Atherosclerosis is a disease of civilization caused by too high LDL cholesterol. Years of unhealthy diets, inadequate physical activity, and a family history make up hypercholeterolaemia that can even be diagnosed in children. Therefore, to avoid the risk of a heart attack or stroke, you need to monitor your cholesterol level and lower it effectively when it is too high. There are many ways, they are presented by family doctor Paweł Lewek, MD, PhD.
- Bad LDL cholesterol builds up on the vessel walls in the form of atherosclerotic plaques, contributing to atherosclerotic cardiovascular disease
- Primitive people had cholesterol of 30-40 mg / dL, the current norm for a healthy adult is 115
- The most important cholesterol-lowering drugs with few side effects are the statins atorvastatin and rosuvastatin.
- Cardiac margarines will lower cholesterol by 10 to 12 percent, and bergamot preparations by 40 percent.
- More information can be found on the Onet homepage
What do we need to know about cholesterol?
Bad cholesterol – LDL is the most important risk factor for atherosclerosis and the cause of the development of atherosclerotic disease of the cardiovascular system. Lipids, mainly LDL cholesterol, accumulate on the inner walls of the arteries for a long time in the form of the so-called atherosclerotic plaques. Sudden detachment of such a plaque can trigger an atherosclerotic cardiovascular event, i.e. a heart attack or stroke. Atherosclerotic disease of the cardiovascular system causes as much as 85 percent. cardiovascular deaths, it is also the leading cause of death throughout the European Union and worldwide.
Despite the widespread availability of effective and safe cholesterol-lowering drugs – statins, research shows that LDL is still well above the norm in most of the population.
Meanwhile, the legend of world cardiology, Dr. Eugene M. Braunwald, author of one of the most famous textbooks on heart disease, once said: “In life you cannot have too much money and too low cholesterol”.
– Always the lower its blood content, the better – says Krzysztof Pujdak, MD, a specialist in internal medicine and cardiology. – We have studies that prove that lPrimary legs had cholesterol levels of 30-40 mg / dL (milligrams per deciliter), which is well below the current reference (threshold) values. It’s just that these people led a completely different lifestyle and did not eat as much meat as we do. Their diet, unlike ours, was not conducive to atherosclerosis, so they were not affected by coronary heart disease.
The strangest thing is that to this day, European societies hold prejudices that low cholesterol is harmful to health. There was even a documentary on the subject on one of the popular Franco-German channels.
The commenting physician argued that low cholesterol may cause the risk of Alzheimer’s disease, intellectual deficits and cognitive disorders. I emphasize that these claims have never been confirmed by scientific research. Cholesterol is important in a child’s development, but in adults, the lower the better. After the publication of this controversial document, the European Society of Cardiology issued an official statement denying all theses put forward in the program.
Why do we beat cholesterol?
Family doctor Paweł Lewek, MD, PhD, head of the Le-Med clinic in Łódź, orders his patients about 10 cholesterol tests a day and about 200 a month. The results speak for themselves. You have to start lowering it. There are several ways.
To lower cholesterol, you can use the Omega-3 1000mg supplement – the strength of the heart from the depths of the ocean BLUE Forte available on Medonet Market.
Monika Zieleniewska, MedTvoiLokony: When should we start testing cholesterol?
Dr Paweł Lewek: There is no specific age at which you should first order a lipid profile. Every adult patient should know what his cholesterol level is. On the occasion of other tests, it is possible to perform a lipidogram even in children, because thanks to this we can diagnose hereditary hypercholesterolaemia. It is recommended for teenagers and even younger children, especially if their families have had early heart attacks, heart diseases or vascular diseases.
What is this test?
Blood is taken and cholesterol fractions are checked, including total cholesterol, but also standard LDL and HDL cholesterol and triglycerides. Let me add that cholesterol does not need to be tested on an empty stomach. If the blood was drawn on an empty stomach, you will see a slight change in triglycerides. Their level is 10-15 percent. lower. However, it does not affect the other fractions of cholesterol – LDL and HDL. The guidelines say that it is not necessary to come to the test without breakfast, but nevertheless it is necessary for other tests, and therefore it is worth reporting for blood sampling on an empty stomach.
What does the result tell us about?
The most important is LDL cholesterol, which is indicative of cardiovascular risk. The higher the so-called bad cholesterol, the greater the risk that in the future a person will develop atherosclerosis, and atherosclerosis is associated with heart attacks or ischemic strokes. It translates directly into these diseases, so we try to do everything to lower the LDL level. We also have a second parameter, non-HDL cholesterol, which is associated with high cardiovascular risk. But most of all, we are interested in LDL, which is an indicator of whether a person has an increased risk of cardiovascular disease in the future.
What are the norms of cholesterol levels for a healthy person at the moment?
For a healthy person with low cardiovascular risk, LDL should be below 115 mg / dL. In the moderate-risk group – less than 100 mg / dL, in the high-risk group – less than 70 mg / dL, and in people who have a very high cardiovascular risk – below 55 mg / dL. Patients at extreme cardiovascular risk should aim for an LDL concentration below 40 mg / dL. A person’s cardiovascular risk should be calculated and LDL cholesterol lower limit should be adjusted accordingly. You have to try to achieve it in various ways, not only through pharmacology, but also through diet, whenever possible.
What is this individual standard calculation?
