Cardiovascular Numbers

Suppose your blood test results include measurements of these substances (referred to as “lipids”): 

• Total cholesterol 
• LDL cholesterol 
• HDL cholesterol 
• Triglycerides 

Which two numbers tell most about your risk of cardiovascular disease (CVD)?

1. LDL cholesterol and HDL cholesterol 
2. LDL cholesterol and total cholesterol 
3. Triglycerides and LDL cholesterol 
4. Triglycerides and HDL cholesterol 

Correct answer:

d. Triglycerides and HDL cholesterol

What You Should Know: 

This answer may be surprising, because there is popular notion that what is most dangerous to arterial health are high levels of total cholesterol and “bad” LDL cholesterol.

But as we’ve seen so often in the field of health and the human body, “popular” is not the same as “true.” Actually, the idea that total cholesterol and/or LDL cholesterol is a cause of CVD is far from universally accepted. Recent research ^1,2 has generated very strong evidence that: 

• People with high cholesterol levels are not at higher risk for CVD than people with normal cholesterol levels, and

• A high LDL level is not associated with higher risk of cardiovascular disease. In fact, for people over 60, a careful review of 19 studies involving more than 68,000 people revealed the fact that low LDL is correlated to higher rates of all-cause mortality in people over 60 (that is, death due to any cause)³.
  

What is generally accepted is that there are five symptoms that are clearly associated with higher risk for CVD. Any one of the five is a risk factor, and the five together are referred to as “metabolic syndrome.”⁴ Two of those symptoms are low HDL and high triglycerides. High LDL and high cholesterol are not on the list. (You can learn about all five in this eSavvyHealth Insight.)  

Also not controversial is the positive impact on health of addressing the causes of the five symptoms of metabolic syndrome. Many eSavvyHealth articles, Guidebooks and courses can help you with that. 

References:

1. LDL-C does not cause cardiovascular disease: a comprehensive review of the current literature
2. Assessing cardiovascular disease: looking beyond cholesterol
3. Lack of an association or an inverse association between low-density lipoprotein cholesterol and mortality in the elderly: a systematic review
4. Cardiovascular Consequences of Metabolic Syndrome