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Hypercholesterolemia

Hypercholesterolemia, also called high cholesterol, is the presence of high levels of cholesterol in the blood. It is a form of high blood lipids and hyperlipoproteinemia (elevated levels of lipoproteins in the blood).

Elevated levels of non-HDL cholesterol and LDL in the blood may be a consequence of an unhealthy diet, obesity, inherited (genetic) diseases (such as LDL receptor mutations in familial hypercholesterolemia), or the presence of other diseases such as type 2 diabetes and an underactive thyroid.

Cholesterol is one of three major classes of lipids which all animal cells use to construct their membranes and is thus manufactured by all animal cells. Plant cells do not manufacture cholesterol. It is also the precursor of the steroid hormones and bile acids. Since cholesterol is insoluble in water, it is transported in the blood plasma within protein particles (lipoproteins). Lipoproteins are classified by their density: very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL), low density lipoprotein (LDL) and high density lipoprotein (HDL). All the lipoproteins carry cholesterol, but elevated levels of the lipoproteins other than HDL (termed non-HDL cholesterol), particularly LDL-cholesterol, are associated with an increased risk of atherosclerosis and coronary heart disease. In contrast, higher levels of HDL cholesterol are protective.

Avoiding trans fats and replacing saturated fats in adult diets with polyunsaturated fats are recommended dietary measures to reduce total blood cholesterol and LDL in adults. In people with very high cholesterol (e.g., familial hypercholesterolemia), diet is often not sufficient to achieve the desired lowering of LDL, and lipid-lowering medications are usually required. If necessary, other treatments such as LDL apheresis or even surgery (for particularly severe subtypes of familial hypercholesterolemia) are performed. About 34 million adults in the United States have high blood cholesterol.

  • Association between consumption of yerba mate and lipid profile in overweight women

    Abstract Title:

    [Association between consumption of yerba mate and lipid profile in overweight women].

    Abstract Source:

    Nutr Hosp. 2019 Oct 15. Epub 2019 Oct 15. PMID: 31610673

    Abstract Author(s):

    María Virginia AvenaÁlvarez, Diego Nicolás Messina, Carla Corte, Jessica Anabella Mussi Stoizik, Aldana Saez, Paola Boarelli, Rafael Pérez Elizalde

    Article Affiliation:

    María Virginia AvenaÁlvarez

    Abstract:

    INTRODUCTION:yerba mate is a traditional drink consumed in South America, produced from toasted leaves of Ilex paraguariensis. Several studies have demonstrated its lipid-lowering properties due to the presence of polyphenols and saponins.

    OBJECTIVE:to analyze the effect of daily yerba mate consumption on the values of serum lipids and body composition in overweight women.

    METHODS:119 overweight women between 25 and 50 years were divided into three groups: Mate and Diet (MD), Mate without Diet (M), and Water and Diet (AD). For 12 weeks the M and MD groups were supplemented with mate, while the AD and MD groups maintained a hypocaloric food plan. Anthropometric measurements and blood tests (total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) were taken at the beginning and at the end of the study. The statistical analysis was performed using Student's t-test or Wilcoxon's test for paired samples and ANOVA (p<0.05 was considered significant in all cases).

    RESULTS:total cholesterol decreased in all groups (10.21 mg/dL in MD, 18.29 mg/dL in M, and 17.63 mg/dL in AD, without differences between groups). LDL-cholesterol decreased in both groups with mate (8.07 mg/dL in MD, 16.04 mg/dL in M, without differences between groups) while HDL-cholesterol decreased in M (2.09 mg/dL). On the other hand, triglycerides fell 10.74 mg/dL in the MD group.

    CONCLUSIONS:a daily intake of mate helps reduce total cholesterol and LDL-cholesterol, and provides a reduction of triglycerides along with a low-calorie diet.

  • Berberine is a novel cholesterol-lowering drug working through a unique mechanism distinct from statins.

