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High Cholesterol Message Board


High Cholesterol Board Index


[QUOTE=Mark1e;3413482]I keep on reading about "experts" saying this. But I haven't seen a study that actually supports it. I would like to see such a study, if you could point me in the right direction.

The theory is that small LDL particles are able to penetrate the endothelium in major arteries and are used in forming plaque deposits. The counter arguement is, if artery walls are inflammed, suitable LDL particles will be sourced regardless of the number and size of LDL particles circulating in the bloodstream. A number of butresses have been thrown up to support the crumbling lipid hypothesis cathedral. And the question in my mind is, could the particle size arguement just be one of them?[/QUOTE]

Unfortunately we can't post forum links here, so I can't give you any direct links to studies. But I know of an impaired endothelium dysfuntion study and remember reading a coronary artery study a while ago, which put the blame on small LDL. I also know a lot of cardiologists consider small LDL a big culprit in coronary disease, including Dr. Davis, of 'Track your plaque' fame. I think the idea is that large LDL can't fit so well into the endothelium, so even if it's inflamed, LDL won't cause plaque. If this is true or not... *shrugs* not sure.

But you do have an interesting argument, that if one's arteries are inflamed, it won't matter as to the size of the particles, which I admit could be possible for all I know, as I'm not a super expert or anything. I think one of the other problems with small LDL is that it generally has a bunch of lousy friends with it too: high tryglycerides, low HDL and a very carbohydrate-heavy diet. A person with such a pattern, who changed their diet, increased exercise, etc could probably shift their LDL to large, lower triglycerides, etc.

Maybe small LDL is a marker for inflammation then, due to diet, lifestyle, or genetics that would put a person at a greater risk for heart disease? Although one could then say if this small LDL isn't corrected, inflammation still exists and a statin could be helpful (maybe just for anti-inflammatory reasons).
I have been wondering a lot lately since my Doctor has put me on Niacin if HDL is now becoming more important than previously thought? They say the higher ones HDL the better despite having higher than average LDL. I see many on the board do not need medication as their HDL is high and have low triglycerides as well. This can go with this statin debate. Can we count on an old stand bye like Niacin? It seems that Niacin offers some protection? I am just awfully confused. :confused:
[QUOTE=Arizona77;3417481]I have been wondering a lot lately since my Doctor has put me on Niacin if HDL is now becoming more important than previously thought? They say the higher ones HDL the better despite having higher than average LDL. I see many on the board do not need medication as their HDL is high and have low triglycerides as well. This can go with this statin debate. Can we count on an old stand bye like Niacin? It seems that Niacin offers some protection? I am just awfully confused. :confused:[/QUOTE]

Your post prompted me to do a bit of research on Niacin and I would strongly recommend you to do the same. It seems that Niacin can cause liver damage in certain cases but it is considered to be an effective medication for raising HDL levels. Apparently, it can also inhibit the effectiveness of statins in lowering LDL if taken at the same time. However, as you have said, it also seems that raising HDL is now considered more important that lowering LDL in cases where the LDL level is not sky high.
I shall certainly take this up with my doctor so many thanks for the tip.





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