Glenn Ellis2

Glenn Ellis

If you’re not on medicine to lower your cholesterol yet, you might be soon. The latest guidelines from the American Heart Association and the American College of Cardiology for prescribing cholesterol-lowering drugs have raised many eyebrows. Based on these guidelines, the number of people over the age of 55 in this country who are on statins would double from the almost 1 out of every 4. 

Expect your doctor t ask four questions:  Do you have heart disease? Do you have diabetes (Type 1 or 2)? Do you have a bad cholesterol level more than 190? And is your 10-year risk of a heart attack greater than 7.5 percent? Answering yes to either of these questions means you should be taking a statin drug. 

Why is this so important? 

Every cell membrane in our body contains cholesterol, a waxy fat that makes our cells waterproof. When cholesterol levels are not adequate, the cell membrane becomes leaky or porous. The body interprets as an emergency, releasing a flood of corticoid hormones that work by seizing cholesterol from one part of the body and transporting it to areas where it is lacking. 

Cholesterol is the body’s repair substance: scar tissue contains high levels of cholesterol, including scar tissue in the arteries. Two sources contribute to the amount of cholesterol in the human body. First, the liver manufactures about 80 percent of it. Second, people consume it by eating animal products such as meat, eggs and dairy products. Cholesterol is carried through the bloodstream by certain proteins.  

There are four different types of lipoproteins that carry cholesterol through the bloodstream: High-density lipoproteins (HDL), which are associated with “good” cholesterol; Low-density lipoproteins (LDL), which are associated with “bad” cholesterol; Very-low-density lipoproteins (VLDL), which are associated with “very bad” cholesterol; Chylomicrons, which only carry a small percentage of cholesterol. Chylomicrons are mostly rich in another type of fat (lipid) called triglycerides. 

  Cholesterol is the precursor to vitamin D, necessary for numerous biochemical processes in the body, including mineral metabolism. The bile salts, required for the digestion of fat, are made of cholesterol. Those who suffer from low cholesterol often have trouble digesting fats. Cholesterol also functions as a powerful antioxidant, thus protecting us against cancer and aging. 

When cholesterol levels drop too low, the serotonin receptors cannot work. Cholesterol is the main organic molecule in the brain, constituting over half the dry weight of the cerebral cortex. 

Corticoids are the cholesterol-based adrenal hormones that the body uses in response to stress of various types; it promotes healing and balances the tendency towards inflammation. The adrenal cortex also produces sex hormones, including testosterone, estrogen and progesterone, out of cholesterol. 

The drugs that doctors use to treat the new disease are called statins, which are sold under a variety of names, including: Lipitor; Zocor; Mevacor; and Pravachol. Cholesterol-fighting drugs, which are taken by millions, are ranked as the most widely prescribed and most profitable drugs in the world. According to studies, cholesterol drugs, or statins, have pulled in $26 billion worldwide, with $14 billion of that amount in the United States alone. 

In recent years, we’ve come to realize that to decide whether a person’s cholesterol levels are dangerous, these levels need to be considered in the light of the person’s overall risk of heart disease. In particular, it’s the balance of different types of lipoproteins, rather than the overall total cholesterol level, that matters.

This overall risk is determined by a combination of factors, including age, gender, family history of heart disease, and whether someone smokes, is overweight, has high blood pressure or diabetes. 

The higher the risk of heart disease (for example, a male smoker with high blood pressure and diabetes), the greater the need to get cholesterol levels down.

But, as stated earlier in this column, what constitutes a healthy cholesterol level is controversial, even among doctors. 

Heart disease death rates have fallen for a whole host of reasons, some of them overlapping. Fewer Americans smoke. Treatment of heart disease has improved. Emergency treatment of heart attacks is faster. The American diet is better for the heart than it used to be. But lower cholesterol levels also belong on the list of positive influences. 

Remember, I’m not a doctor. I just sound like one.

 

DISCLAIMER:

The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.)

 

Glenn Ellis, is a regular media contributor on Health Equity and Medical Ethics. He is the author of Which Doctor?, and Information is the Best Medicine. Listen to him every Saturday at 9 a.m. (EST) on  www.900amwurd.com and Sundays at 8:30 a.m. (EST) on www.wdasfm.com. For more good health information, visit: glennellis.com