    Abstract Title:

    Berberine is a novel cholesterol-lowering drug working through a unique mechanism distinct from statins.

    Abstract Source:

    Nat Med. 2004 Dec;10(12):1344-51. Epub 2004 Nov 7. PMID: 15531889

    Abstract Author(s):

    Weijia Kong, Jing Wei, Parveen Abidi, Meihong Lin, Satoru Inaba, Cong Li, Yanling Wang, Zizheng Wang, Shuyi Si, Huaining Pan, Shukui Wang, Jingdan Wu, Yue Wang, Zhuorong Li, Jingwen Liu, Jian-Dong Jiang

    Abstract:

    We identify berberine (BBR), a compound isolated from a Chinese herb, as a new cholesterol-lowering drug. Oral administration of BBR in 32 hypercholesterolemic patients for 3 months reduced serum cholesterol by 29%, triglycerides by 35% and LDL-cholesterol by 25%. Treatment of hyperlipidemic hamsters with BBR reduced serum cholesterol by 40% and LDL-cholesterol by 42%, with a 3.5-fold increase in hepatic LDLR mRNA and a 2.6-fold increase in hepatic LDLR protein. Using human hepatoma cells, we show that BBR upregBerberineulates LDLR expression independent of sterol regulatory element binding proteins, but dependent on ERK activation. BBR elevates LDLR expression through a post-transcriptional mechanism that stabilizes the mRNA. Using a heterologous system with luciferase as a reporter, we further identify the 5' proximal section of the LDLR mRNA 3' untranslated region responsible for the regulatory effect of BBR. These findings show BBR as a new hypolipidemic drug with a mechanism of action different from that of statin drugs.

  • Dose-response associations between cycling activity and risk of hypertension in regular cyclists: The UK Cycling for Health Study📎

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    Abstract Title:

    Dose-response associations between cycling activity and risk of hypertension in regular cyclists: The UK Cycling for Health Study.

    Abstract Source:

    J Hum Hypertens. 2015 Apr ;29(4):219-23. Epub 2014 Oct 2. PMID: 25273856

    Abstract Author(s):

    M Hollingworth, A Harper, M Hamer

    Article Affiliation:

    M Hollingworth

    Abstract:

    Most population studies on physical activity and health have involved largely inactive men and women, thus making it difficult to infer if health benefits occur at exercise levels above the current minimum guidelines. The aim was to examine associations between cycling volume and classical cardiovascular risk markers, including hypertension and hypercholesterolemia, in a population sample of habitual cyclists. A nationwide sample comprising 6949 men and women (aged 47.6 years on average) completed questions about their cycling levels, demographics and health. Nearly the entire sample (96.3%) achieved the current minimum physical activity recommendation through cycling alone. There was a dose-response association between cycling volume and risk of diagnosed hypertension (P-trend =0.001), with odds ratios of 0.98 (95% confidence interval (CI), 0.80-1.21), 0.86 (0.70, 1.06), 0.67 (95% CI, 0.53-0.83) across categories of 23-40, 40-61 and>61 metabolic equivalent hours/week (MET-h/week) compared with<23 MET-h/week. These associations persisted in models adjusted for age, sex, smoking, alcohol, body mass index (BMI) and other moderatevigorous physical activities. We also observed inverse associations between cycling volume and other risk factors including BMI and hypercholesterolemia. In summary, results from a population sample of cyclists suggest that additional cardiovascular health benefits can be achieved beyond the current minimum physical activity recommendation.

  • Effect of increased magnesium intake on plasma cholesterol, triglyceride and oxidative stress in alloxan-diabetic rats.

    Abstract Title:

    Effect of increased magnesium intake on plasma cholesterol, triglyceride and oxidative stress in alloxan-diabetic rats.

