There is another rumor among WeChat friends that heart disease is not the culprit of cholesterol. A 25-year-old U.S. Heart surgeon in white robes also said that restricting fat intake has created a large number of obesity and diabetes patients, triggering human hope, disaster and serious economic losses.
Eisenhower, the 34th president of the United States, was a hypercholesterolemic patient. The hero of World War II who galloped across the board and died of heart disease caused by hypercholesterolemia. The president’s cholesterol once became the main character of the White House press conference, arousing the world’s attention to cholesterol.
Is hypercholesterolemia and coronary heart disease the relationship between how?
Hypercholesterolemia is only one step away from coronary heart disease.
A large number of epidemiological investigations and clinical trials have further confirmed that hypercholesterolemia is the cause of atherosclerosis from different aspects. Lowering cholesterol can prevent atherosclerosis diseases such as coronary heart disease.
In 1947, the Framingham Heart Study, launched in Massachusetts, continued to investigate and study three generations of local people for 56 years, and finally confirmed that coronary heart disease had a significant linear correlation with the increase of cholesterol level.
In 1958, a study in seven countries showed that the mortality rate of cardiovascular diseases, mainly coronary heart disease, increased with the increase of cholesterol level.
In 1973, MRFIT, a multi-risk factor intervention test, showed that the number of deaths from coronary heart disease increased with age and blood total cholesterol level.
Epidemiological studies in Beijing and Shanghai have also confirmed a significant correlation between elevated cholesterol levels and the risk of coronary heart disease.
It is not alarmist to say that there is only one step away between hypercholesterolemia and coronary heart disease.
What is hypercholesterolemic
Hypercholesterolemia refers to the high level of total cholesterol, which is mainly caused by the increase of low density lipoprotein cholesterol.
Cholesterol plays an important physiological role. It is the main component of cell membrane and the raw material for hormone synthesis. It can form bile acid in bile and maintain an appropriate cholesterol level, which is a good manifestation of body function.
Cholesterol is divided into two types: low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C). Cholesterol is also divided into [good] and [bad]. Low density lipoprotein cholesterol (LDL-C) accounts for 60% of blood cholesterol and is [bad cholesterol]. High density lipoprotein cholesterol (HDL-C) is [good cholesterol], which can effectively reduce atherosclerosis and belongs to the small guard of cardiovascular system with more and better.
Hypercholesterolemia is the cause of atherosclerosis
The clarification of the relationship between the two has gone through a long scientific process.
In 1863, German pathologist Virchow first proposed the lipid infiltration theory of atherosclerosis.
In 1889, Lehzen and Knauss reported that a 3-year-old child suffered from familial hypercholesterolemia, with xanthoma on the skin and sudden death at the age of 11. Anatomy found that a large amount of xanthoma-like substances were deposited on the inner walls of major arteries such as aorta and coronary artery.
In 1910, German chemist Adolf Win-daus discovered that atherosclerosis of coronary heart disease is related to abnormal increase of cholesterol.
In 1913, Anitschkow, a 28-year-old pathologist from the former Soviet Union, discovered the mechanism of atherosclerosis by establishing a rabbit atherosclerosis model and a series of studies, and proposed [cholesterol-free and atherosclerosis-free].
In 1954, Malinow et al. Successfully established a rat atherosclerosis model by damaging the cholesterol metabolism function of rats and supplemented by a high cholesterol diet, further revealing the close relationship between cholesterol and atherosclerosis.
In 1974, Professor Goldstein and Professor Brown of Southwest Medical Center of the United States discovered LDL-R, a receptor with high affinity on the surface of cell membrane, and put forward the classical theory [LDL-R mediated endocytosis], which laid an important foundation for the invention and application of statins. They jointly won the 1985 Nobel Prize in Medicine and Physiology for their outstanding contributions to cholesterol metabolism research.
Hypercholesterolemia is the cause of coronary heart disease in how.
Coronary heart disease is a disease caused by atherosclerosis and stenosis of blood vessels supplying the heart.
Atherosclerosis is caused by eating too much high-fat, high-sugar and high-calorie foods such as big fish and big meat, less body exercise, and the decline of metabolic function cannot be consumed, or the metabolic function of the body has problems and becomes [impurity cholesterol], just as impurities in water become scale to block pipelines, cholesterol deposition forms plaques and causes stenosis.
If the vascular stenosis of coronary heart disease exceeds 70%, it will affect myocardial blood supply and cause angina pectoris. Once plaque rupture forms thrombus to completely block blood vessels, it will lead to myocardial necrosis, i.e. Myocardial infarction, which is very likely to lead to sudden death!
The key to preventing heart disease is to control cholesterol level.
How to control cholesterol level
As for cholesterol levels, people with different risk strata have different target values, and cannot only look at the normal values of laboratory tests. Doctors will divide patients into low, moderate and high-risk risk groups according to the possibility of future ischemic cardiovascular and cerebrovascular diseases in people without cardiovascular diseases. Consult your doctor for specific grouping and target values.
The main blood lipid indexes are TC (total cholesterol) and LDL-C (low density cholesterol), which must be controlled below the target value. There are two ways to control cholesterol level to reach the standard.
The first is lifestyle intervention.
Choosing a healthy lifestyle is the basis for cholesterol control. Studies have found that [bad cholesterol] can be reduced by more than 30% through a healthy diet such as Mediterranean diet, quitting smoking and strengthening exercise.
Reducing the intake of unhealthy fats such as saturated fatty acids, trans fatty acids and cholesterol, eating more coarse grains, fruits and vegetables to increase the intake of dietary fiber, and eating more phytosterol-rich foods such as corn oil or phytosterol-added yogurt can effectively reduce [bad] cholesterol. Intensive exercise and weight loss are also beneficial to blood lipid health.
The second method is drug therapy.
There are five kinds of lipid-lowering drugs clinically, the most worthy of attention is statins, which are also recognized as the most effective drugs for lowering cholesterol. The discovery of statins in cardiovascular system can match the significance of penicillin in infectious diseases.
In 1976, Japanese scholar Akira Endo led his colleagues to successfully extract the first statin drug, Mavastatin, from a mold after more than 6,000 experiments over two years. In 1978, Merck researchers discovered lovastatin from oxytetracycline fermentation broth. In 1987, FDA approved lovastatin to go on the market.
Research results published in 1994 showed that simvastatin can significantly reduce total mortality, non-fatal myocardial infarction and cardiovascular death.
In 2012, the New England Journal of Medicine listed the determination of risk factors for coronary heart disease such as hypercholesterolemia, the discovery of statins and the National Cholesterol Education Plan as great technologies to change the treatment process of coronary heart disease, which promoted the decline of cardiovascular disease mortality.
Speaking of which, the topic turned to President Eisenhower of the United States.
From September 24, 1955, when Eisenhower suffered his first heart attack, to 1969, he used 18 weapons such as diet adjustment, exercise and smoking cessation to fight against cholesterol. However, he saw the cholesterol level rising continuously and eventually died of heart disease.
Lifestyle intervention is the foundation, but it cannot solve all the problems. Unfortunately Eisenhower did not live in the age of statins. If he fought with statins or other lipid-lowering drugs, he might be able to defeat cholesterol.
Of course, there is no absolute truth in science, but science is rigorous and evidence-based. Only by constantly approaching the essence of things in questioning, exploring and verifying can we have a more objective understanding of ourselves and the world.
Editor: Xu Zhuojun
Author: Qiao Yan