Just lowering LDL cholesterol level isn’t sufficient because the prevention and treatment of atherosclerosis are much more complex than just that. Within the battle against atherosclerosis, LDL cholesterol reduction is only half of it. Even using the absence of other risk elements (like cigarette smoking, diabetes mellitus and high blood pressure) people who’ve regular or mildly elevated LDL cholesterol levels can still create atherosclerosis, heart attacks and strokes.
Atherosclerosis and heart attacks can’t usually be prevented by a effective lowering of elevated LDL cholesterol levels. In numerous clinical trials to lower LDL cholesterol, patients still suffered progressive atherosclerosis although they adhered to their assigned diets, successfully lowered their LDL cholesterol to target levels and faithfully took their cholesterol lowering medications. It’s clear that you will find other elements involved, although lowering LDL cholesterol below NCEP target levels is an essential step.
Lipoprotein (a) (Lp(a) cholesterol
Lipoprotein (a) or Lp(a) is an LDL cholesterol particle that’s attached to a unique protein known as apo(a). Within the blood, a person’s level of Lp(a) is in a big component inherited. In both men and ladies, elevated levels of Lp(a) (greater than 20 milligrams per deciliter to 30 milligrams per deciliter) within the bloodstream are usually linked to a higher likelihood of heart attacks, strokes, or atherosclerosis. If the patient also suffers from high LDL/HDL ratios the risk is even much more substantial if the Lp(a) cholesterol level is also elevated.
How Lp(a) accumulates cholesterol plaques on the artery walls has not been nicely defined however, there are lots of theories to how Lp(a) causes atherosclerosis. Clinical trials conclusively proving that lowering Lp(a) reduces the risk of heart attacks, strokes and atherosclerosis have not been conducted. Commercial sources of Lp(a) testing might not have the exact same accuracy as study laboratories and because clinical trials have not been conducted, presently there isn’t any international regular for determining Lp(a) cholesterol levels. Over the world, particularly measuring and treating elevated Lp(a) cholesterol levels aren’t widely performed just for that reason.
Decreasing Lp(a) cholesterol levels
With regards to lowering Lp(a) cholesterol levels, most lipid lowering medications like statins (Lopid and cholestyamine) have a extremely restricted impact on it. In ladies with elevated Lp(a) cholesterol, estrogen has been shown to lower Lp(a) cholesterol levels by about 20 percent. When given to postmenopausal ladies, estrogen may also improve HDL cholesterol levels.
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