You have to take into account the patient’s other diseases, cardiovascular risk (calculated on the basis of risk factors, for which special tables are used) and classify him into one of the risk groups on this basis. Then we try to reduce cholesterol as much as possible for a given risk group, because research shows that thanks to this we lower the risk of heart disease.
What methods of reducing cholesterol do you recommend to patients?
There are various formulas and dietary supplements available that can be used, especially if your LDL is not too high. I am thinking mainly of preparations based on fermented red rice extract containing a compound called monacolin K. It is true that monacolin K is the same as one of the statins, i.e. lovastatin, also called mevinoline, but it is a more natural product.
Once your doctor decides that you need treatment, your first and most important treatment will be statins. At the moment, mainly two – atorvastatin and rosuvastatin. They are the leading and most studied drugs with relatively few side effects.
If the statin is unsuccessful, we can start another drug – ezetimibe. When the test shows high triglycerides, we use statins, and if there is a need for fibrates, you can also take omega-3 acids and nicotinic acid. Such drugs are prescribed by general practitioners in primary care.
However, when we are dealing with hypercholesterolaemia that is very resistant to treatment or with familial hyperchoresterolaemia, we need to use more advanced preparations – e.g. PCSK9 inhibitors. Thanks to them, it is possible to reduce the level of LDL cholesterol by up to 60%, and in combination with a statin and ezetimibe by 85%.
Who is prescribing these more advanced drugs?
Most often it is a cardiologist, and in the case of a drug program, it is done in centers dealing with the treatment of hypercholesterolaemia.
Should you take statins for life?
Usually yes, because if you stop taking them, your LDL can go up a lot. In addition, when the drugs are well tolerated, they also stabilize the plaque, reducing the risk of it tearing off and clogging a vessel, causing a heart attack. They have a protective effect, so if you turn them on for the rest of your life, because the tendency to high cholesterol does not change. Therefore, it is important to always take advantage of the dietary options at the beginning. If the diet proves to be successful, it is of course best to treat the patient with a diet.
And while taking statins, when cholesterol levels go down, does the dose change?
It can be like that. If you are losing weight, are on a diet and your LDL has lowered significantly, you may want to reduce your statin dose a little by checking that your cholesterol targets are met. However, this is extremely rare in clinical practice.
How then do you need to eat to lower cholesterol?
First of all, the Mediterranean diet is recommended as standard. We want the patient to give up saturated fats in favor of unsaturated fats. Meat should be limited to a maximum of two or three times a week. However, fish rich in omega-3 fatty acids is a good idea to eat often (at least twice a week), as fish fatty acids have a positive effect on cholesterol. This is the basis of the nutrition.
You can also use additional products, i.e. various types of nutraceuticals, functional food, e.g. margarines with plant phytosterols, which additionally lower cholesterol. If we forgo butter, cardiovascular margarines can lower cholesterol by 10 to 12 percent. Of course, you also have to avoid sugar and eat plenty of plant foods. There should be vegetables in every meal.
There are probably a lot of nutraceuticals on the market?
Another example is vitamin E. Thanks to it, it is possible to reduce the level of LDL by 5%. It’s not much, but it’s always natural. Artichoke has a similar effect. There are preparations containing artichoke leaf extract. Patients know, and this is confirmed by research, that garlic also has a similar effect. Garlic extracts can lower LDL cholesterol by 5-10%. Bergamot too, we have bergamot preparations that lower LDL by up to 40 percent. Unfortunately, they are not cheap, but effective. Most grocery stores also find drinkable phytosterols.
Dietary supplement Cholesterol + contains a large amount of artichoke extract – a plant rich in cynarin, which supports the proper functioning of the liver. It lowers the level of bad cholesterol. Artichoke root is also a rich source of niacin and inulin, which stimulate digestive processes. You can find a set of three supplements to support liver function at Medonet Market.
And you probably have to move a lot?
Of course, move is always advisable. Preferably 150 minutes a week, i.e. five days 30 minutes each. movement involving the lower limbs. It can even be a brisk walk, you don’t have to run right away. The most important thing is that the patient gets tired when doing physical activity, sweats a little, that this activity leads to shortness of breath, that it is not just a walk from point A to point B without much effort. Often, patients tell me that they worked in the garden, treating this work as the equivalent of exercise. It’s not quite like that, work is about repeating the same movements, engaging the same muscles. The idea of exercising is to activate different parts of the muscles so that the effort is relatively constant and leads to shortness of breath.
How many times should we check the cholesterol level?
If the condition is stable, the test is usually done every six months to a year.
Can we break down cholesterol on our own, without consulting a specialist?
Cholesterol has been linked to a variety of chronic diseases. Its high level may be, for example, a symptom of hypothyroidism. This can often be overlooked, so additional tests are performed, especially if it is elevated, and in the course of the interview, we learn about symptoms suggestive of hypothyroidism, such as: weight gain, fatigue, drowsiness, constipation, slow heart rate. They indicate that hypothyroidism is potentially responsible for high cholesterol, not a patient’s genetics. Therefore, high cholesterol should not be treated alone, but always in consultation with a doctor.
We encourage you to listen to the latest episode of the RESET podcast. This time we devote it to self-compassion – a trend that has developed very strongly in the United States, but is still in its infancy in Poland. What is it and how does it affect our daily functioning? You will hear about this and many other issues related to self-compassion in the latest episode of our podcast
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