Cholesterol isn’t entirely the health villain it’s made out to be, its name darkly linked to heart attack, stroke, and other types of cardiovascular disease.
Our bodies need cholesterol, which is a type of lipid (another name for fat) to make cell membranes, key hormones like testosterone and estrogen, the bile acids needed to digest and absorb fats, and vitamin D. Cholesterol is so important to the body that the liver and intestines make it from scratch.
What is “bad” about cholesterol isn’t the substance itself — in fact, we can’t live without it — but how much of it is in the bloodstream.
The body packages cholesterol in two main particles: low- density lipoprotein (LDL), the so-called bad cholesterol, and
high-density lipoprotein (HDL), the so-called good cholesterol. Too much LDL in the bloodstream helps create the harmful cholesterol-filled plaques that grow inside arteries. Such plaques are responsible for angina (chest pain with exertion or stress), heart attacks, and most types of stroke.
What causes a person’s LDL level to be high? Most of the time diet is the key culprit. Eating foods rich in saturated fats, trans fats, and easily digested carbohydrates boost LDL. Genes are sometimes at the root of high cholesterol, and some medications can boost LDL.
If you have high cholesterol, making changes in your diet can help bring it down into the healthy range. Exercise can help boost the level of protective HDL. Several types of medication, notably the family of drugs known as statins, can powerfully lower LDL. Depending on your cardiovascular health, your doctor may recommend taking a statin.
Given the many conditions that affect the heart, it’s no surprise that hundreds of medications have been developed to treat heart disease and related conditions. Medications are available to: · lower cholesterol · lower blood pressure · slow the heart rate · stop abnormal heart rhythms · improve the force of heart contractions · improve circulation in the coronary arteries (nitrates and other anti-angina medications) · prevent blood from clotting (anticoagulants (also known as blood thinners) and antiplatelet agents) · break apart clots that have formed in an artery or vein (thrombolytics, also known as clot busters) · remove excess water from the body (diuretics, also known as water pills)
The development of these medications have helped dramatically decrease death rates from cardiovascular disease in the United States and other developed countries.
To do its job—pump blood to every part of the body—the heart needs its own supply of oxygen-rich blood. That pipeline is provided by the coronary arteries. No wider than strands of spaghetti, these arteries deliver blood to hard-working heart muscle cells. A heart attack occurs when blood flow through a coronary artery is suddenly blocked. A blood clot can block flow; so can a sudden spasm of the artery.
Each coronary artery supplies blood to a specific part of the heart. A blockage damages that part of the heart. Depending on the location and amount of heart muscle affected, a blockage can seriously interfere with the heart’s ability to pump blood.
Since some of the coronary arteries supply areas of the heart that regulate heartbeat, blockages there can cause potentially deadly abnormal heartbeats. The most common symptom of a heart attack is chest pain, usually described as crushing, squeezing, pressing, heavy, stabbing, or burning.
The pain or feeling tends to be focused either in the center of the chest or just below the center of the rib cage, but it can spread to the arms, abdomen, neck, lower jaw or neck. Other symptoms can include sudden weakness, sweating, nausea, vomiting, breathlessness, or lightheartedness.
If you think that you, or someone you are with, is having a heart attack, call 911 right away. The sooner you call, the sooner treatment can begin — “time is muscle,” as emergency room doctors say.
The most effective treatments are artery-opening angioplasty with stent placement or an infusion of a clot-busting drug.
The term “heart disease,” also known as cardiovascular disease, covers a lot of ground. It’s used for a variety of problems with the circulatory system, from high blood pressure to abnormal heart rhythms. Most of the time, though, when people speak of heart disease what they really mean is coronary artery disease—a narrowing of the coronary arteries.
No wider than a strand of spaghetti, each coronary artery deliver bloods to hard-working heart muscle cells. The cause of coronary artery disease is almost always atherosclerotic plaque—gooey cholesterol-filled deposits that form inside artery walls.
Plaque is usually the result of an unhealthy diet, too little exercise, high cholesterol, high blood pressure, smoking, and other “insults” that damage the lining of artery walls.
When a coronary artery becomes clogged with plaque, it can’t always deliver enough blood to the heart muscle cells it is supposed to supply. Sometimes this doesn’t cause any noticeable symptoms. Sometimes it causes angina — chest pain that occurs with physical exertion or stress.
Coronary artery disease can also be the root cause of a heart attack, or lead to the chronic condition known as heart failure. Coronary artery disease affects millions. Once limited almost entirely to older people, it is now beginning to appear in younger folks, a change driven by the rising tides of obesity and type 2 diabetes. Coronary artery disease isn’t an inevitable part of growing older. A healthy lifestyle that includes exercise, a healthy diet, and not smoking goes a long way to preventing it, especially when started at a young age. Lifestyle changes and
medications can also reverse coronary artery disease, or at least prevent it from getting worse