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If your cholesterol number is a little high – DON’T WORRY

Posted by Dr Sandy on in cholesterol | 784 Views | Leave a response

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When are your cholesterol levels too high ?

worrying about cholesterol number

Your cholesterol number needs to be just right and the just right number, if you don’t have high BP, is somewhere between 5 and 7 mM. It’s NOT 4 mM.

You’re health conscious, so you know your numbers…..

  • You feel okay.
  • Your blood pressure is normal.
  • But, your total cholesterol level is above the threshold of healthy i.e. it is above 5 mM.

Oh dear !

Officially, you are a heart attack waiting to happen.

Get that cholesterol down STAT

You must get your cholesterol number down, any which way you can.  For most,  this means a prescription of a statin.  Since the statin blocks your body’s ability to make cholesterol, total cholesterol levels drop.

Everyone, breathes a collective sigh of relief.

You’ve dodged the risk of a potentially fatal cardiovascular event.

But have you ?

A team of Norwegian researchers think not.  And worse, you might have actually increased your risk of dying of something else, especially if you are a women.  Ouch !

A careful look at the numbers….

A community effort

In the mid-nineties,  the majority of the residents of Nord-Trondelag county in Norway, agreed to be part of a big health study, known as the HUNT2 study.

Ultimately 52 087 healthy adults, between the ages of 20 – 74 years, signed up for the study.

details of HUNT study

Between August 1995 and June 1997, each participant

  • had their blood pressure checked,
  • donated a vial of blood, to have their total serum cholesterol level checked and
  • recorded their smoking status

Then, they went about their business – living and dying.

Counting person years

10 years down the line…………..the team accessed the Norwegian Death Registry to count the living and the dead.  And in the case of the dead, what they had died of.

The number they were interested in was the mortality rate per 1000 person years.

The what ?

Yes, it is odd number to look at – but it’s a way to quantify risks.

Bear in mind, most of the people in the study, would still be alive and kicking at the 10 year mark, because they were relatively young (less than 75 years), and healthy, at the start of the study.

So what was the risk of dying of heart disease ?

Being OLD was the biggest risk

No big surprise here.

Here is a look at the data…. green boxes are good, red boxes are bad.

hunt data

Ten-year incidence of fatal cardiovascular disease per 1000 person-years in the population of Nord-Trøndelag (HUNT 2 study). Copyright 2011 Blackwell Publishing Ltd

It’s not too hard to see, there are a lot more green boxes, in the under sixties.

Unfortunately, you can’t stop the clock ticking, so what else can you do to avoid being A RED BOX ?

The risk of cardiovascular disease

Is a lot higher in men.  Give estrogen a shout out, if you’re a lady, as long as she is around, she protects you from heart disease.  Just like age, you can’t change your gender – so what can you do ?

Don’t smoke.  It creates red boxes on steroids.

Nothing new here.

Also, watch that blood pressure !   A blood pressure higher than 140 mmHg is a red box, especially if you are male.

This makes sense,  the more pressure in the pipes, the greater the likelihood of a blow out.

But, what about “high” cholesterol ?

Heart disease is not related to cholesterol

The red box is not where it is “supposed” to be……

zoom in on heart disease in 60 to 74 year olds

Ten-year incidence of fatal cardiovascular disease per 1000 person-years in the population of Nord-Trøndelag (HUNT 2 study). Copyright 2011 Blackwell Publishing Ltd

High serum cholesterol is “supposed” to be a heart attack waiting to happen, but in this study, the risk of dying from a cardiovascular disease was marginally higher, when cholesterol levels were LOW and blood pressure was normal.

Hazard ratio of death for different cholesterol levels

Risk of death (all causes) associated with different levels
of total cholesterol. Copyright 2011 Blackwell Publishing Limited

It seems……..high cholesterol IS NOT a fatal disease !

Low cholesterol levels are risky

Actually, when the team looked at the risk of dying PERIOD, rather than just the risk of dying from cardiovascular disease,  an interesting trend emerged –  the people with the lowest cholesterol levels, were more vulnerable i.e. they were more likely  to die.

This was especially noticeable in ladies.

In fact, the team concluded both low (<5.5 mM) and high (>7.0 mM) levels of cholesterol, were problematic.

Which begs the question………….

Why is a cholesterol level <5.0 mM considered optimum ?

Cholesterol the scapegoat

Politics, economics, ignorance ?  I suspect, it is a little of all three.

What does it mean for you ?     STOP and  THINK !

Your cholesterol number  needs to be  just right and the just right number, if you don’t have high blood pressure, is somewhere between 5 and 7 mM.

It’s NOT 4 mM.

Too little cholesterol is risky

If you have a low cholesterol number and YOUR DOCTOR  is very happy !   Realize, your body might not be as HAPPY, with the situation.

Cholesterol does stuff, it’s most notable jobs

  • It is used to make steroid hormones, which include estrogen, progesterone, testosterone, aldosterone and cortiosone
  • It makes vitamin D and bile acids
  • It stabilizes membranes
  • There is lots of it in your brain

This research concluded…..

the ‘dangers’ of cholesterol should be revised. This is especially true for women, for whom moderately elevated cholesterol (by current standards) may prove to be not only harmless but even beneficial.

Fight the right battles…………. high insulin and high sugar are heart disease maker

NOTE : If you have high blood pressure, this IS A PROBLEM – click here, for tips & strategies

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Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid? Ten years prospective data from  the Norwegian HUNT 2 study.  Journal of Evaluation in Clinical Practice (2012) 18 : 159 – 168.  Halfdan Petursson, Johann A. Sigurdsson, Calle Bengtsson, Tom I. L. Nilsen and Linn Getz.

Further reading

back to the future

If you count bodies, not cholesterol levels, vegetable oils are deadly

Substituting vegetable oils for saturated fat, definitely lowers your cholesterol levels. But does this protect your from heart disease ? In a word – NO.

sugar stripping the glycoccalyx

Blood vessels clog up when they become sticky

A special non-stick layer, known as the glycocalyx, prevents things from sticking to the sides of blood vessels. When it’s not there, atherosclerosis happens.

statin stopping cholesterol

Statins lower cholesterol but raise sugar levels and this is bad

When cholesterol levels are TOO low, sugar levels rise, because, the uptake of sugar, depends on cholesterol. Too much sugar is the real cause heart disease.

 

Posted in cholesterol | Tagged blood pressure, cholesterol, heart attack, high cholesterol, smoking, statin, women

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Located in Johannesburg, South Africa

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