If you’re not on medicine to lower your cholesterol yet, you might be soon.
Late last year, the American College of Cardiology and the American Heart Association released an updated guideline for the use of statins to prevent and treat atherosclerotic cardiovascular disease (ASCVD). Until now, the drugs had primarily been used to treat high cholesterol; now, the guidelines say they should be used as preventive tools to lower an individual’s overall risk of heart attack and stroke. This change will pave the way for tens of millions of Americans who were previously not candidates for statin therapy to be placed on statins. These new guidelines would double the amount of people on medication to lower their cholesterol.
One in three Americans dies of a heart attack, and 60% of people will have a heart attack in their lifetime. In the past, we were to pay close attention to our "bad" (LDL) cholesterol number. Ideally, it was though that it should be kept at 100 or less. Under the new guidelines, we now are asked to ignore the numbers. Instead, using specific risk factors to determine who should be treated with cholesterol-lowering statin drugs, and who should simply make lifestyle changes.
Four questions are now to be asked to determine your risks:
- Do you have heart disease?
- Do you have diabetes (Type 1 or 2)?
- Do you have a bad cholesterol level more than 190?
- And is your 10-year risk of a heart attack greater than 7.5%?
According to these new guidelines, if you answered yes to any of those four questions, you should be on a statin. Period.
But as we continue to move forward with these new "guidelines", let’s look back at cholesterol and it role in our health.
Cholesterol is essential for our bodies to work, so why are there so many health warnings about high cholesterol levels? Let’s look at what cholesterol does and it benefits, as well as can be a risk to our health.
Every cell membrane in our body contains cholesterol because cholesterol is what makes our cells waterproof. When cholesterol levels are not adequate, the cell membrane becomes leaky or porous; a situation the body interprets as an emergency, releasing a flood of corticoid hormones that work by seizing cholesterol from one part of the body and transporting it to areas where it is lacking. Cholesterol is the body’s repair substance: scar tissue contains high levels of cholesterol, including scar tissue in the arteries.
Cholesterol is a waxy fat that is present in all human beings. Two sources contribute to the amount of cholesterol in the human body. First, the liver manufactures about 80 percent of it. Second, people consume it by eating animal products such as meat, eggs and dairy products. Cholesterol is carried through the bloodstream by certain proteins.
When these proteins wrap around cholesterol and other types of fats (lipids) to transport them through the bloodstream, the resulting "packages" are called lipoproteins. There are four different types of lipoproteins that carry cholesterol through the bloodstream: High-density lipoproteins (HDL), which are associated with "good" cholesterol; Low-density lipoproteins (LDL), which are associated with "bad" cholesterol; Very-low-density lipoproteins (VLDL), which are associated with "very bad" cholesterol; Chylomicrons, which only carry a small percentage of cholesterol. Chylomicrons are mostly rich in another type of fat (lipid) called triglycerides.
Cholesterol is the precursor to vitamin D, necessary for numerous biochemical processes in the body, including mineral metabolism. The bile salts, required for the digestion of fat, are made of cholesterol. Those who suffer from low cholesterol often have trouble digesting fats. Cholesterol also functions as a powerful antioxidant, thus protecting us against cancer and aging.
Cholesterol is also vital to proper neurological function. It plays a key role in the formation of memory and the uptake of hormones in the brain, including serotonin, the body’s "feel-good" chemical. When cholesterol levels drop too low, these serotonin receptors cannot work. Cholesterol is the main organic molecule in the brain, constituting over half the dry weight of the cerebral cortex.
Cholesterol is the forerunner to all the hormones produced in the adrenal cortex of the brain, which regulate blood sugar levels, and mineral corticoids, which regulate mineral balance. Corticoids are the cholesterol-based adrenal hormones that the body uses in response to stress of various types; it promotes healing and balances the tendency towards inflammation. The adrenal cortex also produces sex hormones, including testosterone, estrogen and progesterone, out of cholesterol. Thus, low cholesterol-whether due to an innate error of metabolism or induced by cholesterol-lowering diets and drugs-can be expected to disrupt the production of adrenal hormones and lead to:
- Blood sugar problems
- Mineral deficiencies
- Chronic inflammation
- Difficulty in healing
- Reduced libido
- Various reproductive problems
High cholesterol is seen as the health issue of the 21st century. It is actually an "invented" disease; in other words, a "problem" that emerged when health professionals learned how to measure cholesterol levels in the blood. High cholesterol exhibits no outward signs – unlike other conditions of the blood, such as diabetes or anemia, diseases that manifest telltale symptoms like thirst or weakness. High cholesterol requires a doctor, and a blood test, to detect its presence. Many people who feel perfectly healthy suffer from high cholesterol.
The cholesterol levels in the human body can rise to abnormally high levels when someone eats a diet high in saturated fats or trans fats – especially when that person is obese and/or rarely exercises.
Any discussion of fats cannot be complete without including carbohydrates, since sugars and starches can be converted into fats. Refined carbohydrates such as table sugar, fructose, syrups, puffed cereal grains, processed flours, and honey provide an excellent source of energy, but if there is no activity or exercise requiring this energy, then the body has an excess supply of glucose.
In recent years, we’ve come to realize that to decide whether a person’s cholesterol levels are dangerous, these levels need to be considered in the light of the person’s overall risk of heart disease. In particular, it’s the balance of different types of lipoproteins, rather than the overall total cholesterol level, that matters.
This overall risk is determined by a combination of factors, including age, gender, family history of heart disease, and whether someone smokes, is overweight, has high blood pressure or diabetes.
Enter the new guidelines…
Take good care of yourself and live the best life possible!
The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.
Glenn Ellis, is a Health Advocacy Communications Specialist. He is the author of Which Doctor?, and Information is the Best Medicine. A health columnist and radio commentator who lectures, nationally and internationally on health related topics, Ellis is an active media contributor on Health Equity and Medical Ethics.
For more good health information, visit: www.glennellis.com