Heart disease/cholesterol, density

Cholesterol is biosynthesized in the liver trans ported throughout the body to be used in a va riety of ways and returned to the liver where it serves as the biosynthetic precursor to other steroids But cholesterol is a lipid and isn t soluble in water How can it move through the blood if it doesn t dis solve in if The answer is that it doesn t dissolve but IS instead carried through the blood and tissues as part of a lipoprotein (lipid + protein = lipoprotein) The proteins that carry cholesterol from the liver are called low density lipoproteins or LDLs those that return it to the liver are the high-density lipoproteins or HDLs If too much cholesterol is being transported by LDL or too little by HDL the extra cholesterol builds up on the walls of the arteries caus mg atherosclerosis A thorough physical examination nowadays measures not only total cholesterol con centration but also the distribution between LDL and HDL cholesterol An elevated level of LDL cholesterol IS a risk factor for heart disease LDL cholesterol is bad cholesterol HDLs on the other hand remove excess cholesterol and are protective HDL cholesterol IS good cholesterol... 

Low density lipoprotein (LDL) (Section 26 11) A protein which cames cholesterol from the liver through the blood to the tissues Elevated LDL levels are a nsk factor for heart disease LDL is often called bad cholesterol... 

To control risk factors and prevent major adverse cardiac events, statin therapy should be considered in all patients with ischemic heart disease, particularly in those with elevated low-density lipoprotein cholesterol. In the absence of contraindications, angiotensin-converting enzyme inhibitors should be considered in ischemic heart disease patients who also have diabetes melli-tus, left ventricular dysfunction, history of myocardial infarction, or any combination of these. Angiotensin receptor blockers... 

Vascular disease-A positive association is observed between the amount of estrogen and progestin in OCs and the risk of vascular disease. A decline in serum high-density lipoproteins (HDL) has occurred with progestins and has been associated with an increased incidence of ischemic heart disease. Because estrogens increase HDL cholesterol, the net effect depends on a... 

Lowering cholesterol levels can arrest or reverse atherosclerosis in all vascular beds and can significantly decrease the morbidity and mortality associated with atherosclerosis. Each 10% reduction in cholesterol levels is associated with an approximately 20% to 30% reduction in the incidence of coronary heart disease. Hyperlipidemia, particularly elevated serum cholesterol and low density lipoprotein (LDL) levels, is a risk factor in the development of atherosclerotic cardiovascular disease. 

Sharrett AR, Ballantyne CM, Coady SA, et al. Coronary heart disease prediction from lipoprotein cholesterol levels, triglycerides, lipoprotein (a), apolipoproteins A-I and B, and HDL density subfractions the Atherosclerosis Risk in Communities (ARIC) study. Circulation 2001 104 1108-13. 

Principal risk factors for heart disease are elevated levels of LDL cholesterol, a family history of heart disease, and hypertension. Other risks include being male, smoking, low levels of high density lipoprotein (HDL) cholesterol, diabetes mellitus, hyperhomocystinemia, high levels of lipoprotein a (Lpa), and high blood levels of C-reactive protein. (Table 23.1). C-Reactive protein is a marker for cellular inflammation. 

LDL, low-density lipoproteins CHD, coronary heart disease. Classification <130 mg/dL is the desirable LI3L cholesterol level 130-159 mg/dl is borderline-high-risk >160 mg/dl is high-risk. 

Choi, cholesterol TG, triglyceride CHD, coronary heart disease LDL, low density lipoproteins LPL, lipoprotein lipase VLDL, very low density lipoprotein HDL, high-density lipoprotein IDL, intermediate-density lipoprotein. 

Heart disease is any condition that diminishes the hearts ability to pump blood. A common heart disease is arteriosclerosis, a buildup of plaque on the inside walls of arteries. As discussed in Section 13.8, plaque deposits are mostly an accumulation of low-density lipoproteins, which are high in cholesterol and saturated fats. Plaque-filled arteries are less elastic and have a decreased volume. Both these effects make pumping blood more difficult, and the heart becomes overworked and weakens. Accumulated damage to heart muscle from arteriosclerosis or other stresses can result in abnormal heart rhythms, known as arrhythmia. Chest pains, known as angina, result from an insufficient oxygen supply to heart muscles. Ultimately, the weakened heart does not adequately circulate blood to the body. People with heart disease have decreased stamina and frequently need to catch their breath. 

The effects of wine and its polyphenol constituents on early indicators of coronary heart disease such as elevated levels of plasma lipids, platelets and serum antioxidant activity were discussed in a review by Cooper et al. (2004). This review also addressed whether the polyphenols or alcohol are responsible for the beneficial effects of wine on cardio-vascular health. The authors conclude that red wine polyphenols have little effect on plasma lipid concentrations, but that wine consumption reduces the susceptibility of low-density lipoprotein (LDL) cholesterol to oxidation and increase serum antioxidant capacity. These effects, however, do depend on the amount of wine that is consumed and the period of supplementation. It was suggested that specific polyphenols appear to have endothelium-dependent vaso-relaxing abilities. Red wine phenolics also have an inhibitory effect on platelet aggregation. Evidence suggests that alcohol has a positive synergistic effect with wine polyphenols on some atherosclerosis risk factors. Thus, evidence that wine drinking is beneficial for cardiac health appears positive. 

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