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Whats the supposed scientific link between high cholesterol blood levels and CHD?

Answered on September 12, 2014
Created June 22, 2012 at 5:29 AM

Title pretty much sums it up.

Was reading some standard lipid hypothesis study today to counter the studies that show no link between dietary sat fat intake and CHD, which was on the whole pretty unconvincing.

Much of what it claimed was opinion and unreferenced. It even recommended a minimum of 10% PUFAs (all the studies it referenced didnt differentiate pufa 3's from 6's at all either). Some pretty crazy stuff, lol.

One thing it assumed, without references, but for which ive never seen or heard any evidence for is that blood cholesterol is linked to CHD. Id like to examine that evidence myself, however weak it is.

Anyone know of any studies linking blood cholesterol to CHD?

Medium avatar

(10611)

on October 01, 2012
at 04:01 PM

I started losing weight at about the same age and BMI, do this study is interesting to me. Thanks for linking it. Weight loss is critical and generally leads to a blood pressure reduction. It's not surprising to me that any diet type (within reason) works so long as it accomplishes weight loss.

Medium avatar

(10611)

on June 24, 2012
at 11:54 PM

I infer weak correlation because in statistics that's what you see when y doesn't respond to changes in x. In this case my CV risk for a 5 year event only increases by 5% when I plug 250 TC into the correlation instead of 200. A similar magnitude change in HDL - from 35 where I started to 85 where I am now - causes a huge reduction in risk. The reason that more sophisticated lipid measurements are not used is because the study has been going on since the 1950's when these were the only tests available.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on June 24, 2012
at 03:25 AM

If its only a weak correlation, how do we know it matters at all? Did they control for sugar and carb intake? Did they measure small dense LDL versus light and fluffy? I am pretty sure theres a good correlation between blue jeans and heart disease. Good response tho, thanks :)

Medium avatar

(10611)

on June 22, 2012
at 07:00 PM

They're better than nothing because they correlate with CV risk, however weakly, whereas overall inflammation measurement is only marginally useful for some people who have already had a stroke or heart attack. There are much better indicators of risk, and artificially depressing LDL with a statin without dealing with obesity is not going in the right direction. By the same logic, I do not see having a 300 TC as being an indicator of heart health. You can be Paleo and stay below that. Eating butter sticks isn't required to join the club.

1407bd6152d9fdbc239250385159fea1

on June 22, 2012
at 06:35 PM

You don't. I never said you did. The original question did not pertain to what tests might be useful for determining risk of CHD/CVD. I'm merely stating that cholesterol numbers are not as stupendous a measurement as the Wizard of Oz (Dr. Oz) would lead people to believe.

Medium avatar

(10611)

on June 22, 2012
at 06:34 PM

And how exactly do you measure inflammation at arterial walls which would make them prone to cholesterol deposition? Inflammation tests like CRP are even cruder than lipid panels. Macros like blood pressure, obesity, family history and diabetes are surer indicators of CV propensity than any existing lab test.

Medium avatar

(10611)

on June 22, 2012
at 06:29 PM

And how exactly do you measure propensity the inflammation at arterial walls that would make them prone to cholesterol deposition? The tools for this are even cruder than lipid tests. Macroindicators like blood pressure, obesity, family history and diabetes are surer indicators of CV propensity than any existing lab test.

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6 Answers

best answer

0
1407bd6152d9fdbc239250385159fea1

on June 22, 2012
at 06:19 PM

The thought held by conventional medicine is that if there is high circulating blood cholesterol (carried by lipoprotein transport molecules), then by default there must be an excess of cholesterol (and other sterols) being deposited in the arteries--e.g. atherosclerosis. There is some correlation there, but also about a half a million exceptions and other contributing factors. The real driver of thrombotic events is inflammation, not arbitrary blood lipid numbers. The current doctrine is akin to blaming the guy who fixes a hole in the wall with plaster rather than the guy who took a hammer to said wall in the first place.

