Heart Health – It’s Not ALL About Cholesterol

For years, doctors and patients alike have believed that cholesterol levels are the best predictor of heart disease. But emerging science is showing that the longstanding approaches to lowering cholesterol, such as low-fat/low-cholesterol diets and statin drugs, may not be targeting and treating some of the more important causes of heart disease.   

Dietary Cholesterol vs Serum Cholesterol 

The laser focus on the link between dietary cholesterol and heart disease began with a flawed 1968 research review which led to American Heart Association (AHA) recommendations that people reduce their intake of high cholesterol foods like butter, eggs and shrimp.  When it was finally revealed that it was serum cholesterol, not dietary cholesterol, that was linked to heart disease, plenty of foods had already earned very bad reputations.  Dietary cholesterol is the cholesterol that you eat.  Serum cholesterol is the cholesterol in your blood.  As it turns out, eating foods high in cholesterol, like eggs, does not raise your serum cholesterol.   

Good Cholesterol (HDL) vs Bad Cholesterol (LDL) 

Once the link between serum cholesterol and cardiovascular disease (CVD) was broadly established pharmaceutical companies swung into action, creating cholesterol lowering drugs (statins) and promoting research suggesting that almost anybody could benefit from a daily statin. With this in mind, the American College of Cardiology (ACC) and the AHA issued recommendations that anyone with total cholesterol levels above 200 should discuss pharmaceutical intervention with a physician, and statins became a $14 billion industry.  By the time the AHA started separating good cholesterol (HDL) from bad cholesterol (LDL), many patients had been taking daily statins for several years even if their high numbers were caused by high HDL.   

Regardless of the bad hype, your body needs cholesterol to function properly. Cholesterol aids in the formation of cell membranes, is used to produce hormones like testosterone and estrogen, and supports digestion. Additionally, HDL, or “good” cholesterol, is helpful in that it sweeps and patches your blood vessels, reducing the areas where LDL, or “bad” cholesterol, can accumulate and cause blockages in your vessels.  In fact, high HDL is as good, or better, than a statin for mitigating the risk of heart disease.  And you can increase your HDL with lifestyle changes. 

Myths vs Facts about Heart Disease 

Myth: High cholesterol is the major predictor of heart disease.    

Fact: Chronic inflammation is the major predictor of heart disease.   

LDL cholesterol is only a minor player in the cascade of inflammation which is a cause of heart disease. Studies show that elevated levels of inflammatory markers are linked with a 2x increase in your risk of dying from a cardiovascular-related problem, like heart attack or stroke, and chronic, low-grade inflammation contributes to cancer, type 2 diabetes, and other chronic illnesses.  

Myth: Inflammation always leads to heart disease. 

Fact: Acute inflammation is a sign that our body is actually fighting disease.  Chronic inflammation is much more dangerous. 

Inflammation isn’t strictly good or bad. It can be either, depending on how long the inflammation lasts. Small flare-ups of inflammation are good since it’s our immune system working to heal our bodies, but chronic inflammation can be a sign of something more concerning such as rheumatoid arthritis, type 2 diabetes or even cancer. The good news is that chronic inflammation can very often be avoided or mitigated with lifestyle changes. For example, the number one dietary contributor to inflammation in the artery walls is sugar. Excess blood sugar decreases the elasticity of blood vessels and causes them to narrow, impeding blood flow, leading to a heart attack or stroke.  Decreasing your A1C can go a long way towards reducing inflammation and your risk of cardiovascular disease. 

Myth: Statin drugs can’t hurt and can be useful for everyone. 

Fact: Statins are not risk free and are now recommended for patients with high LDL who are also at HIGH RISK for cardiovascular disease. 

A study in 1993 showed that cholesterol-lowering statin drugs nearly deplete a necessary enzyme, CoQ10, which is required for healthy heart function. Other studies show that statins increase blood sugar, accelerating the diagnosis of Type 2 diabetes in people who already have higher than normal blood sugar.   

However, there are plenty of studies proving statins can reduce inflammation and improve blood viscosity, making it flow more easily through your vessels, and less likely to stick on accumulations of cholesterol. The latest ACC and AHA guidelines (updated in 2018) suggest that statins are only unequivocally recommended for patients with low HDL and high LDL, who have additional risk factors for cardiovascular disease like type 2 diabetes, obesity or a family history of CVD.  

What You Can Do to Stay Heart Healthy 

1. Learn your heart health numbers.  

Call Amaze and talk with one of our medical providers about your health numbers, like BMI, cholesterol, blood sugar, and blood pressure. If you don’t know what any of these are, you should definitely call! We can order labs and will work with your insurance plan or look for self-pay options to find you the lowest cost. Then, one of our experienced providers will explain the results to you and discuss ways to optimize your health.  

2. Analyze your stress.  

What is your stress level on a daily basis? Can you identify your stressors? Stress is linked with inflammation, so finding ways to understand and decrease your level of stress is essential to a long and healthy life.  

3. Take a look at your diet and level of daily exercise. 

Is there room for improvement in your diet choices and how much you exercise? Most of us could eat more veggies and drink more water, as well as sit less and move more. Where can you add healthy choices into your life? Studies show that a mindset shift occurs when you make healthy choices, causing you to think of yourself as a healthy person and making it natural to opt for things that improve your health. 

At Amaze we want to help you get healthy and stay healthy. If you think Amaze might be able to help, chances are we can. So, please reach out! Connect with a medical provider through your Amaze account or call (720) 577-5251. 

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