MadSci Network: Medicine
Query:

Re: Coronary artery disease and LOW blood cholesterol?

Date: Tue Jan 23 09:48:20 2001
Posted By: David Burton, Post-doc/Fellow, Physiology, University of Oxford
Area of science: Medicine
ID: 979178161.Me
Message:

Hello Terry,

	Coronary artery disease is caused by the formation of 
atherosclerotic plaques in the coronary arteries that restrict blood flow 
and may lead to thrombosis, where the plaque ruptures and a blood clot 
forms.  These clots further restrict the artery and may break off and 
completely block the artery further down.  These are the reasons for chest 
pain known as angina where the flow of blood is restricted and more 
seriously myocardial infarction when an artery becomes blocked.

	It is generally accepted by almost everyone in the field that 
cholesterol is a crucial element during the first stages in the formation 
of an atherosclerotic plaque.  Therefore, elevated cholesterol levels are 
an important RISK FACTOR in the development of atherosclerotic plaques.  
The most important thing about the development of this disease is that it 
is associated with a large number of different risk factors.  Risk factors 
are environmental or genetic factors that affect your chances of getting 
the disease.

	The most obvious risk factor in this disease is high levels of 
cholesterol or more specifically low density lipoproteins (LDLs).  High 
fat, high cholesterol diets are usually required for the development of 
atherosclerosis in experimental animals.  Other important risk factors 
associated with atherosclerosis and coronary heart disease are: elevated 
blood pressure; family history of atherosclerosis; diabetes; smoking; lack 
of exercise; and reduced levels of high density lipoproteins (HDLs), which 
protect against the formation of atherosclerotic plaques.

	Therefore, I am afraid to say that under certain circumstances, it 
is possible for people with normal levels of cholesterol to get 
atherosclerosis and coronary artery disease.  However, by keeping 
cholesterol levels low the likelihood of getting the disease is very much 
reduced and reducing cholesterol levels once someone has the disease 
significantly improves their prognosis, especially if this is done whilst 
concurrently reducing other risk factors such as stopping smoking and doing 
more exercise.

	Thank you for your question.

David Burton  Ph.D.



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