High cholesterol and Heart Attack

High blood cholesterol and heart attack

Cholesterol is a complex fatty substance produced by liver for various functions in the body. The amount of cholesterol in our food also contributes to the cholesterol level in blood. If we take excess amount of cholesterol rich food it well predisposes us to increased risk of heart attack. Any excess of cholesterol results in the deposition of cholesterol in the arteries resulting in narrowing and hardening of the arteries (atherosclerosis). When the narrowing of the artery becomes severe enough to result in insufficient blood supply to the heart, chest pain (angina) occurs. The chest pain usually occurs on exertion and is usually relieved by rest. When the artery is completely blocked, the portion of the heart muscle supplied by the artery will be damaged, resulting in heart attack.

Basic research and evidence from observational studies and clinical trials have shown a consistent positive relation between the blood cholesterol level and the risk of heart attack. Recent overviews have indicated that a I percent reduction in a person’s total blood cholesterol level yields a 2 to 3 percent reduction in the risk of coronary heart disease. The seven countries study found that coronary artery disease was less common in Japan and Mediterranean countries (where the average diet is low in cholesterol and saturated fat) than in the United States. Finland and Netherlands (where the cholesterol and saturated fat content of average diet is higher). In the United States, the Framingham Heart Study and more recently the Multiple Risk Factor Intervention Trial (MRFIT) have shown that the incidence of coronary artery disease is positively associated with blood cholesterol levels in a continuous, graded and progressive manner. By reducing the blood cholesterol level to normal the risk of heart attack can be decreased by 23%. In the Oslo study the smoking cessation and cholesterol lowering resulted in 47% reduction of heart attack and sudden death compared to control.
Cholesterol in blood is carried in two main forms, low density lipoprotein (LDL) and high density Lipoprotein (HDL). LDL is called bad cholesterol and HDL is called good cholesterol. High LDL cholesterol is associated with atherosclerosis (blockage of coronary artery). HDL cholesterol or good cholesterol removes excess bad cholesterol from the arteries. It is good for the HDL cholesterol to be high and the LDL cholesterol to be low. The role of another blood lipid, triglyceride in producing heart disease independently is questionable. But a recently published study, Helsinki Heart Study documented an inverse relation between elevated triglycerides and low level of HDL that may be reversed with treatment by Gemfibrozil.
The public health effect of the National Cholesterol Education Program’s guidelines is great. Their aim is to lower mean blood cholesterol levels to less than 200 mg% (5.2 mmol per liter), primarily by decreasing the total fat content of the diet to below 30% of total calories and saturated fat to below 10%. The HDL level is to be kept above 55 mg%. A mean 11% increase in the level of HDL cholesterol (good cholesterol) corresponded to a 34% decrease in the incidence of coronary heart disease.

Aspirin for Heart attack

Can low dose aspirin prevent heart attack?

Attention has recently focused on the possible role of prophylactic low-dose aspirin in reducing the risk of heart disease. The hypothesis that platelet inhibition with low-dose aspirin reduces the risk of heart attack n apparently people have been tested in two trials of primary prevention in men. The U.S physicians Health Study of 22,071 men 40 to 84 years of age observed a statistically significant 44% reduction in the risk of first heart attack whereas the British Doctor’s Trial of 5139 men 50 to 79 years of age observed no significant reduction. However an overview of both trials of primary prevention demonstrated a 33% reduction in the risk of fatal heart attack. Although no randomized trial has been completed specifically in women, the Nurses Health Study recently reported that women who took one to six aspirin weekly were 32% less likely to have an acute myocardial infarction.

At present the data on the role of aspirin in the primary prevention of stroke and heart attack are inconclusive. But some authorities recommend routine use of aspirin in asymptomatic men and women older than 50 years to prevent first myocardial infarction. It is important to view the clear benefits of aspirin in the primary prevention of heart attack in the context of what is already known about the modification of other coronary risk factors. It would be unfortunate if a middle aged smoker took aspirin instead of quitting smoking, because the benefits from quitting far exceed any protective defect of aspirin of heart attack. Any decision to use aspirin prophylaxis should be made on an individual basis, and in general, should be considered only for those whose absolute risk of a first heart attack is sufficiently high to warrant accepting the potential adverse effects of long-term aspirin use.

Antioxidants

Antioxidants with coronary artery disease

Epidemiological studies have suggested that high intake of antioxidants may modify coronary artery disease risk. The relative impact of vitamin E, vitamin C, beta carotene and flavonoids still remains unclear. Nurses Health Study and the Health Professional’s Follow-up Study showed 34% and 36% reduction in coronary events, respectively among women and men who take vitamin E supplement regularly. Oxidized LDL (bad cholesterol particles are believed to play a key role in the atherogenesis (blockage formation). So, theoretically any oxidant is likely to prevent coronary artery narrowing by preventing oxidation of LDL. In the European Community Multicenter Study on Antioxidants, Myocardial Infarction and breast cancer trial high beta carotene intake was protective only among smokers; vitamin C intake showed no relationship with coronary artery disease.

Results from most of the observational and experimental studies consistently support an effect of vitamin E supplemental on reducing the risk of heart attack. It is suggested that supplemental intake of vitamin E at or above 100 IU/day will reduce incidence of coronary artery disease. Long-term intake of vitamin E may reduce the progression of blockage in coronary arteries.

Carnivores and Herbivores

We are Carnivores or herbivores?

Human beings basically are not carnivores. We are basically herbivores (vegetarian) but we always behave like carnivores (flesh eaters). If several characteristics of carnivores are compared, human beings clearly have more characteristics of herbivores than carnivores. The teeth of carnivores are sharp; those of herbivores, mainly flat (for grinding). The intestinal tract of carnivores is short; that of herbivores is long (the small intestine of humans is 26 feet long!). Carnivores cool their bodies by panting; herbivores by sweating (as human beings). Carnivores make their own vitamin C (like animals); herbivores obtain their vitamin C from their diet. Most human beings believe themselves to be carnivores (we eat flesh) but fundamentally our characteristics more closely resemble the herbivores. Foods intended for Homo sapiens (man) probably are only three: starches (rice, corn, potatoes, beans etc), vegetables, and fruits.