Overlooked Cholesterol Triples Risk of Heart Disease

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The Overlooked Ugly Cholesterol

The risk of ischemic heart disease -- the leading cause of death worldwide -- is three times higher in persons with high levels of the so-called 'ugly' cholesterol.

This is the finding of a new study of 73,000 Danes, which is shedding light on a long debate on this topic.

Cholesterol is divided into ‘the good’ HDL cholesterol, ‘the bad’ LDL cholesterol and ‘the ugly’ cholesterol

• The High Density Lipoproteins (HDL) essentially remove cholesterol from the blood and carries them back to the liver preventing accumulation of cholesterol in the blood and therefore are referred to as Good cholesterols.
• The Low Density Lipoproteins (LDL), on the other hand do exactly the opposite; they deliver more cholesterol to the body, adding to the process of cholesterol build up in the blood vessels and deposits on the walls. Therefore, called Bad cholesterol
• The Triglycerides (TG), the major component in Very Low Density Lipoproteins (VLDL), gets the tag of being the Ugly cholesterol because VLDL gets converted into LDL in the bloodstream adding to the circulating bad cholesterol

It is the so-called ‘ugly cholesterol’ – also called ‘remnant-like particle cholesterol’ – that is the really bad guy.

"High ugly cholesterol is the result of high blood levels of normal fat (triglycerides). The most important cause of high ugly cholesterol is overweight and obesity. Persons with high ugly cholesterol should therefore be advised to lose weight, but drugs such as statins and fibrates may also lower levels of ugly cholesterol in the blood," says Professor Børge Nordestgaard, Chief Physician at Copenhagen University Hospital and Clinical Professor at the Faculty of Health and Medical Sciences at University of Copenhagen.

"LDL cholesterol or 'the bad' cholesterol' is of course bad, but our new study reveals that the ugly cholesterol likewise is the direct cause of atherosclerosis resulting in ischemic heart disease and early death. By examining 73,000 persons, we found that an increase in the ugly cholesterol triples the risk of ischemic heart disease, which is caused by lack of oxygen to the heart muscle due to narrowing or blocking of the coronary arteries," adds Børge Nordestgaard.

"I hope that this new knowledge will lead to better preventive treatment including lifestyle changes, as more than one in five individuals in affluent countries suffers from high ugly cholesterol. We also hope that the pharmaceutical industry will develop new drugs targeted specifically at raised ugly cholesterol levels," he emphasises.

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The above story is based on the January 21, 2013 news release by University of Copenhagen.

The results have just been published in the Journal of the American College of Cardiology:

Anette Varbo, Marianne Benn, Anne Tybjærg-Hansen, Anders B. Jørgensen, Ruth Frikke-Schmidt, Børge G. Nordestgaard. Remnant Cholesterol as a Causal Risk Factor for Ischemic Heart Disease. J Am Coll Cardio, 2012; DOI: 10.1016/j.jacc.2012.08.1026

Omega-3 Fatty Acids Lower Serum Triglycerides

Omega-3 fatty acids has demonstrated an efficacy and safety in adult patients with high and very high triglycerides adjunct to diet.

This well known effect has been shown to be caused by decreased very low-density lipoprotein triglyceride secretion rates in kinetic studies in humans.

An average of four grams of omega-3 fatty acids are typically used to reduce triglycerides in individuals with high trigylceride levels*.

Reference:

McKenney JM, Sica D. Prescription omega-3 fatty acids for the treatment of hypertriglyceridemia. Am J Health Syst Pharm.2007 Mar 15;64(6):595-605.

* The Zestzfulness Team recommends that individuals taking more than 3 grams a day should be under the supervision of a health-care provider, since high doses of omega-3 fatty acids decrease the aggregation of platelets, which may cause bleeding to occur more easily.