In an interesting study from the National Cholesterol Education Program, lipid tests were performed on several individuals once a week for 4 weeks. The conclusion is that there were variations of +/- 20% in total cholesterol (75% of cases), HDL cholesterol (95% of cases !!) and LDL cholesterol (65% of cases). 40% jumped one category within the risk levels used, and 10% jumped two categories, even going from “desirable” to “risky” or the other way around.
That is to say, It may happen that you do the tests one day and your doctor tells you that you are perfect, and yet you go a few days later and leave the office with a prescription for statins. The indicators we use to to size health take just one photo at a specific time of the biological processes that constantly occur in our body. It is like relying on a photo of a street to calculate how many people travel per day. The photo can be quite different depending on the time, the date, if there is a demonstration… Before making drastic decisions (and for me taking medication is drastic), you want to have at least a few photos.
Assuming you already have certain data, let’s see what information is relevant to get an idea of the real risk:
- Total cholesterol: This data says very little. It just gives you an idea of the cholesterol that travels through your circulatory system. As we saw in the previous article, there is virtually no correlation between this number and your risk of cardiovascular disease. This is not to say that abrupt changes in this number should be taken lightly. In many cases it is normal, and in others it can represent an alarm signal. Quite a few people who make the jump to Paleo experience a steep rise in total cholesterol. Next day I’ll talk about possible explanations and solutions (when it represents a risk).
- HDL-C: Although it only gives a partial photo, there does seem to be a correlation between high HDL-C and good cardiovascular health (study). Ideally, its value is above 60mg / dl. Another interesting fact is the Total Cholesterol / HDL-C ratio. If this proportion is greater than 4, it is surely time for a more complete analysis, such as the one I explain later.
- LDL-C: This is the “terrible” bad cholesterol, which many look to as the main indicator of risk. I hope by now you know that it is not exactly like that. Continuing with the analogy of yesterday (the river and the boats), it’s like trying to figure out how many boats are on the river from the total load they carry. You may travel a lot of cargo on a large tanker (low risk) or that same cargo is distributed over hundreds of small rafts (high risk). In general, there is a relationship between total LDL cholesterol (LDL-C) and the number of lipoproteins that transport it (LDL-P), but there are also many people in whom this relationship is not fulfilled and is even the reverse.
- Triglycerides: There is usually a relationship between the level of triglycerides in the blood and the number of LDL lipoproteins (the true risk). The more triglycerides, the more LDL lipoproteins you need to transport them, which increases the risk of oxidation and damage to the arterial walls. If this number is above 125-150 mg / dl, there is probably a problem, especially if your HDL-C is low. A Triglycerides / HDL-C ratio greater than 3.5 may be a cause for concern. In either case, it is more important to test for LDL-P.
Another indicator that I recommend you request in the analysis is the C-reactive protein, which measures your degree of systemic inflammation. As I explained in the first part, the development of atherosclerosis is linked to an inflammatory process, so a high level of this protein can be a sign of cardiovascular disease. Of course, it can be anything else, such as some type of infection, that is why all the information must be analyzed.
Conclusion, are traditional analyzes useful? Of course. Are they reliable enough to make the decision to take medication if they tell you a “risk profile”? In most cases, I think not. But if there is an upward trend in LDL or total cholesterol and your doctor begins to show signs of concern, I recommend using more advanced studies, which offer better information on the real risk and therefore the measures to take.
What other studies are there?
In this article I talk about more advanced tests with more useful information, such as the number of particles or ApoB.
PS: I had planned to write today about natural ways to reduce the risk of cardiovascular disease, but for space, I leave it for the next day (here).