LifeCare Chiropractic

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Cholesterol

Lipoprotein(a) Level Linked to Coronary Events in Middle-Aged Men – (03-11-01)

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Lipoprotein(a) Level Linked to Coronary Events in Middle-Aged Men

I really hate to beat a dead horse, but checking only cholesterol levels with the copious amounts of research on other blood-related risk factors is outdated and a disservice. What is interesting about this study is that the degree of risk from lipoprotein(a) is related to the presence of other risk factors. More support of a global approach to disease management.

J Am Coll Cardiol 2001;37:434-439 Perhaps ending a longstanding controversy, a new population-based study connects elevated levels of lipoprotein(a) with increased coronary risk in middle-aged men, especially those with high LDL cholesterol levels, low HDL cholesterol levels, hypertension and/or other risk factors. Dr. Arnold von Eckardstein, from the Westfalische Wilhelms-Universitat Munster, Germany, and colleagues collected data on 788 men, 35 to 65 years of age, who participated in the Prospective Cardiovascular Munster study. Over 10 years of follow-up, the researchers evaluated levels of lipoprotein(a) as well as traditional cardiovascular risk factors. During that period, 44 men experienced myocardial infarctions, while the remaining 744 subjects survived without a major coronary event or stroke, according to the research team’s report in the Journal of the American College of Cardiology for February. Dr. von Eckardstein’s group found a 2.7 times increased risk for coronary events among men whose lipoprotein(a) levels were 0.2 g/L or more, compared with subjects with lower levels. The risk was especially prominent in men with LDL cholesterol levels of 4.1 mmol/L or more (relative risk 2.6), and men with HDL cholesterol of 0.9 mmol/L or less (relative risk 8.3). The risk was also strongly associated with hypertension (relative risk 3.2). “Because lipoprotein(a) increases the risk of coronary events strongly depending on the presence of additional coronary risk factors, it is imperative to strictly control additional risk factors in individuals with elevated lipoprotein(a),” Dr. von Eckardstein and colleagues conclude.

Dyslipidemia, Fatty Acids Predict Left Ventricular Hypertrophy in 20 Yrs – (02-26-01)

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Dyslipidemia, Fatty Acids Predict Left Ventricular Hypertrophy in 20 Yrs

What a wonderful article illustrating the power and potential for preventative medicine in preventing disease. A group of 475 men were followed for 20 years after an initial profile of fatty acids and cholesterol was obtained. High levels of linoleic acid were shown to protect the heart, while cholesterol and certain other saturated fatty acids were associated with left ventricular damage. Twenty years is a long, long lead time for a disease predictor…

Circulation — Abstracts: Sundström et al. 103 (6): 836

Read entire article here

Lipoprotein(a) Level Linked to Risk of Coronary Events – (03-15-01)

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Lipoprotein(a) Level Linked to Risk of Coronary Events

We’ve talked about “nontraditional” risk factors for cardiovascular disease such as homocysteine, CRP, fibrinogen and lipoprotein a. This study closely examined the role that lipoprotein a plays in relation to heart disease and found that the risk of high levels is greater when other cardiovascular risk factors are also present, such as low HDL, high LDL and hypertension. Could we envision a better way to express the importance of a global approach to heart disease? The one-cause-one-cure idea can be thrown out the window when it comes to chronic diseases such as heart disease, arthritis, diabetes, osteoporosis and cancer.

J Am Coll Cardiol 2001;37:434-439 Perhaps ending a longstanding controversy, a new population-based study connects elevated levels of lipoprotein(a) with increased coronary risk in middle-aged men, especially those with high LDL cholesterol levels, low HDL cholesterol levels, hypertension and/or other risk factors. Dr. Arnold von Eckardstein, from the Westfalische Wilhelms-Universitat Munster, Germany, and colleagues collected data on 788 men, 35 to 65 years of age, who participated in the Prospective Cardiovascular Munster study. Over 10 years of follow-up, the researchers evaluated levels of lipoprotein(a) as well as traditional cardiovascular risk factors. During that period, 44 men experienced myocardial infarctions, while the remaining 744 subjects survived without a major coronary event or stroke, according to the research team’s report in the Journal of the American College of Cardiology for February. Dr. von Eckardstein’s group found a 2.7 times increased risk for coronary events among men whose lipoprotein(a) levels were 0.2 g/L or more, compared with subjects with lower levels. The risk was especially prominent in men with LDL cholesterol levels of 4.1 mmol/L or more (relative risk 2.6), and men with HDL cholesterol of 0.9 mmol/L or less (relative risk 8.3). The risk was also strongly associated with hypertension (relative risk 3.2). “Because lipoprotein(a) increases the risk of coronary events strongly depending on the presence of additional coronary risk factors, it is imperative to strictly control additional risk factors in individuals with elevated lipoprotein(a),” Dr. von Eckardstein and colleagues conclude.

