Cholesterol Archive

Articles

Experts urge intensive lifestyle measures for lowering triglycerides

When cholesterol is measured, so are triglycerides, another type of blood fat that's an independent risk factor for heart disease. High triglycerides increase the likelihood of developing heart disease even when cholesterol levels are normal, especially in postmenopausal women. But triglycerides haven't gotten as much attention as LDL (bad) cholesterol and HDL (good) cholesterol, partly because their role in heart disease and stroke hasn't been well understood.

In recent years, scientists have learned more about how triglycerides are metabolized and how they contribute to atherosclerosis, the clogged arteries that raise the risk of heart attack, stroke, and other cardiovascular problems. High triglyceride levels are often correlated with low HDL and a type of LDL cholesterol that is particularly likely to produce harmful deposits in the arteries. High triglyceride levels are also a component of another heart disease risk factor — metabolic syndrome, a condition that occurs in most people with type 2 diabetes and includes high blood pressure and a large waist size. The American Heart Association (AHA) issued a scientific statement about triglycerides and cardiovascular disease that sets a new, lower optimal level of triglycerides and recommends intensive lifestyle measures for reducing elevated triglycerides. The AHA statement and a review of research were published online April 18, 2011, in the journal Circulation. Here are some of the highlights:

Ask the doctor: Do statins cause hair loss?

Q. My hair's been thinning. Could it be due to simvastatin, which I started taking several months ago?

A. Hair loss, or alopecia, is a very rare side effect of all statin drugs. Widely prescribed in the treatment of high cholesterol, statins work by blocking the action of an enzyme the liver uses to make cholesterol. About 1% of people taking statins report hair loss. This figure hasn't changed since 1987, when statins were introduced. We don't know exactly why statins might cause hair loss. But we do know that cholesterol is an important building block for steroid hormones, which play a role in hair growth.

Health by the numbers

Statins and lower cholesterol …

According to the National Center for Health Statistics (NCHS), the percentage of Americans ages 45 and older taking a statin drug jumped from 2% in 1988–94 to 25% in 2005–08. There are roughly 117 million Americans over age 45, so that means there are almost 29 million statin users, or the equivalent of the entire populations of Florida and Georgia combined. Here is a graph from the NCHS that shows the increase:

The fact that one in every four Americans older than the mid-40s is taking a statin is really kind of stunning (presuming, of course, that there hasn't been a big fall-off since 2005–08).

Medical memo: Cholesterol and prostate cancer

Ask men about their top health worries, and most will put cholesterol and prostate cancer high on the list. That's understandable, since unfavorable cholesterol levels contribute to heart attack and stroke, the first and fourth leading causes of death in America, and prostate cancer takes about 32,000 lives a year. Still, while most men understand the link between cholesterol and cardiovascular disease, few suspect a link between cholesterol and cancer. Research is beginning to change that.

Early worries

Back when scientists were nailing down the relationship between high cholesterol and heart disease, they were also raising concerns that although low cholesterol levels could protect the heart, they might increase the risk of cancer. Indeed, a series of population studies from the 1980s reported a higher incidence of cancer in people with low cholesterol levels. This research also sparked worry about cholesterol-lowering drugs, which was heightened when the first statin was released in 1987.

In Brief

Hypertension on the rise. One-quarter to one-third of U.S. adults — between 60 million and 70 million Americans — have high blood pressure (also known as hypertension). Less than half of them manage to keep their blood pressure under control with diet, exercise, medication, stress reduction, and other strategies (Centers for Disease Control and Prevention and the federal Medical Expenditure Panel Survey).

Exercise and HDL. Physical activity boosts protective HDL more in some people than others. Why? Research suggests that exercise affects the function of several genes that influence HDL (Circulation: Cardiovascular Genetics, February 2011). Variants of these genes from person to person could explain why some people have larger increases in HDL in response to exercise than others.

Heart Beat: HDL function, not just amount, could affect artery health

When it comes to protective high-density lipoprotein (HDL) cholesterol, the most important question has long been "How much do you have?" Numerous studies have shown that the more HDL you have in your bloodstream, the more protected you are from heart attack and the most common kind of stroke. The day may be coming, though, when "How powerful is your HDL?" is an equally important question.

We've known for some time that not all HDL is created equal. Some HDL is better at pulling cholesterol out of white blood cells called macrophages. Less cholesterol inside macrophages means less cholesterol deposited into artery-clogging plaque. Work from the University of Pennsylvania indicates that folks with more powerful HDL have less cholesterol-filled plaque in the coronary arteries nourishing the heart and the carotid arteries that nourish the brain (New England Journal of Medicine, Jan. 13, 2011).

April 2011 references and further reading

Same-day angioplasty feasible, safe

Patel M, Kim M, Karajgikar R, et al. Outcomes of patients discharged the same day following percutaneous coronary intervention. JACC Cardiovascular Interventions 2010; 3:851-8.

Chambers CE, Dehmer GJ, Cox DA, et al. Defining the length of stay following percutaneous coronary intervention: an expert consensus document from the Society for Cardiovascular Angiography and Interventions. Endorsed by the American College of Cardiology Foundation. Catheterization and Cardiovascular Interventions 2009; 73:847-58.

Fish oil questioned as treatment for heart disease

It may be okay for prevention. But eating fish is a better strategy than gulping pills.

Fish oil has been flying high as a supplement for the past few years. It has garnered a reputation as an easy way to protect the heart, ease inflammation, improve mental health, and lengthen life. Such claims are one reason why Americans spend more than $1 billion a year on over-the-counter fish oil, and why food companies are adding it to milk, yogurt, cereal, chocolate, cookies, juice, and hundreds of other foods.

11 ways to prevent stroke

It's never too late to strike out against a potentially devastating brain attack.

Like close cousins, heart disease and stroke share a common lineage. Both emerge from a mix of nature (genes), nurture (upbringing and environment), and personal choice (smoking, exercise, etc). For most of us, personal choice largely determines whether a stroke lies ahead. Guidelines on the prevention of stroke suggest that a healthy lifestyle can cut the risk of having one by 80%. No drug, device, or other intervention can come close to doing that.

Eyelids as windows into the heart

People who develop yellow bumps on their eyelids often visit a dermatologist to get them removed. They may want to see a cardiologist as well.

Such a skin lesion is actually a cholesterol deposit known medically as xanthelasma (ZAN-thuh-LAZ-muh) — derived from the Greek word for yellow. (The plural is xanthelasmata. You can see what they look like at www.health.harvard.edu/166.) Xanthelasmata are strikingly similar to the cholesterol deposits that develop inside blood vessels and contribute to atherosclerosis. This raises the question of whether the eyelids might provide a diagnostic window into the heart.

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