04 April 2014

Cardiovascular disease linked to Metabolic Syndrome

Cardiovascular disease is one in a cluster of the chronic diseases associated with Metabolic Syndrome

Heart disease or coronary artery disease (CAD) is a major contributor to the cluster of diseases known as cardiovascular disease.

How do blood fats feature?

There are various risk factors associated with the development of CAD, including being overweight, having diabetes and smoking. However, the main culprit in the eyes of many experts is dyslipidaemia or what is commonly but mistakenly referred to as ‘high bad cholesterol’.

Dyslipidaemia is about much more than cholesterol levels though as it refers to excessive amounts of blood fats or triglycerides, AND the problems associated with high cholesterol. In fact, the main driver of CAD appears to be what the medical scientists call atherogenic dyslipidaemia, i.e. the build-up of  deposits or plaques on the lining of the walls of arteries resulting in atherosclerosis or ‘hardening of the arteries’ which may eventually lead to a heart attack.

Hardening of the arteries (atherogenic dyslipidaemia) is caused by a combination of three interdependent elements – high blood fats or triglycerides, low HDL-cholesterol (‘good’ cholesterol) and a majority of small dense particles of LDL-cholesterol (‘bad’ cholesterol).  

‘Bad’ cholesterol

Using ‘bad’ cholesterol to describe LDL-cholesterol is simplistic and unfortunate because not all LDL-cholesterol is bad. Thanks to research, we now know that LDL-cholesterol is not just ‘one thing’. It is made up four categories of particles differing in size from LDL-1 ( largest) to LDL-4 (smallest), and these can be further divided into as many as eight sub-fractions.

Only the very small dense particles of LDL-cholesterol appear to be harmful , according to research. They may be harmful because they much more susceptible to oxidation than the larger particles, and thus cause the inflammation that leads to atherosclerotic disease. The large buoyant LDL cholesterol particles  appear to be harmless.  

This means that a person with a ‘high cholesterol’ may not be at risk for CAD or other aspects of cardiovascular disease, if they have far more large buoyant particles (harmless Pattern A) than small dense particles of LDL-cholesterol (harmful Pattern B). Of course, the reverse is also true. A person with ‘low cholesterol’ may be at risk if they have more small dense than large buoyant particles of LDL- cholesterol.

How do you know if you are at risk?

The first key question then is, ‘How do I know if I have more large than small cholesterol particles?’
There are  a number of  sophisticated techniques used to determine LDL-cholesterol particle size, but a simple blood test known a lipogram will do. The triglyceride value obtained from this blood test is divided by the HDL-cholesterol value. The answer gives a good idea of the ratio of large to small LDL-cholesterol particles. While expert opinions may differ on what the cut-off should be, one can safely assume that an answer or ratio of   less than 1.4 mmol/l indicates that the LDL-cholesterol consists of more large (harmless) than small (harmful) particles.

What you can do to reduce your cardiovascular risk?

The second key question is, ‘What can I do to change the ratio if I need to?’
This is unequivocally answered by many studies that have shown that low-carbohydrate diets are associated with favourable LDL-cholesterol particle size. Contrary to popular opinion, low-fat, high carbohydrate diets, on the other hand, are associated with the development of atherogenic dyslipidaemia, a major cardiovascular risk factor.

So if you are at risk, or your cholesterol levels are cause for concern, your best option is to get rid of the sugar and other refined carbohydrates in your diet and improve your blood fat levels, i.e. triglyceride levels, HDL-cholesterol levels and LDL-cholesterol particle size.

If you feel you are at risk of cardiovascular disease, and the other chronic diseases associated with Metabolic Syndrome, visit a Dis-Chem pharmacy, get tested and get help.

Read more: Met-S Care works with Dis-Chem Pharmacies to empower people living with Metabolic Syndrome to take control of their condition.


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