 

Walnut consumption and plasma fatty acids and lipoproteins – (07-19-01)

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Walnut consumption and plasma fatty acids and lipoproteins

So many times nuts get a bad rap because of their fat content, and yet most nuts are high in monounsaturated fats. This type of fat in many types of nuts has consistently shown the ability to lower lipid levels and reduce risk of heart disease. Any patient that has concerns about high lipid levels should consider nuts as a part of their diet plan to bring those levels under control.

AJCN — Abstracts: Almario et al. 74 (1): 72

Read entire article here

Was the Caveman Fat? Paleo Diet Meal Plan Wins Again

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The Paleo diet, formerly known as the caveman diet, seems to be a better match for our genetic makeup.

I’ve written before on my thoughts of the Paleo diet (which can be found by clicking here).  I do feel that this an overall good approach to healthy eating.  However, this is with the caveat that our cavemen ancestors likely had a far more varied source of animal proteins.  Here in the civilized world pork, chicken and beef dominate.  In the truly Paleo, animal protein sources would’ve included insects and small mammals like mice and squirrels.  I’m pretty sure we weren’t pulling down a boar or antelope every day for dinner.  In case you don’t believe me, grab a spear for yourself and try to feed your family.

This particular study takes a very scientific view of the diet to see how it performs physiologically.  Here are the details of the diet used in the study:

  • The diet had a relatively high content of protein (30%) and unsaturated fat [40%–mainly monounsaturated fatty acids like olive oil and nuts] but limited carbohydrates (30%) and saturated fat.
  • The group was small, consisting of 10 overweight, postmenopausal females, on the diet for 5 weeks.

The results were pretty impressive for a mere 5 weeks of what is likely a very palatable and livable diet:

  1. Overall caloric intake decreased by 25%.
  2. Average weight loss was just shy of 10 pounds (9.9).
  3. BMI, waist and hip circumference,  waist/hip ratio and abdominal sagittal diameter also dropped.
  4. Diastolic blood pressure dropped 7 points.
  5. Drops in fasting glucose, cholesterol, triglycerides, LDL/HDL cholesterol, apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1), urinary C-peptide (a sign of insulin release) all dropped.
  6. Liver triglyceride levels plummeted by 49%.

Basically, in just a little over a month, the women in this study turned around their diabetic trajectory.  Makes it hard to believe that well over half our country is either diabetic or on their way to diabetes when it can be so readily controlled with dietary choices.

Exercise and Your Cholesterol Lowering Drug. Don’t Bother

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Fitness is important for the heart. But what if a common drug used to “protect” your heart completely erased the benefit of exercise?

Quite the conundrum, huh?

Or, at least, it would be for the mainstream medical provider who puts any degree of faith in statins for high cholesterol.

For everyone else who knows the dangers and the incredibly limited benefit, there is no conflict.  It is very well established that statins pretty much suck for preventing a first heart attack and aren’t too much better for secondary prevention either.  Just to make it worse, the list of side effects are quite long and are highlighted in my eBook on statins that can be found by clicking here.

While the side effects of cholesterol lowering drugs are all of concern, the ones related to the heart are of the gravest concern.  After all, aren’t we all taking statins to lower our risk of having a heart attack?

The irony is so strong that it would be laughable if we weren’t spending $20+ billion per year on these drugs.

This particular study finds yet another particularly disturbing side effect of cholesterol lowering drugs.  Here are the details:

  • 37 sedentary overweight or obese adults
  • At least 2 prediabetes risk factors
  • 12 weeks of aerobic exercise training or
  • Exercise in combination with simvastatin (Zocor-40 mg per day)
  • Cardio fitness and mitochondrial function (as measured by citrate synthase activity) were monitored.

And here are the results that should make any cardiologist think twice about prescribing this worthless class of drugs:

  1. Cardiorespiratory fitness increased by 10% in the exercise group.
  2. In the exercise group taking the statins, there was only a paltry 1.5% increase.
  3. Skeletal muscle mitochondrial function in the exercise group increased by 13%.
  4. In the statin group?  A drop of 4.5% in mitochondrial function.

