Cardiovascular disease risk


Cholesterol is a type of fat that has many vital functions in the body. It is part of cell membranes and is necessary for the manufacture of bile acids and many hormones. Cholesterol is manufactured in the body and is also found in foods of animal origin. Plant foods do not contain cholesterol.

As cholesterol is a fat-soluble molecule it cannot dissolve in the blood. It is therefore attached to compounds known as lipoproteins, which transport it to different places in the body. There are several types of lipoprotein cholesterol compounds. These include LDL (low density lipoprotein) cholesterol, which transports cholesterol to the tissues; and HDL (high density lipoprotein) cholesterol, which transports it to the liver for metabolism and excretion.

Cardiovascular disease riskHigh levels of LDL cholesterol promote build-up in atherosclerotic plaques in the artery walls while HDL cholesterol reduces this. Hence LDL cholesterol is often referred to as bad cholesterol while HDL cholesterol is referred to as good cholesterol. The ratio of LDL to HDL cholesterol is an important factor in disease development as it determines whether cholesterol is being deposited into the arteries or taken to the liver to be excreted.

Cholesterol levels are influenced by genetic make up and by diet. For years it was thought that foods high in cholesterol raised blood cholesterol. Further research has shown that while high cholesterol foods can raise blood cholesterol levels, the saturated fat content of foods has a greater effect. It is currently recommended that total blood cholesterol should be less than 200 mg per deciliter of blood. LDL cholesterol should be less than 130 mg per deciliter and HDL cholesterol more than 35 mg per deciliter. At these levels, a person's risk of heart disease is low.

Recently, a compound called lipoprotein(a) or Lp(a) has been found to be an independent risk factor for heart disease. When Lp(a) levels are above 30

mg per deciliter, the risk of heart disease is increased. Lp(a) may act by delaying the breakdown of blood clots.


Triglycerides are the chemical form in which most fats exist in food and in the body. Calories not used by the body immediately are converted to triglycerides and transported to fat cells. Hormones regulate the release to meet energy needs between meals. An excess of triglycerides in the blood is linked to an increased risk of heart disease. It is currently recommended that triglyceride levels should be lower than 150 mg per deciliter.

Blood platelets

Blood cell fragments known as platelets play an important role in the process of atherosclerosis. The gathering together or"aggregation''of platelets is essential for the formation of blood clots in wound-healing. However, excessive platelet aggregation increases the risk of cardiovascular diseases such as heart attack and stroke. When platelets clump together around atherosclerotic plaques, they release compounds which cause the plaques to grow further and eventually block the artery. There are many chemicals in food which affect platelet function and these can either have beneficial or harmful effects depending on whether they increase or decrease aggregation.

High homocysteine levels

Several studies have found a link between high levels of a substance called homocysteine and cardiovascular disease. Homocysteine forms when the body breaks down protein. Enzymes either turn homocysteine back into the amino acid methionine, which can then be used to build protein, or break it down for excretion in the urine. High levels of homocysteine may be toxic to the cells that line blood vessels and may also increase the adhesiveness of platelets and other clotting factors.

Homocysteine levels are influenced by dietary intakes of folate, vitamin B6 and vitamin B12. They also vary according to race, gender, age and certain disease conditions. A dangerous cause of high blood pressure known as isolated systolic hypertension has also been found to be linked to homocysteine levels. Homocysteine may cause excessive stiffening of the aorta and other blood vessels thus forcing the heart to pump harder and thereby increasing the risk of heart and blood vessel diseases.


Being overweight increases the risk of cardiovascular disease by raising blood pressure, increasing blood fats, reducing HDL cholesterol and raising the risk of diabetes. This is particularly the case when the excess body fat is stored in the chest and abdomen.

Cardiovascular disease riskSmoking

Smoking increases the risk of cardiovascular disease. Smoking reduces the ability of the blood to deliver oxygen to the heart, stiffens arteries, damages blood vessel linings, promotes clotting, increases cholesterol levels and makes LDL cholesterol more susceptible to oxidative damage by free radicals. Even nonsmokers who live with heavy smokers have an increased risk of heart disease, und women may be more susceptible to the risks of smoking than men.


Stress increases the risk of heart disease and those who have high levels of hostility and unexpressed anger are also at higher risk. Sudden psychological stress may also trigger heart attacks. Depression also seems to be linked to heart disease, particularly new depression. Effective relaxation techniques such as meditation have been found to reduce stress and prevent heart attacks.

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