma homocysteine levels are strongly influenced by diet, as well as by genetic factors. The dietary components with the greatest effects are folic acid and vitamins B6 and B12. Folic acid and other B vitamins help break down homocysteine in the body. Several studies have found that higher blood levels of B vitamins are related, at least partly, to lower concentrations of
homocysteine. Other recent evidence shows that low blood levels of folic acid are linked with a higher risk of fatal coronary heart disease and stroke. In this case, please read about our Oral Chelation products that contain amino acids, B vitamins, antioxidants and chelators that can help decrease homocysteine safely and effectively.
Several clinical trials are under way to test whether lowering homocysteine will reduce CHD risk. Recent data show that the institution of folate fortification of foods has reduced the average level of homocysteine in the U.S. population.
Recent findings suggest that laboratory testing for plasma homocysteine levels can improve the assessment of risk. It may be particularly useful in patients with a personal or family history of cardiovascular disease, but in whom the well-established risk factors (smoking, high blood cholesterol, high blood pressure) do not exist.
Although evidence for the benefit of lowering homocysteine levels is lacking, patients at high risk should be strongly advised to be sure to get enough folic acid and vitamins B6 and B12 in their diet. Foods high in folic acid include green, leafy vegetables and grain products fortified with folic acid. But this is just one risk factor. A physician taking any type of nutritional approach to reducing risk should consider a person's overall risk factor profile and total diet.
How is a high homocysteine level harmful?
High homocysteine levels in the blood can damage the lining of the arteries. In addition, high homocysteine levels may make blood clot more easily than it should. This can increase the risk of blood vessel blockages. A clot inside your blood vessel is called a thrombus. A thrombus can travel in the bloodsteam and get stuck in your lungs (called a pulmonary embolism), in your brain (which can cause a stroke) or in your heart (which can cause a heart attack.) People who have very high levels of homocysteine are at an increased risk for coronary artery disease.
How is the homocysteine level measured?
Homocysteine is measured using a simple blood test. You don't have to prepare in any special way for the blood test.
If your homocysteine level is too high, you need to lower it, especially if you have blockages in your blood vessels. If you have no other major risk factors for cardiovascular disease and you do not have
atherosclerosis, your doctor may take a watchful waiting approach and monitor the level closely. If it increases further, you may need to lower it.
While no studies have shown that lowering homocysteine levels helps reduce strokes, heart attacks and other cardiovascular conditions, it is a good idea to lower a high homocysteine level because it is a risk for heart disease.
How can I lower a high homocysteine level?
Eating more fruits and vegetables (especially leafy green vegetables) can help lower your homocysteine level by increasing how much folate you get in your diet. Good sources of folate include many breakfast cereals, fortified grain
prodcuts, lentils, asparagus, spinach and most beans.
If adjusting your diet is not enough to lower your homocysteine, your doctor may suggest that you take a folate supplement. You may also need to take a vitamin B-6 and vitamin B-12 supplement. Enhanced Oral Chelation is an excellent supplement that contains everything you need to start lowering your homocysteine levels safely and naturally.
If you don't have enough vitamin B-6 in your diet, foods like fortified breakfast cereals, potatoes, bananas, garbanzo beans (also called chickpeas) and chicken are good sources. Dairy products, organ meats (such as liver), beef and some types of fish are good sources of vitamin B-12 .
What happens next?
If you start taking folate or vitamin B supplements, you should have your homocysteine level rechecked after 8 weeks. If your homocysteine level remains high, your doctor may have you try a higher dose. You may need to have some tests to see if you have another health condition that causes high homocysteine levels. If you have had a high homocysteine level, you will probably need to have your level checked regularly (2 or 3 times a year).
What is C Reactive Protein
“Inflammation” is the process by which the body responds to injury or an infection. Laboratory evidence and findings from clinical and population studies suggest that inflammation is important in atherosclerosis
(ath”er-o-skleh-RO’sis). This is the process in which fatty deposits build up in the inner lining of
arteries.C-reactive protein (CRP) is one of the acute phase proteins that increase during systemic inflammation. It’s been suggested that testing CRP levels in the blood may be an additional way to assess cardiovascular disease risk. A more sensitive CRP test, called a highly sensitive C-reactive protein
(hs-CRP) assay, is available to determine heart disease risk. The American Heart Association and the Centers for Disease Control and Prevention published a joint scientific statement in 2003 on the use of inflammatory markers in clinical and public health practice. This statement was developed after systematically reviewing the evidence of association between inflammatory markers (mainly CRP) and coronary heart disease and stroke.