Regular readers of the Rantings will know that I consider mitochondrial function as the holy grail of longevity.  Preserve or improve it, and life it good.  Worsen mitochondrial function and all hell will break loose.

Look at these results again.  Exercise, yes exercise, became worthless in the face of the intake of statin drugs.  Worse than worthless, mitochondrial function deteriorated during exercise, something that should never, ever, ever happen.

If your doctor has told you to take statins to avoid heart attacks, there is just no way he or she is actually reading the medical research centered around cholesterol lowering drugs.  There is no other valid excuse to write that prescription.

Effective and Safe Modification of Multiple Atherosclerotic Risk Factors – (02-12-01)

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Effective and Safe Modification of Multiple Atherosclerotic Risk Factors

This article looks at the lowering of multiple risk factor for atherosclerosis simultaneously. As far as I’m concerned, this is the ONLY way to address this problem. Of interesting note in this study was the use of niacin, 500mg twice daily (a very reasonable dose) to raise HDL levels 30%. Add some exercise and avoidance of saturated fat and your LDL/HDL ratios will be looking pretty good!!

Am Heart J 140(5):792-803, 2000 Patients with peripheral arterial disease (PAD) are at an increased risk of cardiovascular mortality and morbidity and thus are an excellent group in whom to evaluate the feasibility and the effect of an aggressive multifactorial intervention on atherosclerotic vascular disease risk factors. The Arterial Disease Multiple Intervention Trial (ADMIT) was designed to determine the efficacy, safety, and compliance of an multifactorial therapy on selected atherosclerotic disease risk factors in patients with PAD. Niacin increased HDL cholesterol levels by 30%, with the majority of effect achieved at a dosage of 500 mg twice daily. Warfarin had an anticoagulant effect. The antioxidant vitamins resulted in a significant increase in vitamin E, C, and beta-carotene plasma levels. Overall, compliance was high and few adverse effects were reported. ADMIT demonstrates that it is both feasible and safe to modify multiple atherosclerotic disease risk factors effectively with intensive combination therapy in patients with PAD.

Lp(A) Levels and ApoE4 Allele Predictive of Coronary Events in Men – (03-05-01)

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Lp(A) Levels and ApoE4 Allele Predictive of Coronary Events in Men

The Lp(a) marker has been used in many functional medicine lab’s coronary risk profiles for years now. And to that homocysteine, cholesterol, CRP, fibrinogen and several others and you get a very good picture of cardiovascular risk. Remember that many of today’s chronic diseases have more than one contributing factor–do you think checking only one factor (cholesterol) is anywhere near all we need to be doing these days to evaulate cardiovascular risk? I’ve got a better idea–save the money on the lab tests and just start leading a healthy lifestyle…

Am J Med 2001;110:22-32,71-72 Adjusted multivariate analysis revealed cholesterol level, diabetes, smoking status, diastolic blood pressure, Apo-AI, age, and Lp(a) as independent risk factors for cardiac events. Dr. Seed and colleagues found that “coronary events were lowest in the group with Lp(a) levels below 2.9 mg/dL (the 25th percentile), highest in those with levels higher than 26.3 mg/dL (the 75th percentile), and intermediate in the group with levels of 2.9 to 26.3 mg/dL.” In the second study, Dr. Angelo Scuteri and colleagues, from the National Institutes of Health, in Baltimore, measured apoE genotypes in 730 men and women who participated in the Baltimore Longitudinal Study of Aging. The researchers identified the apoE4 allele in 200 subjects. On follow-up, 104 of the 730 subjects had coronary events. These events were significantly more frequent in subjects with the apoE4 allele (20%) than in those without it (12%), Dr. Scuteri’s team reports. “In a multivariate model, apoE4 was an independent predictor of coronary events in men (risk ratio 2.9), but not in women (risk ratio 0.9),” they note. Dr. Scuteri and colleagues also found that cholesterol levels did not appear to mediate the association. Despite the findings of these two studies, Dr. Peter W. F. Wilson, from Boston University School of Medicine, maintains that there is nothing definitive about using these markers as predictors of cardiac events. In an accompanying editorial, he writes that “improvement in vascular disease risk prediction with apoE allele determination is marginal [and] for Lp(a), the situation is [even] more murky.”