What many people have learned about cholesterol is summarized by the following: High cholesterol will clog up your arteries and cause a heart attack. There are two main types of cholesterol. Good cholesterol or HDL for high density lipoprotein that prevents clogging of the arteries and bad cholesterol called LDL for low density lipoprotein clogs the arteries. If your cholesterol is high, avoid foods high in cholesterol. If that does not work, you can take a statin drug to lower the cholesterol. The following 10 facts illustrate the truth is much more complex.

1. Only 25 percent of the cholesterol in your body comes from your food. The liver produces most of the other 75 percent produced by your body.

2. The standard cholesterol test, a lipid profile, is only one of many tests developed over the years to estimate your risk of heart disease. Other tests measure the cholesterol in different ways. Examples of these tests include Apolipoprotein A and Apolipoprotein B. The other tests are rarely used because the standard test works well to estimate your risk and is less expensive.

3. When you have a cholesterol test, the bad cholesterol (LDL) is usually not measured. It is estimated from a calculation. For most people, this gives a good estimate of the bad cholesterol. However, some people require a special test because the calculation is not accurate for them. Unfortunately, this doubles the cost.

4. Cholesterol guidelines no longer advise lowering your cholesterol to a specific number. In the past, cholesterol guidelines advised lowering the bad cholesterol (LDL) below a target number, usually 100. The latest guidelines advise taking statins based on your risk of developing heart disease rather than your cholesterol levels.

5. Raising the good cholesterol (HDL) may not decrease your risk of heart disease. An HDL raising drug called torcetrapib was expected to generate billions of dollars in profit for Pitzer. Then a 2004 trial had to be stopped because more people died of heart attacks who were taking the drug than a placebo. The exact cause for this is unknown, but one explanation is a rise in blood pressure from the drug caused the increased number of deaths.

6. Some people (DuBroff) question if cholesterol lowering medications actually work. However, sound scientific reviews (Taylor) confirm their effectiveness. The most common cholesterol lowering medications, statins, have risks and benefits, but they do prevent heart attacks.

7. The first statin approved for use in the United States, lovastatin is found naturally in red rice yeast. Unfortunately, the cost of lowering cholesterol with this natural product is higher than the $4 a month cost of lovastatin.

8. If you are taking a statin, grapefruit can raise the level of the medication in your blood as much as 260 percent. Fortunately, this rise in medication levels, rarely causes serious problems.

9. A low cholesterol may not always help prevent heart attacks. After age 85 individuals with a high cholesterol are less likely to die from a heart attack. One explanation for this is older patients with low cholesterol are more likely to die because low cholesterol indicates poor nutrition.

10. There are many other proposed explanations for hardening of the arteries. This include inflammation and the bacteria in your intestine.

To summarize, preventing heart disease by lowering cholesterol is more complex than most people realize with many surprising facts.

References

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