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Preventing and arresting coronary atherosclerosis
1Baylor Cardiovascular Institute, Baylor University Medical Center, Dallas, TX 75246, USA.
Insights
Coronary atherosclerosis, a common condition, can be prevented or arrested by maintaining serum total cholesterol below 150 mg/dl. Lifestyle changes and medication can lower cholesterol levels, reducing arterial plaque buildup.
Area of Science:
- Cardiovascular Medicine
- Atherosclerosis Research
Background:
- Coronary atherosclerosis often develops asymptomatically due to significant arterial plaque buildup.
- While not typically hereditary, atherosclerosis is commonly linked to dietary factors like high fat, cholesterol, and calorie intake.
- Elevated serum total cholesterol above 150 mg/dl directly correlates with increased arterial plaque deposition.
Purpose of the Study:
- To investigate the relationship between serum total cholesterol levels and the development and progression of coronary atherosclerosis.
- To explore preventive and therapeutic strategies for managing atherosclerosis based on cholesterol levels.
Main Methods:
- Analysis of the correlation between serum total cholesterol levels and plaque quantity in arteries.
- Evaluation of dietary interventions (fruit-vegetarian-starch diet) aimed at achieving target cholesterol levels.
- Assessment of the role of lipid-lowering drugs in managing hypercholesterolemia and atherosclerosis.
Main Results:
- Serum total cholesterol levels above 150 mg/dl are associated with plaque formation.
- Maintaining cholesterol below 150 mg/dl prevents plaque deposition, and lowering levels to this threshold can reduce existing plaque.
- A fruit-vegetarian-starch diet is often required to reach the 150 mg/dl target in adults.
Conclusions:
- Coronary atherosclerosis can be prevented in non-hereditary cases by managing serum total cholesterol.
- Lowering elevated serum total and LDL cholesterol to 150 mg/dl can halt and potentially reverse plaque buildup.
- Dietary changes and lipid-lowering medications are key interventions for controlling atherosclerosis.
Abstract:
The good news about coronary atherosclerosis is that it takes an awful lot of plaque before symptoms of myocardial ischemia occur. The bad news is that despite the need for large quantities of plaque for symptoms to occur, nevertheless nearly half of us in the United States eventually have the necessary quantity. Atherosclerosis is infrequently hereditary in origin. Most of us get atherosclerosis because we consume too much fat, cholesterol, and calories. The consequence is an elevated ( > 150 mg/dl) serum total cholesterol level, and the higher the number is above 150, the greater is the quantity of plaque deposited in our arteries. If the serum total cholesterol level can be prevented from rising to more than 150 mg/dl, plaques are not laid down; if elevated levels are lowered to 150 mg/dl, further plaque does not form, and parts of those present may vanish. A fruit-vegetarian-starch diet is necessary as a rule to achieve the 150 mg/dl level in most adults. Lipid-lowering drugs are required in the patients with familial hypercholesterolemia and in most patients with atherosclerotic events. The best news about atherosclerosis is that it can be prevented in those without the hereditary form, and it can be arrested by lowering elevated serum total (and LDL) cholesterol to the 150 mg/dl level.