Coronary heart disease: What you need to know The coronary arteries supply oxygen and blood to the heart. They can narrow, often because cholesterol accumulates on the arteries’ walls. This results in coronary heart disease, the most common type of heart disease in the U.S. Here, learn about risk factors, early warning signs, means of prevention, and treatments. Read now
Part of the “French paradox”-lower heart-disease rates in butter-and-cream-feasting France-may stem from the HDL benefits of wine consumption. For some people, however, alcohol causes more troubles than it cures. “Men should limit themselves to one or two drinks a day,” Willett says. “After that, you start worrying about adverse consequences.” While any alcoholic beverage will do, the antioxidants in red wine or dark beer may give you an added benefit.
Perhaps most disappointing of all, a new class of drugs (the so-called CETP-inhibitors), which several pharmaceutical companies have been enthusiastically developing for several years to raise HDL levels, has become a great disappointment. While these drugs do indeed increase HDL levels, they have not demonstrated an ability to improve cardiac risk — and on the contrary, studies appear to show a worsening in cardiac risk with some of these drugs. It is unclear today whether any CETP-inhibitors will ever reach the market.
While diet and exercise should be your two main options for fighting off LDL cholesterol, you can also look into the various dietary supplements that are on the market today. Consider omega-3 fish oils, artichoke extract, and green tea extract. Keep in mind that these natural products have not been fully proven to reduce your level of LDL cholesterol, but they may be able to help along the way. 

Perhaps most disappointing of all, a new class of drugs (the so-called CETP-inhibitors), which several pharmaceutical companies have been enthusiastically developing for several years to raise HDL levels, has become a great disappointment. While these drugs do indeed increase HDL levels, they have not demonstrated an ability to improve cardiac risk — and on the contrary, studies appear to show a worsening in cardiac risk with some of these drugs. It is unclear today whether any CETP-inhibitors will ever reach the market.
Rich in omega-3 fatty acids and all-around delicious, walnuts have also been shown to improve the HDL-to-total cholesterol ratio, according to a study published in the American Diabetes Association’s peer-reviewed journal, Diabetes Care. This ratio is used by physicians to assess overall cardiovascular risk and can provide more information than just one value alone. A desirable ratio is anything below 5:1, but a ratio of 3.5:1 indicates very minimal cardiovascular risk.
Typically, a fasting plasma lipid profile is ordered to measure LDL, HDL, total cholesterol, and triglyceride levels. Lipids in plasma and in isolated lipoprotein fractions are quantified by enzymatic methods. Prior consumption of food has little effect on the determination of HDL, with postprandial blood samples usually yielding results that can be well interpreted. [14, 2] Current clinically available techniques can determine the cholesterol content, but not the biologic function, of HDL particles. [2]
Coronary heart disease: What you need to know The coronary arteries supply oxygen and blood to the heart. They can narrow, often because cholesterol accumulates on the arteries’ walls. This results in coronary heart disease, the most common type of heart disease in the U.S. Here, learn about risk factors, early warning signs, means of prevention, and treatments. Read now
HDL serves as a chemical shuttle that transports excess cholesterol from peripheral tissues to the liver. This pathway is called the RCT system. In this system, plasma HDL takes up cholesterol from the peripheral tissues, such as fibroblasts and macrophages. (A study by El Khoury et al indicated that in persons with HALP, macrophages have an increased plasma cholesterol efflux capacity. [18] ) This may occur by passive diffusion or may be mediated by the adenosine triphosphate (ATP)–binding cassette transporter 1. The latter interacts directly with free apo A-I, generating nascent, or so-called discoidal, HDL. Cholesterol undergoes esterification by lecithin-cholesterol acyltransferase (LCAT) to produce cholesteryl ester, which results in the production of the mature spherical HDL. Cholesterol is also taken up from triglyceride-rich lipoproteins in a process mediated by a phospholipid transfer protein (ie, CETP). [19, 20, 21, 22]
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