Dislipidaemia &/Or Hypercholesterolaemia
Dislipidaemia, or abnormalities in blood lipid and lipoprotein concentrations, is a major modifiable cause of coronary heart disease (CHD) and a widespread problem. For example, 49% of adult men and 43% of adult women in the United States have elevated low-density lipoprotein cholesterol (LDL-C) concentrations (eg. >130 mg.dL) (2). Elevated blood LDL-C and triglyceride (TG) concentrations and low high-density lipoprotein cholesterol (HDL-C) concentrations are all independent risk factors for CHD (17). A linear association between elevated blood cholesterol levels and coronary artery disease and atherosclerotic disease in general is well established.
Atherosclerosis, the buildup of fatty, plaque material in the inner layer of blood vessels, is the underlying factor in 85% of heart disease (15, 33). When atherosclerotic plaque blocks one or more of the heart’s coronary blood vessels, the diagnosis is coronary heart disease (CHD), the major form of heart disease. Often, a blood clot forms in the narrowed coronary blood artery, blocking the blood flow to the part of the heart muscle supplied by that artery. This causes a heart attack, or what clinicians call a myocardial infarction (MI). Each year, as many as 1,100,000 Americans have a heart attack, and about one third of them die as a result (1, 28).
Atherosclerosis can also block blood vessels in the brain (leading to a stroke) or legs (defined as peripheral artery disease (1). Stroke kills over 150,000 Americans each year and is the third largest cause of death. Peripheral artery disease affects up to 20% of older people and leads to pain in the legs brought on by walking (intermittent claudication). Patients with peripheral artery disease are able to walk only short distances before they must rest to relieve the pain in their legs, brought on by poor circulation due to atherosclerosis. The atherosclerotic plaques range from small yellow streaks to advanced lesions with ulceration, thrombosis (formation or existence of a blood clot within the blood vessel system), hemorrhage, and calcification (15, 33).
Can Atherosclerosis Be Reversed Without Surgery?
Obviously, preventing atherosclerosis from forming in the first place is the primary goal for all who value their health. If an individual has had a heart attack, however, or is at high risk for one because of poor lifestyle habits, can the accumulation of atherosclerotic plaque be reversed through improvements in diet, exercise, weight loss, smoking cessation, and stress management, and initiation of drug therapy?(5, 6, 13, 16, 21)(This is termed “secondary prevention”(16)).
Since early in the twentieth century, regression of atherosclerosis has been demonstrated in many different types of animals, including rabbits, roosters, pigs, and monkeys (13). In the typical animal experiment, atherosclerosis is promoted by diets high in fat and cholesterol, followed by a vegetarian “regression” diet that leads to a reduction in plaque size within 20-40 months (5). (The earliest human studies were with World War II prisoners who had been subjected to semi-starvation diets in prisoner camps and were found at autopsy to have far less atherosclerosis than well-nourished people.)
Since the mid-1970s, controlled trials have convincingly demonstrated that intensive drug and diet therapy to lower LDL cholesterol and raise HDL cholesterol retards the progression of coronary atherosclerosis, promotes regression, and thus decreases the incidence of coronary events (5, 6, 13, 16, 21). In general, secondary prevention stabilizes progression of atherosclerosis in about half of patients and induces regression in about one fourth of patients (16). In patients with CHD, when blood pressure and blood lipids are brought below recommended levels through vigorous drug and diet therapy, stabilization and regression of atherosclerosis occurs in 75% of cases (6). In several trials, the effect of lifestyle interventions without drug therapy was investigated (6, 16, 21, 22). In patients combining exercise with a low-fat diet, coronary artery disease progresses at a slower pace than for a control group on standard care. The challenge is getting patients to adhere to the improved lifestyle over long time periods.
Obviously, prevention of atherosclerosis in the first place is the best strategy to follow, and this can be accomplished for most people by avoidance of smoking, eating a diet low in saturated fat and cholesterol, maintaining ideal weight, exercising regularly, managing stress, and keeping blood pressure and cholesterol under control. Such a healthy lifestyle prevents 80-90% of coronary heart disease events (25).
Click here to read more about Dislipidaemia &/or Hypercholesterolaemia and Exercise
If you have Dislipidaemia &/or Hypercholesterolaemia, learn about how they are both chronic diseases which are eligible to receive a Medicare Rebate when seeing an Accredited Exercise Physiologist:
Did you know you could get up to 50% off with a Medicare Rebate?
Learn how an Accredited Exercise Physiologist can help you to begin and maintain exercise in your life, so you can enjoy the health benefits of Exercise for Dislipidaemia &/or Hypercholesterolaemia:
What Does an Exercise Physiologist Do?