CHOLESTEROL AND LIPIDS MADE SIMPLE

“Cholesterol is bad.” Right? Well, maybe, and maybe not. It definitely plays a role in Cardiovascular disease, but it serves us well in other ways.

Let’s start here, though. Cardiovascular disease is what you’re most likely to die from – it’s the number one cause of death worldwide. Some statistical “Cause of Death” summaries lump stroke in with heart disease.

I think this is legitimate since the two are intimately related, and even when they are separated, stroke comes in second. So why not just lump them together? Most strokes are caused by blood clots that originate in your vascular system and migrate to your brain. In fact, this number is above 80%, so we’ll stick with cardiovascular disease and stroke lumped together.

Blood clots are at the root of most of this death, and these usually (but not always) develop in veins in the lower extremities. So clots become a common denominator of both heart attacks and strokes – not always, but often enough to make clots a central point of discussion that we’ll get back to later.

Your Lipid Profile.

Clots and blood lipids are also intimately related. They don’t directly cause each other but do lay the groundwork for each other to do damage. In the link I just gave you, I talk about clots, heart attacks, and strokes – so I won’t go over these again, although I do recommend you read it as a foundation for this post.

In the media, you hear a lot about cholesterol and ways to deal with it. Keep in mind that there is a lot of disagreement about cholesterol’s role in cardiovascular disease and other maladies. To keep it simple, let’s first take a look at your cholesterol level and what makes it up.

CHOLESTEROL

A fatty wax-like substance made by your liver and widely available throughout your body. Cholesterol is a building block for many things throughout your body, including most of your hormones.

So what does that “total cholesterol” number of your blood lab report mean?

Here’s some cholesterol numbers from my latest blood test:

Total cholesterol	193
LDL (bad) cholesterol	99
HDL (good) cholesterol	81
Triglycerides	73

OK, anyone would be happy with these numbers. But the numbers aren’t as important as the ratio of Total cholesterol to HDL cholesterol. In my case, that’s 2.4. These cholesterol numbers are in milligrams per deciliter, so the “amounts-per” cancel each other out, and the 2.4 becomes a pure reference number with no units.

Now, this is one of those numbers where lower is better. Most HCPs look for a ratio below 5:1, and below 3.5:1 is considered very good. Why? Because the higher the HDL (good) cholesterol, the smaller the ratio. Pretty simple, really.

Now you know how to read your cholesterol numbers – your goal obviously is to get your ratio down by either increasing your HDL or lowering your total cholesterol, preferably both.

Enough with cholesterol numbers. Let’s go to atherosclerosis and the accumulation of plaques.

Here is the nexus between cholesterol, heart disease, and strokes. Cholesterol has the habit of sticking to the inside of your arteries (not your veins – that’s another story involving clots).

This is usually to repair damage to arteries resulting from trauma – the most common of which is the hard and relentless pounding of high blood pressure.

Think of stretching a thick rubber band repeatedly, almost to its limit. The rubber band will stretch and recover, but with enough repetitions, the rubber band will develop small tears and eventually fail. This is the kind of damage high blood pressure does to your arteries.

But… unlike the rubber band, your arteries don’t fail. They get patched up by a process using cholesterol and fibrin. This is a complex process that involves clotting. The simple point here is that this is how cholesterol starts building up in your artery walls, making them harder and narrowing their inside diameter. These outcomes force your heart to pound even harder and more often – making the situation even worse.

Plaque buildup (from repeated patching) in the arteries and high blood pressure are self-reinforcing. I.e., each condition is made worse by the other.

In fact, this process is informally called “hardening of the arteries,” and it can progress to the point where arteries clog up (in your brain, heart, and elsewhere). Ogan damage occurs, and new arteries can sprout up in response (sometimes this helps, but it’s not a good situation.)

Note: the reason HDL cholesterol is called “good” is that it slows down and, in some cases, prevents this hardening process. This is another complex process, but the takeaway is that high HDL is good, and Low HDL is bad.