    Abstract Source:

    Afr J Med Med Sci. 2007 Jun;36(2):155-61. PMID: 19205579

    Abstract Author(s):

    L A Olatunji, A O Soladoye

    Abstract:

    Cardiovascular disorders are the primary causes of morbidity and mortality in patients with diabetes mellitus (DM). Agents that improve lipid profile and reduce oxidative stress have been shown to reduce the ensuing risk factors. In the present study, we investigated whether increased magnesium intake could improve hyperglycaemia, dyslipidaemia, and reduce oxidative stress in alloxan-induced diabetic rats. Male Wistar rats were divided into non-diabetic (ND), diabetic (DM) and diabetic fed on a high magnesium diet (DM-Mg) groups. Plasma concentrations of thiobarbituric acid reactive substances (TBARS) were used as markers of oxidative stress. Plasma levels of ascorbic acid, magnesium and calcium were also determined. Diabetes was induced by injecting alloxan (100 mg/kg B.W). The fasting blood glucose levels were significantly lower in the DM-Mg rats than in the DM rats. Plasma total cholesterol, triglyceride, TBARS levels were significantly higher while plasma HDL-cholesterol, HDL-cholesterol/total cholesterol ratio, ascorbic acid levels were significantly lowered in DM rats compared with the ND rats. Increased intake of magnesium significantly abrogated these alterations. There were no significant differences in the plasma levels of magnesium and calcium between the DM and ND groups. However, plasma levels of magnesium but not calcium were significantly elevated in DM-Mg rats when compared with other groups. In conclusion, these results suggest that diet rich in magnesium could exert cardioprotective effect through reduced plasma total cholesterol, triglyceride, oxidative stress and ameliorated HDL-cholesterol/total cholesterol ratio as well as increased plasma ascorbic acid and magnesium in diabetic rats.

  • Effects of Vegetarian Diets on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials📎

    Abstract Title:

    Effects of Vegetarian Diets on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Abstract Source:

    J Am Heart Assoc. 2015 ;4(10). Epub 2015 Oct 27. PMID: 26508743

    Abstract Author(s):

    Fenglei Wang, Jusheng Zheng, Bo Yang, Jiajing Jiang, Yuanqing Fu, Duo Li

    Article Affiliation:

    Fenglei Wang

    Abstract:

    BACKGROUND:Vegetarian diets exclude all animal flesh and are being widely adopted by an increasing number of people; however, effects on blood lipid concentrations remain unclear. This meta-analysis aimed to quantitatively assess the overall effects of vegetarian diets on blood lipids.

    METHODS AND RESULTS:We searched PubMed, Scopus, Embase, ISI Web of Knowledge, and the Cochrane Library through March 2015. Studies were included if they described the effectiveness of vegetarian diets on blood lipids (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride). Weighted mean effect sizes were calculated for net changes by using a random-effects model. We performed subgroup and univariate meta-regression analyses to explore sources of heterogeneity. Eleven trials were included in the meta-analysis. Vegetarian diets significantly lowered blood concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol, and the pooled estimated changes were -0.36 mmol/L (95% CI -0.55 to -0.17; P<0.001), -0.34 mmol/L (95% CI -0.57 to -0.11; P<0.001), -0.10 mmol/L (95% CI -0.14 to -0.06; P<0.001), and -0.30 mmol/L (95% CI -0.50 to -0.10; P=0.04), respectively. Vegetarian diets did not significantly affect blood triglyceride concentrations, with a pooled estimated mean difference of 0.04 mmol/L (95% CI -0.05 to 0.13; P=0.40).

    CONCLUSIONS:This systematic review and meta-analysis provides evidence that vegetarian diets effectively lower blood concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol. Such diets could be a useful nonpharmaceutical means of managing dyslipidemia, especially hypercholesterolemia.

  • Hypercholesterolemia

    Hypercholesterolemia, also called high cholesterol, is the presence of high levels of cholesterol in the blood. It is a form of high blood lipids and hyperlipoproteinemia (elevated levels of lipoproteins in the blood).

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