What is high ldl
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Understanding High LDL Cholesterol
What is LDL Cholesterol?
Low-density lipoprotein (LDL) cholesterol is often referred to as "bad" cholesterol. It is one of the types of lipoproteins that carry cholesterol through the bloodstream. High levels of LDL cholesterol can lead to the buildup of cholesterol in the arteries, which increases the risk of cardiovascular diseases (CVD) such as heart disease and stroke .
Global Burden of High LDL Cholesterol
Trends and Statistics
From 1990 to 2020, global LDL cholesterol levels have increased, particularly in high-income countries and regions like Central and Eastern Europe and Central Asia. In contrast, Sub-Saharan Africa has maintained the lowest LDL levels. Elevated LDL cholesterol is a significant contributor to cardiovascular morbidity and mortality. In 2020, approximately 2.9 million deaths from ischemic heart disease (IHD) and 1.5 million deaths from ischemic stroke were attributed to high LDL levels.
Impact on Health
The burden of disease attributable to high LDL cholesterol has been rising. In 2020, high LDL was responsible for 4.5 million deaths and 91.8 million disability-adjusted life-years (DALYs) globally. This increase is partly due to population growth and aging. Men experience more DALYs from elevated LDL than women.
Dietary Influence on LDL Cholesterol
Dietary Cholesterol and LDL Levels
Diet plays a crucial role in managing LDL cholesterol levels. Reducing the intake of saturated fatty acids, trans fatty acids, and dietary cholesterol can help lower circulating LDL cholesterol. A meta-regression analysis of 55 studies found that an increase of 100 mg of dietary cholesterol per day can raise LDL cholesterol levels by approximately 1.90 to 4.58 mg/dL, depending on the model used.
HDL Cholesterol and Dietary Impact
Interestingly, dietary cholesterol also affects high-density lipoprotein (HDL) cholesterol, often referred to as "good" cholesterol. The relationship between dietary cholesterol and HDL levels varies by gender, with men showing a modest inverse relationship and women showing a positive relationship. However, the clinical implications of these changes in HDL levels remain uncertain.
LDL Cholesterol and Cardiovascular Risk
LDL as a Risk Factor
High LDL cholesterol is a well-established risk factor for atherosclerosis, a condition characterized by the buildup of plaques in the arteries. This can lead to serious cardiovascular events such as heart attacks and strokes . The National Cholesterol Education Program recommends maintaining LDL levels below 70 mg/dL to reduce the risk of atherosclerosis and improve clinical outcomes.
Importance of HDL Functionality
While high HDL cholesterol levels are generally considered protective, recent studies suggest that HDL functionality, particularly its cholesterol efflux capacity (CEC), is more important for cardiovascular health. HDL's ability to remove cholesterol from macrophages and transport it to the liver for excretion is a key factor in reducing atherosclerosis risk. Therefore, enhancing HDL functionality could be a promising strategy for reducing cardiovascular risk.
Conclusion
High LDL cholesterol is a major public health concern due to its strong association with cardiovascular diseases. Global trends indicate rising LDL levels, particularly in high-income regions, contributing to increased morbidity and mortality. Dietary modifications can help manage LDL levels, but the role of HDL functionality in cardiovascular health is also crucial. Effective strategies to reduce LDL cholesterol and improve HDL functionality are essential for mitigating the global burden of cardiovascular diseases.
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