Your Guide To The Cholesterol Hypothesis
Do you want to know what the cholesterol hypothesis really is and whether it is still valid after all these years? Here is some information that could be very useful to you!
Cholesterol, LDL cholesterol, Cholesterol drugs, HDL cholesterol, Statin cholesterol drugs.
Most cardiologists in the health community have long supported the “cholesterol hypothesis”. This hypothesis, simply put, is the belief that high LDL cholesterol levels are the proximate cause of atherosclerosis. Therefore, improving high LDL cholesterol levels is an important step in reducing the risk of atherosclerotic cardiovascular disease.
In fact, health experts have been stressing the importance of dietary changes to improve cholesterol levels for many years. On the other hand, the pharmaceutical establishment has invested billions of dollars in the development and testing of cholesterol drugs.
As a result, the cholesterol hypothesis has taken root not only among health professionals but also among the general public.
It may be surprising, therefore, to hear many cardiologists questioning the validity of this hypothesis. Although this debate is largely a closed-door affair among professionals, this does not detract from the relevance and vitality of the topic. For example, despite what some of the most prominent health experts have publicly stated, the cholesterol hypothesis is not a well-established science.
What exactly is the cholesterol hypothesis?
The cholesterol hypothesis is based on two important premises. The first premise is that, according to pathologists, cholesterol deposition in the body is a major component of atherosclerotic plaque. Secondly, epidemiological studies have shown that people with high cholesterol levels are at increased risk of cardiovascular disease.
Similarly, in randomized clinical trials conducted in the 1990s, people with high cholesterol did better when treated with statins. All of this helped prove to cardiologists and other health professionals that the cholesterol hypothesis is indeed valid.
What new doubts have emerged about the cholesterol hypothesis?
Over time, however, the validity of the cholesterol hypothesis has come into question. This was mainly due to the fact that people accepted that multiple clinical trials of drugs other than statins showed no significant improvement.
Therefore, if the cholesterol hypothesis was correct, these people would have experienced significant improvement regardless of the cholesterol-lowering medication they were taking.
However, this has not been observed to be the case. More specifically, studies in which people received drugs other than statins, such as niacin, fibrates, PEC inhibitors, etc., did not show improvements in cardiovascular outcomes.
Thus, it could be argued that in clinical trials of cholesterol-lowering, cardiovascular outcomes are only improved when individuals receive statins. All of this casts serious doubt on the credibility of the cholesterol hypothesis.
It is also important to mention here that these doubts were made public in 2013 in the form of a publication. This publication cites new cholesterol control guidelines that focus on the population that should be treated with statins. In fact, for many people, these new guidelines warn against the use of non-state medications to lower high cholesterol levels. As a result, these new guidelines move away from the classic cholesterol hypothesis and have caused much controversy in the medical community.
What is the reason for the complete abandonment of the cholesterol hypothesis?
The rationale for the complete abandonment of the cholesterol hypothesis is that if high levels of LDL cholesterol are the direct cause of atherosclerosis, then lowering these LDL cholesterol levels with any type of drug should improve cardiovascular outcomes by default. However, this result has not been observed after several randomized clinical trials of cholesterol-lowering. Therefore, the cholesterol hypothesis must be wrong.
But one might ask, what about statins? To answer the question: Statins do not improve cardiovascular risk by lowering high cholesterol levels alone. Instead, they do so through other non-cholesterol-related effects.
What is the rationale for modifying the cholesterol hypothesis?
On the other hand, some health experts are strongly opposed to abandoning the focus on cholesterol levels. In fact, they have the idea that cholesterol will always be important regardless of how one chooses to lower cholesterol levels in relation to cardiovascular disease.
To further clarify this statement, arterial plaque contains cholesterol. And when you work to lower the high levels of LDL cholesterol in your body, the process of atherosclerosis is reduced to some extent. So it would be unwise to completely ignore the importance of cholesterol levels and the cholesterol hypothesis.
What should I focus on in my review of the cholesterol hypothesis?
It is already clear that cholesterol is necessary for the formation of arterial plaque in the body. It is also clear that if high LDL cholesterol is associated with the risk of developing atherosclerosis, it is not just a matter of blood levels.
In fact, not all people with high LDL cholesterol levels develop atherosclerosis, and not all people with atherosclerosis have high LDL cholesterol levels. Thus, it tells us that it is not only the level of cholesterol in the blood that plays a role, but also the type of lipoprotein particles and their behavior.
Therefore, the newly revised cholesterol hypothesis should take into account the elements of LDL, HDL, lipoproteins and their behavior.
In summary, we can see that the classical cholesterol hypothesis, which treats cholesterol levels as the sole determinant of cardiovascular disease, is rather limited and simplistic. As a result, health professionals find themselves in an unknown place where the hypothesis once held true.
From this point of view, therefore, we must keep in mind that significant lifestyle changes and medications prescribed for the treatment of coronary heart disease have great benefits. However, you must be careful not to interrupt your treatment without first talking to your doctor.