Blogs & Comment

Confused about cholesterol?

There's good and bad cholesterol, and yes, there's a test for that.

With all the emphasis on cholesterol, it’s no wonder clients come to me confused about their cholesterol levels and the role they play in heart attacks. (They think it’s all about levels when it’s really about the connection between cholesterol particle size and arterial inflammation).

First, stop thinking of cholesterol as some nasty ‘C’ word. Not all cholesterol is bad. A high total cholesterol level may mean that you have lots of the good stuff—HDL cholesterol—a type your body needs. So while we do consider quantity, the quality of cholesterol is what’s critical when it comes to arterial plaque. The smaller or denser the cholesterol particles, like the ones found in bad LDL, and especially VLDL and lipoprotein (a), the greater the concern. Similarly larger or less dense HDL (such as HDL2 molecules) is more protective because it ‘mops up’ the bad stuff better.

So it’s not as simple as knowing how high your cholesterol is—it’s important to understand what type it is and how it interacts with inflammation proteins in your bloodstream. That additional information can help to determine whether you’re developing an arterial blockage.

What hangs with your cholesterol, hangs with you. Both cholesterol and protein molecules move through the bloodstream, and some of those proteins inflame and damage artery walls. Once those proteins have caused that damage, cracks begin in the arterial walls. Cholesterol sticks to those cracks and the cracks are furthermore prone to calcium build up. In essence, it’s like a scab that develops from grazed skin but in arteries. We call it ‘plaque.’ Plaque causes arteries to narrow, decreasing blood flow that leads to atherosclerosis or hardening of the arteries.

Now that you get the cholesterol-inflammation connection, you need to know what cholesterol might be roaming about in your body so you take the right action. In a previous post, I said that heart attacks are predictable and preventable. You don’t have to wait for angina symptoms to wake you up and then hope for the best that your local hospital will save your life.

Four tests tell you what you need to know The science is proven and professional experts are ready to help you determine if you’re at risk of a heart attack. These experts know how to leverage information from diagnostic imaging and specific biomarker levels. Cardiovascular testing is not a ‘nice to have.’ It should be a standard of care now. If your executive medical pla does not cover all the critical biomarkers of cardiovascular risk detection (like differentiating cholesterol quantity with a cholesterol profiling), it’s time to shop around.

This is your shopping list (and it should be part of any executive health program):

  1. Cholesterol profile – quantity and particle size
  2. Inflammation markers – hsCRP, homocysteine, arachidonic acid
  3. Anti-inflammatory and anti-oxidant nutrients – fatty acids, CoQ10
  4. Genetic risk – saliva testing, SNPs for lipoproteins, Factor II and V

These tests won’t take a lot of time and they reveal a lot (but they aren’t yet covered by provincial health plans).

Remember former U.S. President Bill Clinton? He’s become a great believer in getting these tests done, and it has generated a great deal of discussion not only about that but also about going vegan and whether you can eat your way out of a heart attack. He’s decided it’s not too late for him—even after a quadruple bypass and a second surgery to unblock an artery. Today, he’s all about healing himself from the damage he’s done in the past. You can, too.