September, Cholesterol Awareness Month, is a fantastic time to learn about advances in the science of heart health, according to Edwin Dean, MD, medical director of the Edwin J. Dean Medical Wellness Center. While we all live with cholesterol and all cholesterol is not bad, concentrations of the wrong kind will not produce symptoms until damage is apparent and heart attack, blood clots and stroke are well on their way. Blood tests are the only way to determine cholesterol make-up, and the earlier the better.
“The relationship between heart disease and cholesterol, between health and longevity, has never been clearer,” said Dr. Dean. “When people are committed earlier in life to paying attention to the make-up of the body’s cholesterol, the end result is much, much better.”
Good news! Education and early testing prevents heart disease. Dr. Dean offers an overview of the story of cholesterol leading up to the latest scientific breakthroughs in cholesterol testing.
In brief, contemporary research shows that the stress test and other methods conventionally used might very well miss key areas of concern. He advises health-savvy individuals to avoid the quickie tests at mobile testing operations, which he describes as hit or miss gambles at best. Even those who visit cardiologists, he explains, should be asking for advanced testing that reveals cholesterol particle size.
The science of cholesterol has advanced considerably over the years. The earliest thinking on cholesterol was that it was all bad. In 1843, clinician J. Vogel was the first person to draw a connection between cholesterol and atherosclerosis (narrowing of arteries because of fatty deposits) when he documented the presence of cholesterol in arterial plaque. In 1913, Nikolai Anitschkow, a prominent Russian pathologist, went a step further, with studies revealing that rabbits given a great amount of cholesterol developed arterial lesions similar to humans with serious coronary heart disease. Anitschkow also found that cholesterol is only found in animal products such as meat, eggs, and milk, which paved the way for dietary recommendations to lower animal product consumption.
There is no doubt that over the decades a growing body of research confirming that atherosclerosis leads to serious coronary heart disease saved lives. Between 1950, when the relationship between cholesterol and heart health was understood and steps were underway to spread the word, and 2004, the death rate for coronary vascular disease in all age categories was cut in half.
With the development of simple cholesterol analysis tests, it became possible to determine the amount of cholesterol present in a human being. In this era, the simple number of 200mg/dL was accepted as the line between good and bad. If a person’s cholesterol was less than 200, it was good. A higher level was not good.
The second breakthrough came with news about good and bad cholesterol. “By this point, it was common knowledge that heart attacks, a leading cause of early death in the United States, could be prevented by paying attention to cholesterol,” said Dr. Dean. “Going forward, though, the emphasis was no longer on how much total cholesterol was present, but its composition.”
In the body, cholesterol synthesizes hormones, bile acids and Vitamin D, and is necessary.
On the ratio of low density lipoprotein (LDL), high density lipoprotein (HDL), and triglycerides,
LDL is responsible for the uptake of cholesterol into cells, while HDL is responsible for the removal of cholesterol. Triglycerides inhibit the work of HDL. The understanding of the relationship moved animal products, which had previously been labeled as bad, into catagories of good and bad. Salmon, high in the type of poly-unsaturated fatty acids that promote HDL, was upgraded to good for the health of the cardiovascular system. Pork, on the other hand, loaded down with the demon saturated fatty acids that cause LDL to spike, stayed in the realm of bad.
In the world of heart health and cholesterol awareness, the breaking news is a new test. This news has been out for several years, but Dr. Dean finds that almost nobody knows about it. Research shows that parts of LDL can break off and form small, dense particles that can infiltrate arterial walls and avoid detection. The size of LDL particles, therefore, is an important indicator of the action of cholesterol in the arteries. Dr. Dean offers the scenario presented by Dr. Arthur Agatston, a professor of Medicine at the University of Miami, who used the metaphor of a beach ball and a dart in explaining the importance of LDL particle size. A beach ball, when thrown, will bounce around harmlessly (off the arterial walls), but when a dart is thrown it will perforate the walls and stick. When more darts build up, the result is a clogged passage, a blockage
According to Dr. Dean, the results are in, and it is clear that people should be screened for LDL particle size. The previously mentioned tests — Total cholesterol, LDL, HDL, and triglycerides — may also be helpful, but the LDL particle test, known as an advanced lipid profile, is the current definitive cholesterol test. Several are available, including the Berkley Heart Lab Gradient Gel Electrophoresis, the VAP profile by Atherotec and the NMR lipid profile by Lipomed. These tests require a simple blood sample, after which the blood is screened to determine the number and size of LDL particles in the blood.
“A day does not go by where a patient does not tell me that his or her cholesterol is under 200, but none of them have any idea of what their particle size and particle numbers are,” he said. “They are 20 plus years behind the times. Coronary heart disease remains one of the great killers in the world, and cholesterol is the greatest contributor to coronary heart disease.”
Dr. Dean’s recommendation is pretty straight-forward, “The advanced lipid profile is currently the way to go for cholesterol testing – get one.”
The Edwin J Dean MD Medical Wellness Center features advanced cholesterol testing that detects vascular disease and risks in the earliest stages. Using these results to provide targeted strategies, patients are able to optimize health and avoid serious health problems before they occur. For the month of September, advanced cholesterol screening promotional discounts are available at facebook pages Edwin J Dean MD Medical Wellness Center. Call 263-0014 for more information or visit www.Dean-Wellness.com.