What’s the role of CRP in predicting recurrent cardiovascular and stroke
A growing number of studies have examined whether
hs-CRP can predict recurrent cardiovascular disease, stroke and death in different settings. High levels of
hs-CRP consistently predict recurrent coronary events in patients with unstable angina and acute myocardial infarction (heart attack). Higher
hs-CRP levels also are associated with lower survival rates in these patients. Many studies have suggested that after adjusting for other prognostic factors,
hs-CRP is useful as a risk predictor.
Studies also suggest that higher levels of hs-CRP may increase the risk that an artery will reclose after it’s been opened by balloon angioplasty. High levels of
hs-CRP in the blood also seem to predict prognosis and recurrent events in patients with stroke or peripheral arterial disease.What’s the role of
hs-CRP in predicting new cardiovascular events?Scientific studies have found that the higher the
hs-CRP levels, the higher the risk of having a heart attack. In fact, the risk for heart attack in people in the upper third of
hs-CRP levels has been determined to be twice that of those whose hs-CRP level is in the lower third. These prospective studies include men, women and the elderly. Studies have also found an association between sudden cardiac death, peripheral arterial disease and
hs-CRP. However not all of the established cardiovascular risk factors were controlled for when the association was examined. The true independent association between
hs-CRP and new cardiovascular events hasn’t yet been established.
What causes low-grade inflammation?
The major injurious factors that promote atherogenesis — cigarette smoking, hypertension, atherogenic lipoproteins, and hyperglycemia — are well established. These risk factors give rise to a variety of noxious stimuli that cause the release of chemicals and the activation of cells involved in the inflammatory process. These events are thought to contribute not only to the formation of plaque but may also contribute to its disruption resulting in the formation of a blood clot. Thus, virtually every step in atherogenesis is believed to involve substances involved in the inflammatory response and cells that are characteristic of inflammation.
In addition, there is also research that indicates an infection — possibly one caused by a bacteria or a virus — might contribute to or even cause
atherosclerosis. The infectious bacteria, Chlamydia pneumoniae (klah-MID'e-ah
nu-MO'ne-i), has been shown to have a significant association to atherosclerotic plaque. The herpes simplex virus has also been proposed as an initial inflammatory infectious agent in atherosclerosis.The notion that chronic infection can lead to unsuspected disease isn't foreign to most doctors. For example, bacterial infection with Helicobacter pylori is now known to be the major cause of stomach ulcers. The treatment for this condition now routinely includes taking a powerful probiotic and in extreme cases, antibiotic therapy.
What is the normal range of hs-CRP level?
If hs-CRP level is lower than 1.0 mg/L, a person has a low risk of developing cardiovascular disease.
If hs-CRP is between 1.0 and 3.0 mg/L, a person has an average risk.
If hs-CRP is higher than 3.0 mg/L, a person is at high risk.
If, after repeated testing, patients have persistently unexplained, markedly elevated
hs-CRP (greater than 10.0 mg/L), they should be evaluated to exclude noncardiovascular causes. Patients with autoimmune diseases or cancer, as well as other infectious diseases, may also have elevated CRP levels.
What Is High Blood Pressure?
Blood pressure is the force in the arteries when the heart beats (systolic pressure) and when the heart is at rest (diastolic pressure). It's measured in millimeters of mercury (mm Hg). High blood pressure (or hypertension) is defined in an adult as a blood pressure greater than or equal to 140 mm Hg systolic pressure or greater than or equal to 90 mm Hg diastolic pressure.
High blood pressure directly increases the risk of coronary heart disease (which leads to heart attack) and stroke, especially when it's present with other risk factors.
High blood pressure can occur in children or adults, but it's more common among people over age 35. It's particularly prevalent in African Americans, middle-aged and elderly people, obese people, heavy drinkers and women taking birth control pills. It may run in families, but many people with a strong family history of high blood pressure never have it. People with diabetes mellitus, gout or kidney disease are more likely to have high blood pressure, too.
Due to the numerous reports of dangerous side effects from pharmaceutical drugs referred to as
antihypertensives, more and more people are realizing there are more natural alternatives to these dangerous prescription drugs that can significantly reduce your blood pressure levels without the negative side effects.