If you've ever been confused about bad cholesterol (or LDL), good cholesterol (or HDL), and how they affect your heart, you're not alone. Our medical community continues to research and understand interactions between these different cholesterol types and their role in hardening of the arteries (plaque buildup) and heart attacks (plaque rupture).
Originally, doctors believed that heart attacks happen only when the heart arteries become critically blocked from progressive plaque buildup in their walls.
However, according to Dr. Aarush Manchanda, cardiologist with Intermountain Valley View Heart Clinic in Cedar City, "Most heart attacks happen in arteries that are only mildly blocked from plaque buildup rather than critical stenosis. The plaque that has been silent all along suddenly ruptures and causes a clot to form in the arteries. This is akin to a volcanic eruption within the artery. Within minutes, this leads to complete blockage of flow in the arteries supplying the heart muscle, causing the infamous heart attack."
Dr. Manchanda continued, "That is why we stress the importance of taking aspirin and statin drugs in preventing heart attacks. Baby aspirin prevents clotting in the blood vessels when these volcanic eruptions happen. Statins help stabilize these plaques, cooling off the lava."
No longer are doctors concerned with just cholesterol, or even just good cholesterol (or HDL) and bad cholesterol (or LDL). "The number we look at is non-HDL cholesterol. We get that number by subtracting your good cholesterol (or HDL) from the total cholesterol."
Non-HDL cholesterol includes not only LDL, but other bad forms of cholesterol, and gives a more accurate picture when assessing risk for coronary artery disease.
"Think of these non-HDL cholesterol particles as the core of the volcano," said Dr. Manchanda. "Understanding heart attack prevention becomes easy when you understand my volcano analogy. First, make sure there is no extra bad cholesterol (non-HDL) to deposit in the volcano core. Second, if plaques (silent volcanoes) have already formed, prevent them from rupturing by taking aspirin and statins."
Diet and exercise along with cholesterol-lowering drugs accomplish the first step. "It is the foundation of all heart attack prevention strategies," Dr. Manchanda said. "If you can keep your arteries clean from plaque, you will never get a heart attack -- it's that simple."
In addition, long-term regular exercise releases hormones that help strengthen the artery walls and cool off the plaque (silent volcano) -- an effect similar to statin drugs.
"Keep in mind that for some people, 20 minutes of daily exercise may not be enough for this kind of benefit," said Dr. Manchanda. "Multiple research trials over the last decade have proven that the combination of diet, regular exercise, and statins can, in fact, regress plaque. If you can regress plaque, you can prevent heart attack."
The LiVe Well Expo (formerly known as the Dixie Regional Health Fair) will be Mar. 2 from 8 a.m. to 1 p.m. at the Health & Performance Center on the east side of the Dixie Regional Medical Center River Road Campus.
The Expo will offer a number of free screenings, and a few paid like cholesterol (fast for 10 hours prior; $25 fee), as well as fun educational displays and screening options for children. For Expo information, call 251-2159.
Live Well represents a collaboration among healthcare professionals, The Foundation of Dixie Regional Medical Center and The Spectrum. Call 251-2108 for information.
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