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Cholesterol and It's Real Threat on Heart Health

heart attack integrative cardiology myocardial infarction silent heart attack Jul 28, 2023
Integrative Cardiology

The cholesterol hypothesis, suggesting a causative role of cholesterol in heart disease is by many considered one of the best-proven hypotheses in modern medicine.  Organizations such as the American Heart Association have dedicated an exorbitant amount of research dollars to prove this hypothesis which has resulted in low-fat diets and cholesterol-lowering medications.

However, recent research into the role of lipoproteins in cardiovascular disease, the role of toxicity and inflammation, has indicated that cholesterol in itself does not cause cardiovascular disease. Certainly, cardiovascular disease as we know it will not occur in the absence of cholesterol. Thus, cholesterol is definitively involved, and necessary for cardiovascular disease to occur, but so are many other important organic molecules that play a role in health and disease.

On the contrary, there are many beneficial roles of cholesterol in the human body.  Cholesterol is vitally important for brain function, cellular repair, and the production of sex hormones.  While your brain represents about 2-3% of your total body weight, 25% of the cholesterol in your body is found in your brain, where it plays important roles in such things as membrane function, protection from toxicity, and regeneration of the brain.

The physiological understanding of cholesterol in the body poses a concern for how cholesterol-lowering methods will impact our brain and hormones over the long term.  This presents concerns with the current rise in Dementia and Alzheimers.

Let's talk science around cholesterol. When cholesterol is bound to atherogenic lipoproteins it can cause atherosclerosis.

In evaluating bloodwork, it is common to see cholesterol and other markers such as LDL and HDL.  LDL stands for low-density lipoprotein and HDL stands for high-density lipoprotein.  The biggest takeaway is lipoproteins bound with cholesterol are what increase the risk for heart disease.  

Lipoproteins need cholesterol because they are insoluble in water which makes it hard for them to travel in the body.  The lipoprotein allows the cholesterol to move through the body effectively.  The lipoprotein is a complex structure that contains a core, triglycerides, cholesterol esters, phospholipid surface, apolipoproteins, and unesterified cholesterol.  Apolipoprotein B is in LDL (low-density lipoprotein) which is also known as apoB.  ApoB plays a large role in atherosclerosis.  When apoB is in abundance it can get trapped in the arterial walls regardless of the blood levels of cholesterol.  

As the LDL, the apoB containing lipoprotein, moves into the arterial wall the proteoglycans allow it to stay and cause plaquing.  Proteoglycans are only present in the event there is inflammation.  The driving forces behind inflammation in the arterial walls are due to acidity in the blood from glucose abundance, processed foods, and toxicity from heavy metals, pesticides, and herbicides.  

Rupture of the plaques with thrombosis can lead to myocardial infarction also known as a heart attack.  Unfortunately, something called a Silent Myocardial Infarction or Silent Heart Attack is more common than an actual heart attack.  A silent heart attack does not always have obvious symptoms, such as pain in your chest, shortness of breath, and cold sweats. In fact, a heart attack can actually happen without a person knowing it. It is called a silent heart attack, or medically referred to as silent ischemia (lack of oxygen) to the heart muscle.

The 7 Signs of a Silent Heart Attack

  • Fatigue
  • Soreness in the back, arms, or chest
  • Shortness of breath
  • Heartburn or belching
  • Stomach upset
  • Throat, neck, or jaw discomfort
  • Dizziness
  • Temperature increase
  • An overall feeling that something's wrong

It can spread down the arms, to the back, or to the head and neck. Both women and men report chest pain as a primary symptom of heart attack, but women more often than men are likely to have some of the other symptoms, such as nausea, jaw pain, or shortness of breath, left arm pain, left-sided headache, that are described below.

You can have a heart attack and not even know it. A silent heart attack, known as a silent myocardial infarction (SMI), accounts for 45% of heart attacks and strikes men more than women.

"SMI symptoms can feel so mild, and be so brief, they often get confused for regular discomfort or another less serious problem, and thus men ignore them," says Dr. Jorge Plutzky, director of the vascular disease prevention program at Harvard-affiliated Brigham and Women's Hospital.

For instance, men may feel fatigue or physical discomfort and chalk it up to overwork, poor sleep, or some general age-related ache or pain. Other typical symptoms like mild pain in the throat or chest can be confused with gastric reflux, indigestion, and heartburn.

Also, the location of the pain is sometimes misunderstood. With SMI, you may feel discomfort in the center of the chest and not a sharp pain on the left side of the chest, which many people associate with a heart attack. "People can even feel completely normal during an SMI and afterward, too, which further adds to the chance of missing the warning signs," says Dr. Plutzky.

The number of people who suffer an SMI and don't realize it is alarming. A study in the Nov. 10, 2015, Journal of the American Medical Association looked at almost 2,000 people ages 45 to 84 (half of whom were men) who were free of cardiovascular disease.

After 10 years, 8% had myocardial scars, which are evidence of a heart attack. Most surprising was that 80% of these people were unaware of their condition. Overall, the prevalence of myocardial scars was five times higher in men than in women.

SMI and regular heart attacks share the same risk factors: smoking, being overweight, lack of exercise, high blood pressure, high cholesterol levels, and diabetes. They can be just as dangerous, too. "A silent heart attack is a loud signal your body sends that you have some kind of underlying health issue that needs attention," says Dr. Plutzky.

How to get checked 

At IY, we have various avenues of testing to clarify if you are at risk for heart disease or if you have experienced a silent heart attack.  We always run comprehensive blood markers to evaluate your cardiovascular risk.  We will run the NMR panel and the ApoB in addition to the traditional lipid (cholesterol) panel.  Most importantly, our physicians are able to properly interpret the labs to determine if you have cardiovascular disease.  

When evaluating the NMR Panel, the LDL-C which provides how much cholesterol is in the lipoprotein is not a great marker for atherosclerosis.  You can also have a false reading of LDL-C when a patient is on a statin (cholesterol-lowering medication).

The LDL-P is the amount of particles and the LDL-C is how much cholesterol is within the particle.  The LDL-P carries cholesterol and also triglycerides, an elevation in triglycerides can crowd out the cholesterol and be more problematic for the vascular system.  All in all, the amount of particles is reflected by the LDL-P which is a better indicator for atherosclerosis and heart disease.  

The physicians at IY also evaluate the DNA, using physics and light, to measure the health of the heart cells.  This technology can provide information about the health of the heart but can also be used to repair tissue using electromagnetic therapy.  

At IY, we believe that there is a cause for every effect which means there is an answer to your array of symptoms.  Most importantly, there is a solution to your cause that will allow you to heal and have the knowledge to prevent it from arising in the future.  

Most importantly, we believe that no matter what your health challenges are, you have the power to be the key player in your health destiny, by doing so, you’ll change your life.

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