If your arteries are getting hard…

Here’s the problem and the good news at the same time.

This hardening doesn’t happen overnight; you don’t wake up one day with hard arteries. This happens slowly, and it’s happening right now in all of us. It is a continuing process that, thankfully, is manageable.

How?

Although there are things on the horizon that I will discuss in future posts, it’s very difficult to reverse this hardening process. It is much easier to slow this process down or even bring it to a halt. The good news is that this can be done, and you can start doing it today.

Slowing and stopping the damage:

These are things you should be doing anyway, so they have a bonus in that they contribute to your overall health. Here are the big four:

So let’s talk about these things:

OK, I’ll admit that you’ve heard these things before, and you know you’re going to have to change your lifestyle and get with your doctor (which you should be doing anyway.)

Yeah, all that’s true, but if you’re reading this, you’re still alive. You won’t be long, though, if you have hard arteries and stay with a crummy lifestyle. Sorry for being so blunt, but that’s what it is.

Stop tobacco and booze.

I shouldn’t have to say this. Anyone who’s been alive more than a week knows these things are bad for you. But just think of this: quitting smoking and dropping booze gives you the speediest return for your efforts. You get better quickly.

In a week, your annoying smoker’s hack will likely go away, and within a month, your lungs will be fairly clean. The toxic waste from smoking will have been removed. Your chances of dropping dead from a heart attack caused by smoking drop quickly as well.

As to booze, if you’re a heavy drinker (more than one or two drinks a day), stop altogether. If you drink less than this, the alcohol might be helpful (there is not a lot of agreement on this). There is, however, no disagreement on the heavy drinking side – stop.

All in all, you get a rapid reward for your sacrifice and efforts.

Control your blood sugar and cholesterol.

There are few things more toxic to your arterial system than high blood sugar. Get it down and keep it down. Take Type 2 Diabetes seriously. As the saying goes, “serious as a heart attack.” Because it is that serious.

Thankfully, blood sugar can be controlled through diet, weight management, and medications. Work with your doctor on this and be a tough self-manager. Blood sugar and healthy years are inversely proportional – when one goes up, the other goes down.

Same thing with cholesterol. Diet, weight management, and medication. As noted above, work towards a cholesterol ratio of less than 4.

Control your blood pressure:

Unfortunately, unless extremely high, hypertension has no symptoms. This is why you need to determine your baseline blood pressure and if it’s high. Get treatment.

Here is my post on finding your baseline blood pressure. Long-term, high blood pressure is a killer – the longer you let it go, the more likely you’ll incur a related event that can and often is fatal.

Respect your blood pressure. Some professionals consider it the most dangerous condition of all – don’t let it go.

Start an exercise program that requires resistance.

Lots of people will tell you to start walking. This is fine, but walking does not make you stronger and more muscular. Resistance exercise does this.

This is important because resistance exercise reduces blood pressure and promotes vascularization (growth of new blood vessels).

Yes, it’s good to start walking because this is easily available to most people. However, resistance exercise is also available using dumbells and resistance bands. You can find complete workouts with these tools – Google it.

If you don’t know where to start, join a local gym and get an instructor who can put together a plan that works for you.

Here’s a simple starting plan almost anyone can do.

Note: before starting any exercise plan, get the OK from your healthcare provider. Be safe, not sorry.

Finally, about blood clots:

At the beginning of his post, I put in a link to an article I wrote about clots. These are the cause of most strokes and sudden heart attacks. The incidence of clotting problems goes up with each of the conditions I discussed above and down with the actions I suggested.

Clots are always dangerous and sometimes crippling and deadly. They don’t just happen. They are triggered by an event that is usually avoidable or a condition that is treatable. Yes, blood clotting is essential to health and survival. In the wrong places and times, it can be deadly.

Please read my post on clots. Information can be lifesaving. Here’s the link again.

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