Nutrition in the Prevention of Coronary Heart Disease and the Management of Lipoprotein Disorders1



Nutrition in the Prevention of Coronary Heart Disease and the Management of Lipoprotein Disorders1


Ernst J. Schaefer





Coronary heart disease (CHD) is a leading cause of death and disability in Western societies. Both increased plasma low-density lipoprotein (LDL) cholesterol (LDL-C; >160 mg/dL or 4.2 mmol/L) and decreased high- density lipoprotein (HDL) cholesterol (HDL-C; <40 mg/dL or 1.0 mmol/L), along with aging, elevated systolic blood pressure (>140 mm Hg), cigarette smoking, and diabetes (fasting glucose >125 mg/dL), have all been defined as independent risk factors for CHD. CHD is caused by atherosclerosis, a process in which the coronary arteries as well as other arteries become occluded. The characteristics of this process in the artery wall are the presence of cholesterol-laden macrophages or foam cells, proliferation of smooth muscle cells with excess connective tissue, calcification, and sometimes thrombosis as the terminal event occluding the artery. A heart attack or myocardial infarction (MI) occurs when one or more of the three major coronary arteries becomes blocked (1). A stroke occurs when one or more of the arteries supplying the brain becomes occluded. CHD and stroke together are known as cardiovascular disease (CVD), which accounts for about half of all mortality in developed societies including the United States.

Aging, high blood pressure, diabetes, and smoking can all damage the lining of the artery wall. Moreover, LDLs can be deposited in the artery wall, especially at sites of damage. Therefore high levels of LDL-C (>160 mg/dL or 4.2 mmol/L) associated with high total cholesterol values (>240 mg/dL or 6.2 mmol/L) are a significant risk factor for CHD. In addition, HDLs serve to remove cholesterol from the artery wall. Low levels of HDL-C (<40 mg/dL or 1.0 mmol/L) are a significant CHD risk factor (2). Diets high in animal fat, dairy products, eggs, sugar, and salt have been associated with excess obesity, elevated blood cholesterol, and high age-adjusted CHD mortality rates (1). Family history of premature CHD and age are also significant risk factors for CHD (2, 3).


Jul 27, 2016 | Posted by in PUBLIC HEALTH AND EPIDEMIOLOGY | Comments Off on Nutrition in the Prevention of Coronary Heart Disease and the Management of Lipoprotein Disorders1
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