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Learn how atherogenic lipoproteins become the deciding factor that leads to heart disease. Learn how to reduce your heart disease risk and the importance of omega-3 fatty acids.
Rethinking Heart Disease Risk and Cholesterol
What’s the most important factor in heart disease?
Not so fast, cautions cardiologist Michael Ozner, MD. “I think it’s very important that we understand the root cause of heart attacks.”
“It’s not cholesterol per se but, rather, these particles which we call atherogenic lipoproteins that carry cholesterol and triglycerides. Cholesterol actually serves a worthwhile purpose. It’s required for cell membranes, for steroid hormone development, for bile, and other things, and triglycerides are useful as energy source. We need them, and they can’t travel by themselves. They need to be carried.”
Dr. Ozner, who is the medical director of Wellness and Prevention at Baptist Health South Florida, likens lipoproteins to vehicles and cholesterol and triglyceride molecules to passengers. Traffic jams are caused not by too many passengers, but by too many vehicles which, when they have nowhere to go, take the exit ramp into the arterial wall where they can become trapped, modified, and oxidized. This process initiates the disease known as atherosclerosis. Atherosclerotic plaque is a collection of lipoproteins with their cholesterol and triglyceride cargo. Rupture of these plaques can lead to heart attack and stroke.1
Cholesterol and Atherogenic Lipoproteins
Understanding heart disease risk:
Apolipoprotein B (ApoB) is a component of some of the most atherogenic lipoproteins, including low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), and intermediate-density lipoprotein (IDL) particles. Apolipoprotein A1 (ApoA1), on the other hand, is primarily associated with high-density lipoprotein (HDL) particles and is potentially helpful. Levels of ApoB and its ratio to ApoA1 have a stronger association with cardiovascular disease risk than the better-known lipoprotein cholesterol fractions.2 These factors can be evaluated with blood tests.
Heart Attack Misconceptions
While LDL cholesterol has long been considered the standard test to assess cardiovascular risk, LDL is not the root cause of atherosclerosis, according to Dr. Ozner. Elevated LDL-cholesterol levels contribute to risk but don’t always…
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