Medium avatar

(10611)

on June 22, 2012
at 06:29 PM

And how exactly do you measure propensity the inflammation at arterial walls that would make them prone to cholesterol deposition? The tools for this are even cruder than lipid tests. Macroindicators like blood pressure, obesity, family history and diabetes are surer indicators of CV propensity than any existing lab test.

1407bd6152d9fdbc239250385159fea1

on June 22, 2012
at 06:35 PM

You don't. I never said you did. The original question did not pertain to what tests might be useful for determining risk of CHD/CVD. I'm merely stating that cholesterol numbers are not as stupendous a measurement as the Wizard of Oz (Dr. Oz) would lead people to believe.

Medium avatar

(10611)

on June 22, 2012
at 07:00 PM

They're better than nothing because they correlate with CV risk, however weakly, whereas overall inflammation measurement is only marginally useful for some people who have already had a stroke or heart attack. There are much better indicators of risk, and artificially depressing LDL with a statin without dealing with obesity is not going in the right direction. By the same logic, I do not see having a 300 TC as being an indicator of heart health. You can be Paleo and stay below that. Eating butter sticks isn't required to join the club.

Medium avatar

(10611)

on June 22, 2012
at 06:34 PM

And how exactly do you measure inflammation at arterial walls which would make them prone to cholesterol deposition? Inflammation tests like CRP are even cruder than lipid panels. Macros like blood pressure, obesity, family history and diabetes are surer indicators of CV propensity than any existing lab test.

2
141171c0810650168d82601d85cfa5a3

(415)

on September 30, 2012
at 09:54 PM

This study found no difference in cholesterol between those who reversed their atherosclerosis and those who progressed.

Also, the type of diet didn't matter. Low Carb, Low Fat, and the Mediterranean diet all reversed the atherosclerosis by the same amount.

The markers associated with the reduction in plaque were:

  • Weight loss
  • A greater decrease in blood pressure*
  • Reduction in homocystine
  • A greater increase in ApoA1

Lowering of blood pressure was the only statistically significant association with reversal of atherosclerosis.

Medium avatar

(10611)

on October 01, 2012
at 04:01 PM

I started losing weight at about the same age and BMI, do this study is interesting to me. Thanks for linking it. Weight loss is critical and generally leads to a blood pressure reduction. It's not surprising to me that any diet type (within reason) works so long as it accomplishes weight loss.

2
Medium avatar

(10611)

on June 22, 2012
at 06:13 PM

The ongoing Framingham population study shows a weak correlation between total cholesterol and elevated CV risk. For me the study points toward maximizing HDL and not obsessing over LDL as long as TC stays below 250. Above 250 there is more CV risk.

Medium avatar

(10611)

on June 24, 2012
at 11:54 PM

I infer weak correlation because in statistics that's what you see when y doesn't respond to changes in x. In this case my CV risk for a 5 year event only increases by 5% when I plug 250 TC into the correlation instead of 200. A similar magnitude change in HDL - from 35 where I started to 85 where I am now - causes a huge reduction in risk. The reason that more sophisticated lipid measurements are not used is because the study has been going on since the 1950's when these were the only tests available.

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on June 24, 2012
at 03:25 AM

If its only a weak correlation, how do we know it matters at all? Did they control for sugar and carb intake? Did they measure small dense LDL versus light and fluffy? I am pretty sure theres a good correlation between blue jeans and heart disease. Good response tho, thanks :)

1
Cbda678b2a6bf0537d8c4ea0ce8aa9ad

(4319)

on June 22, 2012
at 04:00 PM

You have to channel Ancel Keys to find the link. Any medium worth his/her salt can do this nowadays.

0
4b5be253ac1981c690689cab7e4bf06d

(3043)

on June 22, 2012
at 05:13 PM

There isn't any link.

Now, the Plaque that builds up in arteries is a combination of fat and cholesterol, which may have lead to the initial "eat less animal fat, because it's bad and builds up in your arteries" came from. That was before they realized 1) how much cholesterol the body makes on its own, and 2) that the fat buildup is more about inflammation than fat.

-2
B8592e62f9804ddabae73c1103d6bcb9

(1956)

on June 22, 2012
at 01:53 PM

No, because there isn't any.

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