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Cholesterol and atherosclerosis

what is the chance that a male person age 40, with normal cholesterol to have atherosclerosis?
I have a mild hypertension (under 140/90) and it is controlled using (small dose) medicine. I run and walk 4-5 times a week. (60 min each day). Is atherosclerosis all about cholesterol?
9 Responses
159619 tn?1538180937
No, it's not just about cholesterol, but mostly. It is possible for some one with normal serum cholesterol levels to develop plaques. One theory on the cause is inflammation in your vascular system. Think of the golf analogy, a golf ball will roll further on a flat surface, but if there is a dip across the fairway, it is more likely to have golf balls settle in it. The golf balls are LDL cholesterol and the dip is an area of inflammation in your artery.

Having said that, the less LDL the better under any scenario. You are less likely to develop atherosclerosis with low cholesterol levels than high. Exercise is a good thing as it raises HDL, the more HDL the more LDL it can remove from your system.

976897 tn?1379167602
"No, it's not just about cholesterol"
Absolutely. Research now suggests that with inflammation in the arteries, the HDL call white cells into the area to commence repairs and tell LDL to inject the white cells with fat, to make them macrophages. It's what damages the macrophages which is still a mystery. They used to call HDL the good guys but it's becoming more and more apparent that these are the control mechanism for starting atherosclerosis. It seems that the answer lies in somehow turning off the immune system for inflamed arteries, allowing just normal repairs to take place without the macrophages. I don't see how they are needed anyway if there's no infection.
Several things have been attempted on mice. One batch had HDL increased, which accelerated atherosclerosis. Another batch had LDL lowered which made no difference. Another batch had free radicals inhibited, but atherosclerosis formed very quickly. Another batch had more free radicals introduced which had little effect. One thing which is for certain, statins help to stop the initial inflammation of the arteries which starts the whole process. This has been observed over and over again.
Avatar universal
thanks to all.
so what is causing vascular inflammation? if a person doesn't smoke , drink, no diabetes, exercise regularly, cholesterol levels are normal, controlled his mild hypertension then there should not be a risk for vascular inflammation right ?  

reason I am asking this is lately I have been having chest pain (sometimes sharp, sometimes dull, tearing feeling, burning feeling) on my left chest (never on the middle). location is upper far left chest, below left nipple, above left nipple. side of left chest, sometimes an inch right of the left nipple, sometimes top upper left ribcage. I having this almost every day for the past week. today my lower inside left arm is little bit hurt. not terribly hurting. if I put pressure on it, it hurts. I am freaking out here. What is going on
Avatar universal

How do you know you have vascular inflammation?  Your symptoms suggest muscular pain.... have you started exercising your upper body?  Vascular inflammation as such has no symptoms.... I suggest you search internet for answers...
Avatar universal

I have read a few books recently suggesting that there are two camps on the theory of what causes the inflammation - at least as far as nutrition goes.  One camp says it's sugar that does it - the other says it's trans fat or saturated fat.  Each give good arguments to support their case.  Two doctors that i'm aware of have carried out studies that have reversed atherosclerosis based on extreme low fat diets, not just the usual that are recommended by doctors.  These doctors are Dean Ornish and Caldwell Esselstyn.

Of course other things cause inflammation too....some suggestions that if your c-reactive protein levels are high or homocystene levels are high then that could lead to arterial inflammation....these could be checked on request and apparently a good B vitamin complex will lower many cases of high homocystene....

Of course this is just stuff I've rad and I know it will be a more complex picture than this in reality, but just sharing what I can.  
Avatar universal
fascinating new info you've given about HDL - thanks for sharing.  I know Dean Ornish talks about there being two types of HDL, one bad one good, that might explain why different researchers are saying different things....
976897 tn?1379167602
When I was at cardiac rehab in April, I mentioned that my diet is very high in sugar. She said it was nothing to worry about as long I'm not diabetic because sugar is just energy. I've always had a very sweet tooth since I was a little kid.
Of course, artery inflammation can be caused by long periods of emotional stress too.
Avatar universal
Well from the books i've read by Dean Ornish he would say that saturated fat is the main culprit...

In fact his program for reversing heart disease entails relaxtions and meditation techniques - i would recommend the book if you feel that stress is a big player Ed.  I only mention it because i loved the book, so much in it about what is wrong with our world causing us stress and how to manage it, etc.

It was more than a cardiology book, I have a friend reading it now who has no interest in heart disease.  The book is 'Dr Dean Ornish's program for Reversing Heart Disease.'  I don't have anything to do with him or his books, I just got a lot out of it so passing it on.  :-)
Avatar universal
Just my 2 cents contribution...

Inflammation it is always a reaction of the immune system...
In the case of arteries it seems an over reaction of the immune system...
Vitamin D it is known for been a modulator of immune system...
It is estimated that a good percentage of population lack Vitamin D.

Therefore a check of Vitamin D in serum can be a good starting point.

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