Atherosclerosis | Cholesterol, LDL, HDL, Triglycerides

Atherosclerosis & Cholesterol. Are LDL, HDL and triglycerides good measures of atherosclerosis risk? A look at atherosclerosis, cholesterol and tips to dodge a heart attack.how to dodge a heart attack? let's look at atherosclerosis aka plaque and best lab tests to prevent itLDL? LDL-cholesterol? people call them both LDL. HDL? VLDL? IDL…cholesterol is carried in our bloodstream by lipoproteins. lipoproteins are the buses and cholesterol is the passengersome get stuck in the artery wall. if there’s a lot of lipoproteins in the blood, over the years this forms plaque aka atherosclerosisplaque can block blood flow and cause angina (chest pain when the heart muscle doesnt get enough blood). plaque can also break and clot causing a heart attacklipoproteins: LDL (low dens lipoprotein). VLDL or very low density lipoproteinLDL and VLDL are the same family. there’s other families of lipoproteins but these are the main ones that cause atherosclerosisthis family of lipoproteins includes LDLs, VLDLs etc. they all carry apoB.we can measure these lipoproteins by measuring apoBlipoproteins cause atherosclerosis but blood work measures LDL-cholesterol (cholesterol in LDL) and triglycerides. they estimate risk of atherosclerosisEuropean atherosclerosis society: LDL-cholesterol is a satisfactory surrogate for LDL particle number. so high LDL-cholesterol is a red flag. and same for triglyceridesonline: focus on LDL-cholesterol, ignoring triglycerides vs focus on triglycerides & ignoring LDL-cholesterolboth markers of lipoproteins that cause atherosclerosis. risk of atherosclerosis determined by apoB particles regardless of lipids… benefit of lipid-lowering (so, lowering cholesterol or triglycerides) proportional to reduction in apoB regardless of the change in LDL-Cholesterol or triglyceridesif LDL-cholesterol is high, number of LDL lipoproteins is often high. high LDL-cholesterol is a red flag and indicates high apoBcholesterol/triglycerides reflect lipoproteins. exceptions: lipoproteins rule, not LDL-cholesterol or triglyceridesnormal number of lipoproteins, normal apoB + high LDL-cholesterol/triglycerides=normal riskhigh lipoproteins, high apoB + normal cholesterol/triglycerides= high risk of atherosclerosisLDL-c/triglycerides are like the check engine light. checking engine directly = apoB HDL-cholesterol aka ‘good cholesterol’?people with high HDL-cholesterol tend to have less heart diseasecausal relationship? raise HDL-cholesterol specifically analysis: raising HDL-cholesterol did not lower atherosclerosis risk. raising HDL-cholesterol offers no CV protection“the effects on cardiovascular disease of foods or nutrients cannot be judged from changes in HDL cholesterol”HDL-cholesterol: correlates. doesn’t cause benefit. same for ratios using hdl-cholesterolraising my HDL-cholesterol does nothing for riskhigh HDL-cholesterol = distractionkey concepts to dodge atherosclerosis and a heart attack:1) high apoB buses, apoB lipoprots = risk of atherosclerosis2) We can measure apo B lipoproteins by measuring apoB3) LDL-cholesterol and triglycerides are useful but not perfect4) careful with HDL-cholestimproving our lipids including apoB: diet. more detail on lipids in your blood workConnect with me:Facebook: https://www.facebook.com/DrGilCarvalho/Twitter: https://twitter.com/NutritionMadeS3Animations: Even Topland @toplandmediaReferences:https://academic.oup.com/eurheartj/article/38/32/2459/3745109https://jamanetwork.com/journals/jama/article-abstract/2768850https://jamanetwork.com/journals/jamacardiology/article-abstract/2753612HDL-cholesterol:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103514/https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.119.044687Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, Learn more about your ad choices. Visit megaphone.fm/adchoices