Every time we get a medical checkupone of the indexes to which most attention is paid is cholesterol. And it is common for our GP to call our attention when high levels of bad cholesterol (LDL) are detected and even congratulate us if you notice that our good cholesterol (HDL) It’s at the right levels.
It is even usual in any family conversation about health that the question appears: How did they give you the cholesterol values? Do you have the good or the bad?
Okay, all that should change. “The division between good and bad cholesterol is incorrect. It has been used for many years, but cholesterol is neither good nor bad. It is an old misconception that science and scientific evidence has shown in recent years,” he told Infobae the doctor Paul Corral, medical specialist in internal medicine, lipidologist and president of the Argentine Society of Lipids (SAL).
According to the expert, cholesterol is a fatty substance that is present in all tissues of the human body and is necessary for the normal functioning of the body. It serves as a raw material for cell membranes (walls) and for the synthesis (manufacture) of hormones such as estrogens and androgens.
“But having high HDL (the good cholesterol) doesn’t protect you from heart disease. They are not a cardiovascular protective factor. Physicians should stop chasing the HDL cholesterol target. It is not good to have it too high or too low, “the expert completed. And he remarked: “Today science has no way of knowing precisely and by measuring how the HDL lipoprotein works, since it is very complex and has multiple functionalities that medicine has not yet unraveled. Therefore it is a mistake to follow old precepts.
Corral’s statement is supported by a published scientific study last year by the magazine ‘Metabolism Clinical and Experimental’, who states that Not all good cholesterol is healthy, and the presence of large particles may be associated with an increased risk of heart attack. The research has been carried out by researchers from the Hospital del Mar Medical Research Institute (IMIM), the Hospital Clínic-IDIBAPS, IDIBELL, the Hospital de la Santa Creu i Sant Pau Research Institute and the University Clinical Hospital from Saragossa.
In this work, Researchers have analyzed the genetic characteristics that determine the size of the good cholesterol particles, and have subsequently studied their relationship with the risk of presenting a myocardial infarction. The conclusion is that those genetic characteristics associated with the generation of large good cholesterol particles were directly related to a higher risk of heart attack, while the genetic characteristics associated with small good cholesterol particles were related to a lower risk of heart attack.
“There is a positive causal relationship between the size of HDL cholesterol particles and the risk of heart attack, therefore, we have to increase the levels of good cholesterol in the blood, but always in small particles”, indicates Roberto Elosua, researcher at the IMIM and the University of Vic-Central University of Catalonia (UVic-UCC).
“The good cholesterol particles are more effective in transporting cholesterol to the liver for elimination. “If we have to do something with HDL, it is to increase the number of small particles, which are the ones that adequately perform the function of eliminating cholesterol, the ones that actually transport it to the liver for elimination and do not allow it to accumulate. in the arteries and cause cardiovascular diseases”, added his colleague Álvaro Hernáez.
types of cholesterol
To reach the places in the body where it is needed, cholesterol is transported through the blood bound to proteins called lipoproteins. Some lipoproteins are responsible for transporting excess cholesterol from the organs to the liver where it is recycled. These lipoproteins that remove cholesterol are called HDL (acronym corresponding in English to the expression High Density Lipoproteins). Other lipoproteins transport cholesterol from the liver to the rest of the organs. These are called LDL (abbreviation in English for Low Density Lipoproteins). Circulating LDL-cholesterol deposits on the walls of the arteries and damages them causing blockages (a process called atherosclerosis). For this reason, LDL-cholesterol should be low. High levels of total cholesterol imply more fat in the tissues and its accumulation in the arteries is associated with an increased risk of cardiovascular diseases.
“High cholesterol is diagnosed with a laboratory blood test. In general, experts recommend taking the first measurement at age 20 and then every 5 years if the result is normal, that is, if the value obtained is below 200 mg/dl. If cholesterol is high, the doctor will define the type of treatment and the frequency with which the controls should be done, “recommends the Argentine Cardiology Foundation (FCA).
The cardiologist Carlos Reguera, head of the Cardiology and Preventive Medicine areas of the Institute of Neurosciences of Buenos Aires (Ineba) explained to Infobae that “we must understand that many times the risk factors do not anticipate the disease, but rather are the disease”. “For this reason, we must intensify care and control, focusing on the prevention of each one in particular. (hypertension, diabetes, smoking, overweight, among others). Let us remember that currently cardiovascular diseases continue to be the first cause of death worldwide, ”he added.
Does increased cholesterol cause symptoms? Elevated blood cholesterol does not cause symptoms. It is not associated with headaches, tiredness, or other symptoms. “The manifestations of dyslipidemia are its late consequences when it is not controlled for a long time, and among them it is worth highlighting coronary heart disease (obstruction of the arteries of the heart due to the deposit of fats and other substances), stroke, aortic aneurysms and coronary artery disease. peripheral vascular disease (clogged arteries of the legs, kidneys, brain).
In the absence of symptoms, it is important to control cholesterol periodically and carry out treatment if necessary. Cardiovascular diseases (CVD) are due to disorders of the heart and blood vessels. In Argentina, overweight and diabetes are the risk factors that most concern health professionals. Also, high cholesterol, high blood pressure, smoking, sedentary lifestyle, stress and hereditary factors, can also be the cause of this type of pathology.
It is suggested to carry out an annual preventive check-up, which must include an initial cardiological consultation and subsequent complementary studies (laboratory analysis (with discriminated cholesterol profile), electrocardiogram, ergometry, echocardiogram and Doppler of neck vessels.
In turn, the Barceló Foundation offers some tips to promote a healthy lifestyle, reducing the chances of developing cardiovascular diseases, known as “The 9 commandments”:
1- No smoking
2- Maintain low cholesterol levels
3- Improve your diet (eat more vegetables and fruits)
4- Control the weight
5- Give up sedentary life
6- Do not abuse alcohol consumption
7- Avoid hypertension
8- Reduce stress
9- Closely monitor diabetes