Small LDL and Its Clinical Importance as a New CAD Risk Factor: A Female Case Study

Abstract

The underlying metabolic cause of coronary heart disease in many patients is not high blood cholesterol. In fact, the Framingham study has reported that 80% of individuals who go on to have coronary artery disease have the same total blood cholesterol values as those who do not go on to have a cardiovascular event. The most common metabolic contributor to coronary artery disease is the atherogenic lipoprotein profile, characterized by an abundance of highly atherogenic small, dense low-density lipoprotein particles and a deficiency of the high-density lipoprotein (HDL) subtype most associated with coronary artery disease protection (HDL(2b)). This trait is present in 50% of men with coronary artery disease and is not reflected by total or low-density lipoprotein cholesterol values. While fasting triglycerides tend to he higher, and HDL cholesterol lower in patients with the atherogenic lipoprotein profile, the majority have triglyceride and HDL cholesterol values generally accepted to be in the "normal" range. An abundance of basic science and clinical trial evidence convincingly indicates that the presence of an atherogenic lipoprotein profile signifies a three-fold increased risk for a cardiovascular event and rapid arteriographic progression, but it also identifies a group of patients who respond particularly well to specific therapeutic interventions. Often the most effective interventions are the least expensive.

Effects of Palm and Sunflower Oils on Serum Cholesterol and Fatty Liver in Rats

“…LDL cholesterol is often called bad cholesterol because it tends to form deposits in the walls of arteries while circulating through the bloodstream, decrease artery diameter, and result in atherosclerosis. 27 On the contrary, HDL cholesterol is referred to as good cholesterol because it can maintain the healthy state of the inner blood vessel walls by scavenging and recycling cholesterol through transporting it to the liver where it can be reprocessed. [28][29][30] Accordingly, CVD risk indicators such as AI and CRI are measured from the blood levels of LDL cholesterol, HDL cholesterol, and T-CHO.…”

Dietary fatty acids kand inflammatory markers in patients with coronary artery disease

“…[1819] Monounsaturated fatty acids (MUFAs) are predominant in olive oil, and have received increased attention as being potentially beneficial because of their association with low rates of coronary heart disease (CHD) in olive oil consuming populations of the Mediterranean basin. [20] Recommendations to decrease the intake of saturated fatty acids (SFAs) have been as a goal in prevention of CAD. In PIVUS study, a Swedish cross-sectional population based study of healthy elderly men and women, failed to identify a relationship between levels of SFAs in cholesteryl esters and high sensitivity-CRP (hs-CRP) concentration.…”

Gamma Delta Tocotrienols Reduce Hepatic Triglyceride Synthesis and VLDL Secretion

“…Finally, a 8-week hypercholeterolemic human trial with 120 mg/day T3 supplementation was conducted in Japan to evaluate the impact of the two most potent T3 isomers on serum cholesterol, triglycerides, LDLcholesterol, and HDL-cholesterol. Since LDL particles vary in size/density, and studies have shown that smalldense LDL (sd-LDL) particles equate to a higher risk factor for coronary heart disease than larger and less dense LDL particles 21) , we further evaluated whether T3 supplementation impacted the 20 fractions of triglycerides and cholesterol lipoproteins of various size/density 22) .…”