Heart attack and cardiac disease are the banes of industrialized societies. More the wealth that is generated by these economic powerhouses more is its mortality count due to the fall out of ischemic heart disease. The offending agent responsible for this calamity is always cited as high levels of cholesterol.
Let us examine all the factors in the equation—high cholesterol and heart risk.
Cholesterol is a molecule with a cyclopentane phenanthrene backbone and is an integral part of human cell membranes and human steroid hormones and bile acids. It is used for the synthesis of steroid hormones like testosterone and estrogen and forms bile acids which are essential for digesting fats.
So it can be seen that cholesterol is essential for the normal physiology of the human body. It is its excess level that leads to heart disease.
Cholesterol is synthesized from Acetyl coenzyme A which is formed from fatty acids and glucose. Cholesterol is combined into two forms i.e. low-density lipoprotein (LDL) or bad cholesterol and high-density lipoprotein (HDL) or good cholesterol. There is another form called very-low-density lipoprotein (VLDL) which soon converts into LDL
It is this high level of cholesterol and LDL which predisposes to the formation of atherosclerotic plaque in the coronary arteries. This happens because the protective activity of a protein called Transforming Growth factor-beta is turned off. The resultant atherosclerotic plaque narrows the lumen of the arteries supplying the heart resulting in the lowering of blood flow and consequently oxygen flow to the heart. The atherosclerotic plaque is the result of an inflammatory response brought about by the migration of macrophage white blood cells.
The atherosclerotic plaque consists of 3 distinct components namely the atheroma which is a collection of soft yellowish material composed of macrophages near the lumen of the artery, underlying areas of cholesterol crystals, and calcification at the outer base.
These plaques cause three kinds of problems. Firstly as stated earlier the lumen of the coronary artery is narrowed resulting in loss of blood and oxygen supply. Part of the plaque may break off forming a thrombus which may lodge in a distal coronary artery blocking the blood supply. This is called coronary thrombosis. Finally, the wall where the plaque had formed may bulge out forming an aneurysm that may rupture later.
To treat coronary plaques they have to be diagnosed first. Generally, when ischemia shows up on an EKG a dye is injected into the arteries surrounding the heart, and X-Ray images are taken. This process is called angiography. The lumen’s integrity may be restored by either inserting a stent, dilating the obstruction with a balloon or if these procedures don’t work, replacing the entire artery with a graft—the coronary bypass operation.
All this could have been avoided if the individual had cut down on his high cholesterol intake thus decreasing his risk of heart disease. He could have done this by various means. By either reducing food containing high cholesterol like fatty cuts of meat, poultry with skin, lard, and certain types of vegetable oil, like coconut, palm, and palm kernel oils. If taking fatty foods was not avoidable the other option would have been to burn out his calories with mild 30-minute aerobic exercises like walking, jogging, or cycling.
Cholesterol levels could have been lowered by taking foods which suppress cholesterol level. Research has shown that diets rich in oats, sterol, and stanols tend to lower cholesterol levels in the blood. Fishes like sardines or salmon contain omega3 fatty acids that also contribute to this cause.
If all these had failed cholesterol would have still been lowered by drugs such as statins, resins, fibrates, Niacin, and cholesterol absorbing inhibitors.
These regulate the blood cholesterol levels by various mechanisms like suppressing the rate of cholesterol synthesis or inhibiting its rate of absorption from the intestine.
If high cholesterol is combated heart risk will automatically diminish. It is the high-stress lifestyle typical in the industrial west together with cholesterol consumption and cigarette smoking that increase the risk of heart disease.
Remember the old adage ‘Health is wealth’. Would you like to have all your dreams shattered and all your goals disrupted by the mischievous activity of one molecule?
Avoid cholesterol and stay healthy.