Lifestyle is the Culprit

Today, it is generally accepted that two forces come into play with the formation and progression of plaques in arteries. One is the oxidation of LDL cholesterol, the catalyst for instability in the cells that line our blood vessels. Fat build-up occurs in these cells, toxic contents are produced, and then the “healing” process occurring within the cell creates an even bigger blockage. The second is an imbalance between the body’s natural clotting and declotting mechanisms. The typical American sedentary lifestyle combined with fast food and smoking, causes LDL cholesterol to oxidize and tips the balance toward the clotting process and away from de-clotting.

As a result, these micro-clots that form each time a micro-injury occurs on the surface of a plaque are not balanced by an adequate de-clotting mechanism that would limit the size of the clot. Blockages, therefore, progress faster. The ultimate price to pay from this clotting system imbalance occurs when a large plaque rupture occurs. The  clotting response is so aggressive, just as if you developed a large cut on your leg, that the clot totally blocks the artery causing a major heart attack.

The Bad Guys

There are a number of “Bad Guys” in the heart disease equation and you should be
aware of them:

LDL (especially the small dense kind):
LDL, the most evil of the “Bad Guys” has received the most attention from the medical community over the past two decades and is the major instigator of not only the plaque-building process, but also the rupturing process, which leads to a heart attack or stroke.

Low HDL:
A number of years ago, HDL began to receive a lot more attention in the medical community. Data from landmark trials even suggest that having low HDL is worse than having high LDL. A low HDL level is most often seen with a high triglyceride level, though they are independent risk factors for heart artery disease. Together, however, the risk is magnified.

Triglycerides/VLDL:
Triglycerides are actually what is absorbed from the intestine when one eats fat. It is packaged in chylomicrons, which deliver it around the body to be used for energy. “Unused” triglycerides make their way back to the liver and are packaged into VLDL particles. It is the VLDL particle that is broken down in the body to eventually form LDL cholesterol.

Taking Care of Your Heart

Knowing about risk factors, how heart disease progresses, and how to go about getting a more advanced cholesterol test are steps in the right direction for taking care of yourself and your heart. The standard cholesterol panel has withstood the test of time as a good assessment of risk for the general population. But for many individuals Dr. Stocker believes it can be valuable to look at cholesterol in a way that goes far beyond the information a standard test provides. The standard test in many cases does a poor job predicting an individual’s true risk, so an advanced test can often reveal “the truth” as to whether you are prone to a heart attack or not.

Risk Factors

While certain risk factors, such as age and family history cannot be controlled, other critical contributing factors can. You can control high blood pressure, abnormal cholesterol and triglyceride levels. You can also control diabetes, smoking, obesity and a sedentary lifestyle.

Obesity has become an epidemic in this country because of our poor eating habits and lack of exercise. It has become the focal point of a dangerous combination of risk factors called the Metabolic Syndrome, present in as many as one in four Americans. Obesity markedly increases your chance of future cardiovascular problems.

From the medical point of view, it is clear that once you develop one or two of these factors, the others become much more likely to occur – a snowball effect. In fact, they propagate each other and create an inflammatory condition now thought to be the basis for formation of plaques that lead to heart attack and stroke. The typical American high-stress lifestyle and diet high in processed foods, along with lack of exercise, help promote this infl ammatory condition in our blood.

Cardiovascular Disease – Early Start, Steady Progression

What most people do not realize is that Cardiovascular Disease begins in childhood. Even as babies we already have a “fatty streak” in our aortas that represents the first sign of plaque formation in our arteries. Though initially harmless, but starting in our teenage years, plaque formation slowly progresses in the majority of people. Studies show that plaque covers 10-30% of the surface area of aortas in all 15 year-olds, growing to 20-50% by age 35. Even more unnerving, such plaque is present in the heart arteries of 75% of men and women by the age of 35.†

It is important to know you do not have to be overweight
to be at risk of developing hardening of the arteries.

Obesity, cholesterol problems, diabetes and high blood pressure have always been separated as diff erent disease processes. Lack of exercise, high stress and diets high in saturated fat, and refined carbohydrates (sugar and starch) promote obesity. This leads to an inflammatory state in the bloodstream that involves numerous unhealthy proteins that create a “snowball effect” leading to the development of disease states that lead to the Metabolic Syndrome. Though obesity has reached epidemic proportions, it is important to know you do not have to be overweight to be at risk of developing hardening of the arteries.

The Truth about Cholesterol

The “truth” about cholesterol is that knowing only what your standard cholesterol levels are (total cholesterol, LDL (bad), HDL (good), and triglycerides) is very limiting. These levels fail to recognize over half the people who develop a heart attack or stroke at a relatively young age.

Advanced cholesterol testing is the best way to tell you the truth about your risk of a future heart attack or stroke. There are currently three different kinds of advanced cholesterol testing panels that divide LDL, HDL and VLDL (marker for triglycerides) into subcategories based on their size. Though a standard cholesterol panel has withstood the test of time as a good screening test for the general population, advanced lipoprotein testing does a much better job of assessing your individual or true risk.