Atherosclerosis Cholesterol details Not soluble in water but blood is made

Atherosclerosis cholesterol details not soluble in

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Atherosclerosis Cholesterol details Not soluble in water, but blood is made mostly of water Packaged in lipoproteins to transport in body Lipoprotein packages identified by density LDL (low density lipoprotein) bad LDL receptors are molecules on surface of cells where LDL can unload its cholesterol If LDL receptors are full, LDL run into each other and spill cholesterol everywhere HDL (high density lipoprotein) Good Pick up spilled cholesterol and transport it back to liver Size matters: smaller LDL particles are more problematic The atherosclerotic culprit is LDL particle numbers (size), not LDL cholesterol Precursor for cortisol, vitamin D Heart attack happens when plaque bursts in artery Cells rush there and form a clot in the wrong place that blocks the flow of blood Plaque bursts from inflammation: pain, swelling, redness, heat High sensitivity C-reactive protein : blood test, <2mg/L then risk of heart disease decreases Anticarcinogens: resveratrol, lignans, indol-3-carbanol Lesson 3: diet and the heart 2 Intervention studies Intervene with one group but not the other MR FIT Multiple risk factor trial How to reduce risk of heart disease Reduced saturated fat intake by 30% and increased polyunsaturates by 33% Difference in blood cholesterol was only 2% Mortality rate difference was not significant Lots of authors, all had connections to pharmaceutical companies CPPT 3806 high risk men ages 35-39 Half treated w diet, half treated w diet plus cholestyramine “For every 1% decrease in cholesterol, risk of heart attack decreased by 2%” New England Journal of Medicine study Rosuvastatin drug for intervention group JUPITER study 100% reduction in cardiovascular events
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Have to treat 120 people to prevent 1 event, very costly How do you reduce cholesterol? Cholesterol mmol/L = mg/dL x .026 Triglycerides mmol/L = mg/dL x .0113 Total cholesterol <200 (5.2) desirable 200-239 (5.2-6.2) borderline >240 (6.2) high Not causative LDL <130 desirable 130-159 borderline >159 high HDL <40 undesirable >60 desirable Triglycerides <200 desirable 200-400 borderline >400 high Low risk LDL/HDL < 3 Total cholesterol/HDL < 4 LDL not measurable, only calculated Size matter High risk= high particle #, small size Low risk= low particle #, large size Blood cholesterol comes from dietary cholesterol and dietary fats and cholesterol made in liver Dietary fats affect LDL receptor activity No association between egg intake and heart disease Very few impacted blood cholesterol If blood cholesterol does rise, LDL and HDL raise at same rate so it’s chill Fat raises issues Phil Sokolof Thought america was poisoned by amount of fat in american foods Millionaire Got people to make more trans fats, which was bad Saturated fats raise cholesterol ⇒ never been proven Monounsaturated fats do not change cholesterol levels and are biochemically neutral Polyunsaturated fats have omega-3 and omega-6 Low fat/low cholesterol diet doesn’t do shit in clinical trials French paradox:
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