RE: Why some healthy individuals die suddenly?
Hi, @fancybrothers.
The heart is a small organ in the chest, it pumps oxygenated blood to the different organs making it a vital organ.
It is not technically wrong but I would write it as "it pumps blood to the different organs making it a vital organ". It is not only vital for a heart to pump oxygenated blood to different organs, but it also serves an important organ for pumping deoxygenated blood to the lung to be reoxygenated.
It is also worth noting that the event of atherosclerosis was not triggered by a high blood cholesterol (most laymen think it is) but conditions which can cause inflammation to the vessels. In order to mend the damage caused by the inflammation, our body recruits various things including cholesterols. Blaming cholesterol for a atherosclerosis is like blaming a fireman for a fire.
Great article! Keep it up!
One of the reasons being cholesterol is one of the components of the atherosclerotic plaque which has been formed surrounding the vessel walls. When there is inflammation, you can imagine a cut is being made on the vessels surface which would trigger the body repair mechanism to act on the imaginary cut by recruiting platelets, macrophage and cholesterol to mend that. Cholesterol technically doesn't cause atherosclerosis. It just one of the component of atherosclerosis and the triggering factor was the inflammation (diabetes mellitus, high triglycerides level).
There are various studies which have been conducted in the past proving that people who have a low level of cholesterol have a high cardiovascular morbidity rate compared to people who have a high blood cholesterol. It's quite controversial and contradicts most of the things that we know about cholesterol but just because it is not supported by the majority of studies, doesn't mean it is wrong. It still within a grey area of research.
I see your point and i'm litterally very confused now, i've heard about the cholesterol consipracy a long time ago but i didn't believe it.I spent the last hour reading researchs and all i can say to you, there's a huge gap in the resarchs and a lot of controversy.
That's my conclusion:
I don't know if you know about the scavanger pathway, it's the process of accumulating cholesterol in the plaques. There's no feeback so that's why they are prone to become bigger and bigger .Anyway high level cholesterol is indeed associated with more risk of cardiovascular disease and that makes sense if you think about it, the excessive amount of cholesterol is put into the arteries through the same pathways. But still we don't know for fact that the cholesterol cause or not the endothelial dysfunction, i guess that' the whole problem regarding the studies.
Hahaha. Good conclusion though.
Thanks ! Nice chatting with you ^^
@fancybrothers
@chloroform
Interesting conversation guys and a good read. I think the process can be more easily summarised if we consider inflammation and damage as the triggers for atherosclerotic events, while cholesterol is an opportunistic infiltrator of arteries.
I'm not aware of any research that treats lipids or cholesterol as molecules that are actively 'recruited' in an attempt to repair endovascular damage. I believe the working hypothesis more sees cholesterol as an infiltrate, which is consumed by local macrophages in an attempt to 'clean' the site. Obviously, these macrophages cannot deal with such large levels of cholesterol and become foam cells which form the basis of vascular thickening.
Higher levels of cholesterol simply means a larger amount of cholesterol for the macrophages to consume.
It's well understood that inflammatory states are big risk factors for atherosclerotic and cardiovascular disease, which is why rheumatoid arthritis leads to heart and lung disease for example. But I don't think cholesterol can be ruled out so easily. Medical consensus doesn't ever come off the back of one study, or one person's work, it doesn't even stem from what is or isn't FDA approved seeing as medical consensus is global.
While our understanding of fat and cholesterol is still evolving, we do know that high blood cholesterol especially if associated with a low HDL is a strong risk factor for atherosclerotic-related diseases. It's more complex than more = worse, but in a broad sense, it does equal less = safer. The discord here is that the body can regulate its blood cholesterol, so high fat or cholesterol diets DO NOT have a relationship with high blood cholesterol, i quote "dietary cholesterol has a small effect on the plasma cholesterol levels with an increase in the cholesterol content of the LDL particle and an increase in HDL cholesterol, with little effect on the LDL:HDL ratio, a significant indicator of heart disease risk". Also, remember (western) high-fat diets don't only lead to hypercholesterinaemia but also obesity and other gastrointestinal conditions like reflux and biliary cholic etc.
With regards to the video you shared... well it falls into all of the pseudoscience pitfalls... ie. 1. "it's called a hypothesis because it's never been proven"; 2. using cute but physiologically irrelevant metaphors to try and explain-away the risks of fat consumption; 3. drawing loops through a graph that has a clear trend. So I'm not giving it too much credibility. I'd also like to say that this wasn't the work of one man in the hand of pharma companies, it was a broader scientific consensus very consistent with the data we had at the time.
@tfcoates Great analysis ! You mentionned that we need first a damage in the arterial wall, it can be caused by a lot of conditions and risk factors, then comes cholesterol as an opportunistic infiltrator.Well that's my point but still can high cholesterol levels cause arterial damage in the first place ? I checked your profile (By the way it's a great one )and i can see that you are a med student, so have you ever heard about Familial hypercholesterolemia (FH) ? It's a condition marked by high LDL and choesterol levels from birth, generally these individuals die from heart attacks before the age of 20 ! And that's only one dyslipidemia, there are countless diseases out there
Hey, thanks for that! Yes I've heard of the condition, though I'll admit I've never seen it in practice! I didn't know there were other forms of dyslipidaemia, I tend to use the term interchangeably with hypercholesterinaemia... thanks for the info, always love to learn new things!