Cholesterol is actually an important part of your health as it helps the
body build vital hormones, bile acids, vitamin D, and cell walls. Most
of the cholesterol is produced in your body and only a small portion is
absorbed from your diet. Your cholesterol level is dependent upon a combination
of production, absorption, and elimination from the body. Triglycerides
are a source of energy, but like cholesterol, they can also contribute
to the process of atherosclerosis.
It is most important to understand that both cholesterol and triglycerides
are lipids---fatty substances that by their nature cannot dissolve in
the blood. Therefore, the body creates lipid trafficking particles called
lipoproteins. The cholesterol and triglyceride molecules are carried as
passengers in the center of these lipoproteins. The outer surface contains
the protein that allows these particles to be dissolved in the blood and
transported throughout the body.
There are no "bad" or "good" cholesterol molecules.
It is actually the specific type of protein on the outer surface of the
lipoprotein particle that determines if the cholesterol inside is "bad"
or "good". The ApoB protein defines the "bad" LDL
cholesterol particle that can enter the wall of the arteries. The ApoA-1
protein defines the "good" HDL cholesterol particle which helps
keep your arteries clean.
Cholesterol can only enter the walls of your arteries by way of the bad
ApoB lipoprotein particles thereby leading to heart attacks, strokes,
and peripheral artery disease. So in many cases, the more accurate measure
of the risk of your cholesterol causing atherosclerosis--" hardening
of the arteries"---is the actual number of the bad LDL ApoB lipoprotein
particles in your blood more so than your LDL cholesterol concentration
found on the standard lipid panel test.
In some cases, the LDL cholesterol value on your lipid panel is consistent
with the number of your LDL particles and does reflect your true risk.
But in many cases, especially if you have insulin resistance, prediabetes,
metabolic syndrome, or Type 2 Diabetes, the LDL particle number far exceeds
your lipid panel's LDL cholesterol concentration. In these situations
the LDL cholesterol level on the lipid panel significantly underestimates
your true risk and more advanced testing is indicated to determine appropriate
treatment recommendations for therapeutic lifestyle changes and/or medication.
Genetics is certainly a contributor to atherosclerosis. Therefore, your
family history can be a very important risk factor for heart attack and
stroke. If you have a relative, especially parent or sibling, who's
had a heart attack, stent, coronary artery bypass, angina or stroke in
their 60s or younger, then your cardiovascular risk goes up significantly.
Another important contributor to atherosclerosis is inflammation. Factors
that contribute to inflammation include smoking, insulin resistance, high
blood pressure, poor diet, excess fat around the waist line, and inadequate
regular physical activity. Everyone should have their lipids checked by
20 years of age and regularly thereafter. As you grow older, your risk
increases and your lipid and glucose levels can increase. See your physician
soon for an evaluation of your cardiovascular risk factors and appropriate
For more information about the Lipid services available at Baton Rouge
General or to schedule a consultation or appointment,
click here or call (225) 819-1161.
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