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Cardiovascular Disease (4)

Remnant Cholesterol and non-HDL – What’s that? Why bother?

In a previous article "Blood Cholesterol Testing - don't let the routine standard lipid panel fool you!" I talked about the standard lipid panel that doctors use to check your “bad” cholesterol, aka LDL level. In "Why you need to look beyond your “bad" cholesterol” - level" I’ve also gone into some depth on why a myopic focus on LDL-C can do more harm than good.
 
In this article I will talk about 2 relatively unknown cholesterol parameters and explain why you want to keep an eye on these…
 
The routine standard lipid panel checks your levels of:
 
- Total cholesterol 
 
- LDL-C (or just LDL, low-density lipoprotein cholesterol, the “bad" cholesterol)
 
- HDL-C (or just HDL, high-density lipoprotein cholesterol, the “good" cholesterol) 
 
- VLDL-C (or just VLDL, very-low-density lipoprotein cholesterol) 
 
- Triglycerides (a.k.a. blood fats)
 
If you have read my previous articles you know the limitations of LDL-C and the standard lipid panel. However, while the advanced lipid panel gives you much more accurate information on your health status, the standard lipid panel is not totally worthless if you know what to look for…The caveat is, what to look for - non-HDL-C and remnant cholesterol – are not printed in your standar lipid test results. And your doctor may not even know about non-HDL-C and remnant cholesterol! That’s why I had to write this article…
 
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Why you need to look beyond your LDL - “bad cholesterol” - level

In the United States, cardiovascular diseases account for about 1 of every 3 deaths.[1] The cornerstone in heart disease treatment is reducing elevations of LDL, popularly known as the “bad cholesterol” (see table below “What do the terms mean?”) [2, 3], primarily with statins, the most widely used cholesterol/ heart disease drug.[4]  
 
However, when one looks at the aggregate effectiveness of statin treatment in all studies, morbidity and mortality rates among statin-treated patients still remain approximately two thirds to three quarters of those found in patients randomized to placebo.[5, 6] In the “Treating to New Targets” study there were still 80% cases of cardiovascular disease, despite intensive treatment with high-dose statins.[7]
 
Thus, many patients – even those treated aggressively with statins to meet LDL goals - have residual cardiovascular risk.[8-13] This remaining risk is associated with low levels of HDL, increased levels of triglycerides, and elevated numbers of small, dense, atherogenic LDL particles.[8, 10, 11, 14-17] and other common metabolic abnormalities that you will find out about in this article...
 
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Blood Cholesterol Testing - don't let the routine standard lipid panel fool you!

 

The mere word “blood cholesterol” strikes horror in many people. We have been indoctrinated since the well-known Framingham Study in the 1980s that the higher the blood cholesterol level, the higher the risk of heart disease.[1-3] However, much has been discovered in medical research since then. 
 
Today there is compelling evidence showing that strict reliance on the traditional cholesterol test – aka the standard lipid panel - that is routinely run in primary care, can falsely indicate that you're fine, even when you aren't. 
 
Here you will find out what to look for when interpreting your cholesterol levels...
 
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High-Normal Blood Pressure and Cardiovascular Disease

1 in 3 US adults aged 40-59 years has high blood pressure (hypertension); among those over 60 years of age the prevalence is over two-thirds, 67%.[1] High blood pressure is a well known risk factor for cardiovascular disease; the leading cause of death worldwide.[1, 2] As two-thirds of sudden cardiac deaths occur in clinically healthy individuals [2], novel indicators of early recognition of adverse cardiometabolic risk in disease-free adults are clearly needed. It has been demonstrated that healthy disease-free adults with high-normal blood pressure (aka pre-hypertension, defined as 120-139/80-89 mmHg) have an adverse cardiometabolic risk profile.[2]

The prevalence of high-normal blood pressure in disease-free US adults is 36.3%; it is especially common in people with overweight/obesity, enlarged waist lines, and elevated glucose, insulin, hemoglobin A1c (glycated glucose), C-reactive protein (an inflammatory marker), and triglycerides (blood fats).[2]

High-normal blood pressure is an independent risk factor for cardiovascular disease (CVD)...[3-5]

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