cardiodiabetes

Know more about the «bad» and the «good» cholesterol

There are two main types of cholesterol, LDL and HDL.

LDL: The «Lousy» Cholesterol

Low-density lipoprotein (LDL) is considered to be bad because higher levels are strongly associated with cardiovascular disease.

LDL takes fat from the liver and deposits it on the wall of vessels in fatty streaks, or plaques. Plaques that contain high amounts of fat are considered unstable since they predispose us to blood clots (thrombosis) that cause heart attacks and strokes.

To remember its harmful role, think of LDL as the “lousy” cholesterol.

According to the latest NIH information, people with high cholesterol should focus their efforts on lowering LDL “Bad” Cholesterol. To help you with this, the NIH has released a set of goal numbers that are specific to LDL (Bad) Cholesterol. These goals are important because:

1.	It has become even clearer that too much LDL (Bad) Cholesterol is a key contributor to heart attack and stroke.
2.	While there are many causes for heart disease, the higher your LDL (Bad) Cholesterol, the higher your risk*.

Know your LDL (Bad) Cholesterol number

Your LDL (Bad) Cholesterol number is important. It gives you and your doctor a standard for good health much like your temperature, pulse, or blood pressure. Your LDL (Bad) Cholesterol goal number will be based on your current and historical medical situation and any risk factors you may have for heart disease. The average person should try to maintain an LDL (Bad) Cholesterol level below 130 mg/dL.* If you have heart disease or diabetes, your goal is less than 100 mg/dL. If you don’t know what your individual LDL (Bad) Cholesterol goal should be, ask your doctor.

Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.

LDL Think of LDL Cholesterol as “Bad” Cholesterol that makes your arteries dirty and clogged with plaque.

HDL Think of HDL Cholesterol as “Good” Cholesterol that cleans your arteries by carrying away excess cholesterol.

*Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.

HDL: The «Good» Cholesterol

High-density lipoprotein (HDL) is thought to be good because it protects us against cardiovascular disease. Experts consider a very high level of HDL good. HDL works somewhat like a garbage collector, traveling to vessel walls and removing fat from the plaques. HDL carries the unwanted fat back to the liver to be destroyed by enzymes.

To remember its helpful function, think of HDL as the “healthy” cholesterol.

What Causes Low HDL

Primarily the genes you inherit from your family determine your level of HDL. Most people with HDL levels above 60 are simply fortunate to have picked the “right” parents. Women naturally have higher levels of HDL than men. HDL levels of 40 or below are considered unhealthy.

The most common cause of low HDL is obesity. Fat deposited in the middle of the body (the so-called “apple” shape) is linked to both low HDL levels and elevated levels of another kind of fat, the triglycerides.

Most women with a waist size above 35 inches and men with waists above 40 inches have both high triglycerides and a low HDL. This pattern is called dyslipidemia and is an important component of the metabolic syndrome. Over 80 percent of people with type 2 diabetes have this condition. People with dyslipidemia have an increased risk of cardiovascular disease.

A helpful fact is that for every 1 percent that you increase your HDL, you lower your cardiac risk by 1 percent as well. So if you are able to increase your HDL from 40 to 50, you have decreased your risk for a heart attack by 10 percent. So even if your total cholesterol and LDL levels are on target, don’t forget about the importance of HDL, the “healthy” cholesterol. Your life could depend on it!

Ways to Increase Your HDL Levels

•	Lose weight.
•	Exercise.
•	Add soy protein to your diet. Soy proteins contain isoflavones, which raise HDL.
•	Drink red wine if your doctor says it’s safe to include alcohol in your meal plan. Grapes used for red wine contain a substance know as resveratrol that increases HDL. Check first with your doctor or pharmacist to be sure alcohol doesn’t interact with your medications. And remember that drinking alcohol can cause hypoglycemia (low blood glucose) for people on medications such as insulin or oral diabetes drugs that stimulate insulin production.
•	Stop smoking. Among the many health hazards associated with tobacco use is that it lowers HDL levels. If these strategies do not help you to raise your HDL, your physician might decide to prescribe a medication such as one of the fibrates (Lopid or Tricor) or nicotinic acid (finally it will be available in Spain in the year 2005)

Ramiro Antuña de Alaiz
Education Treatment Unit

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