For decades, we have been pointing fingers at cholesterol for most of our heart problems. Naturally, then, we would expect to see low to no heart problems in those with low cholesterol levels, right?
Well, consider what a national study conducted at the UCLA School of Medicine and published in the American Heart Journal found. Nearly 75% of patients hospitalized for a heart attack had recommended cholesterol levels according to national cholesterol guidelines. 75% of people who had heart attacks had normal cholesterol. That is, their LDL cholesterol levels were less than 100 mg/dL.
These guidelines aren't successfully identifying everyone at risk for fatal heart problems. Yet, millions of Americans are still taking statins to lower their cholesterol. In fact, it's estimated that about 30 million Americans are using statins to lower cholesterol.
Are we missing something, though? After all, with such widespread use of treatment for high cholesterol, shouldn't we expect to see lower cases of heart disease? Yet, cardiovascular disease is the leading global cause of death, accounting for 17.3 million deaths per year according to the American Heart Association. That number is expected to grow to more than 23.6 million by 2030.
In America, about 2,150 people die each day from heart disease, stroke, or cardiovascular disease.
Every 90 seconds (probably the time it took you to reach this point of the article) someone dies of heart disease.
Do we need to revisit our strategies for predicting, preventing, or fighting heart disease?
Cholesterol is important but it's only part of the problem. We need to look at the bigger picture. A wealth of recent research has enriched our understanding of heart disease and helped us move on, beyond traditional, and quite limited, views. Thanks to this research we now:
-point to inflammation as cholesterol's "partner in crime" - a key player in heart disease. Inflammation is involved at every step in the development of atherosclerosis (hardening of the arteries)
-look at arteries as extremely organized organs made up of living cells (not just a lifeless "pipe" or "tube") that need to be well taken care of
-hardening of arteries caused by inflammation can be prevented with diet and lifestyle
Your Heart on Fire
We need inflammation. Think back to the last time you had a splinter in your finger or sprained your ankle and you'll have a pretty good idea of what inflammation is. Once injured, your immune system activates the process of inflammation. The site of the injury swells as blood vessels allow an army of various immune cells to come repair the problem and clean up the mess. You start to feel the heat, the swelling, and other signs of inflammation.
We don't need too much inflammation, though. Smoking, high blood pressure, or an unhealthy diet (especially high blood sugar) can all injure the inner layer of vessels that flow throughout our bodies (much like the inner surface of a straw). These injuries invite immune system cells to the scene. Excessive inflammation of these vessels, however, can harden them, make them more narrow, and then increase the risk they'll become blocked.
Cholesterol wouldn't be as dangerous as we make it out to be if it wasn't for inflammation. In fact, those with high markers for inflammation are in more danger than those with high cholesterol levels.
You may have normal cholesterol levels with unchecked, chronic inflammation and be in danger of a heart attack or heart disease.
Take all the cholesterol-lowering drugs you want but a poor diet, a sedentary lifestyle, and an unhealthy weight will still fuel this slow, silent fire.
How to Damp Down the Fire
Aim for a healthy weight and achieve it with a healthy diet and exercise training. Excess body weight means excess pressure for your body. People with excess body fat actually have higher blood levels of substances that cause inflammation.
A report in the Archives of Internal Medicine found that a even a simple 2.2 pound weight loss significantly lowered levels of CRP in the blood, a marker of inflammation.
Emotions can also be inflammatory, especially persistent, uncontrolled negative ones such as stress, worry, anxiety, and anger.
See our next article to find out what your kitchen and pantry need for an anti-inflammatory lifestyle, or continue our article about Cholesterol and Heart Disease.
REFERENCES
Am Heart J. 2009 Jan;157(1):111-117.e2.
Am J Clin Nutr. 2006 Feb;83(2):456S-460S.
N Engl J Med 2005; 352:1685-169
J Am Geriatr Soc. 2008 Nov;56(11):2045-52.
