Cholesterol

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Cholesterol Atherosclerosis - Avoiding
Coronary Heart Disease

• Presented by
• George Guthrie MD MPH CDE CNS

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What is Cholesterol?
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Sat vs mono
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Polyunsaturated fatty acid

• Two or more pairs of hydrogen atoms missing
• Two or more double bonds between carbons
• Hydrogen on same side of double bond cis
  configuration
• Bent molecule, more flexible, not pack together

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(No Transcript)
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Cholesterol Packets

• LDL
• Distribution
• HDL
• Garbage Collection

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Lifestyle effects LDL
Powers, E et al. Which lifestyle interventions
effectively lower LDL cholesterol? Journal of
Family Practice, 566 June 2007.
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Heavenly Darlings
For every increase of 1 mg/dl in HDL 6
decrease in heart disease risk
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Raising HDL

• Regular aerobic exercise - 3-9
• Not Smoking - incr 4 mg/dl
• Wt Control - 1 mg/dl per 3 lb lost
• Decrease glycemic load - simple CHO
• Increase Fiber
• Avoid Trans Fats
• Estrogen - No heart disease protection
• Alcohol (Limit)
• Medications - 10-25 - NiacingtFibratesgtStatins

Singh IM, Shishehbor MH, Ansell BJ. High-density
lipoprotein as a therapeutic target. Journal of
the American Medical Association.
2007298(7)786-798.
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Ratio

• Total Cholesterol/HDL
• gt4 worsening
• 3-4 stable
• lt3 reversing

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Atherosclerosis

• Damaged LDL
• Oxidized Cholesterol
• Blockage
• The Problem??

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The Heart Attack
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(No Transcript)
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IVUS - Intravascular Ultrasound
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Atherosclerosis

• Damaged LDL
• Oxidized Cholesterol
• Blockage
• Intravascular ultrasound
• Inflammation
• Cardio CRP

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Causes of Inflammation

• Infections
• Homocysteine - Vit B-12, Folate, or Pyridoxine
  deficiency
• Auto-immune disease
• Obesity - Lipid Cytokines
• High Blood glucose - Endothelium
• Diet
• Insulin secretion
• More acid environment
• Sedentary lifestyle
• Low emotional intelligence - Anger

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Summary

• Exercise
• Minimize Saturated Fat
• Avoid Trans Fats
• High Fiber diet
• Plant-based diet