Over the months and years I have been researching this topic and it seems that most health practitioners still believe in the doctrine that high LDL and high total cholesterol equates to high cardiovascular death risks. The latest findings suggests this is not true and that the highest lipid risk factor is the amount of LDL particles, (LDL-P) not how much cholesterol they carry.
LDL is short for low density lipoproteins and essentially they are small vessels that carry fats in the water soluble blood.
When doctors tell you your total cholesterol number, they are referring to the total amount of cholesterol which both the LDL and HDL particles carry. This information doesn't mean much because it is good to have high amounts of cholesterol circulating around your body.
They also will check your LDL cholesterol and will advise you of what is a safe range to have.
Cholesterol is an extremely important substance in your body and is used for many purposes including cell structure and maintenance, and it makes many hormones that are vital for life.
Your body makes around 80% of your cholesterol and it is self regulating. If you eat a lot of cholesterol your body will make less, if you eat too little it will make more.
LDL particles (which they call the bad cholesterol, but it is neither good nor bad), comes in 2 sizes - small dense particles and large Fluffy ones. It is the small dense kind that can oxidise and lodge in arterial walls, and then over time can cause a heart attack.
The large less dense particles don't do this. So you can have high LDL cholesterol, but have a low cardiovascular event risk factor.
Remember this, blocking of heart arteries will only occur if particles lodge in artery walls.
I have spoken more in depth about this in a previous post entitled "Heart Disease And How It Works".
HDL stands for high density lipoprotein and is good if you have the recommended amount in your blood. Like LDL I don't just mean a high HDL cholesterol figure, I mean higher HDL particle numbers. (HDL-P)
Why high HDL particle numbers are good, is they have a scavenger role where they pick up cholesterol embedded in arterial walls and either take it back to the liver for reprocessing or to cells for storing or burning for energy.
So high HDL is correlated to low cardio risk but doesn't tell all the story, high HDL particle count is a better indicator of low risk.
A better predictor of heart attack risk would be high blood triglycerides - why? I'll explain further below.
So the question should be, why is a higher particle number a more accurate prediction of a cardio event?
To give you a better understanding of how this all works here is some information that will clarify the role of lipoproteins in the blood.
LDL carries both cholesterol and triglycerides. (TGs) If your TGs in your blood are high then the LDL particles will have less room to carry a set amount of cholesterol that the body needs for cellular maintenance and hormone production.
So when TGs are high, your body produces more LDL particles to carry them, (because it has to take them somewhere) and also has to carry a given amount of cholesterol, that your body requires. This increase in particle numbers has been shown in studies in the USA, is the most important indicator of whether you are at risk of having a future heart attack.
High LDL is only a risk factor when it is concordant with high particle number.
Conventional medicine focuses on supressing symptoms but really doesn't look at the cause of those symptoms. You take a pill to lower blood pressure, another to lower cholesterol, but why are these elevated in the first place. This is what should be looked at. To me it is better to try and find an answer to these questions rather than just taking drugs.
Now I'm not saying you should never take drugs, but I believe they are greatly overused and there are often other options if you look hard enough. In other words try and find the underlying cause of your symptoms.
An example would be if your car gearbox is making a noise you could just put a heavier oil in there and the noise goes away. The trouble is eventually problems will return and usually they will be worse than you had before.
It is better if you can find a doctor or a functional medicine practitioner that is knowledgeable in this information, and who will work with you to find outcomes that are suitable to you.