Why won't your cholesterol come down? Start by understanding what LDL and HDL do

The hidden killer of vascular health

Cholesterol has long been a topic everyone pays attention to. In the effort to control it, people examine their food under a magnifying glass, searching for what helps bring cholesterol down and what sends it out of control. Eggs went from forbidden to permitted; seafood and organ meats inspire fear. The belief is that eating cholesterol must make things worse, so every meal is approached carefully, and the moment the rule is broken the worrying starts. What a difficult way to live.

"You may have misunderstood cholesterol. Your body needs it, and lower is not always better."

Here is a secret: cholesterol is nowhere near as frightening as you imagine. It is in fact an ally, helping repair cell membranes, manufacture important hormones and vitamin D, and even protect your nerve cells.

The formation of a thrombus is a long process, and the marker we should be watching constantly is not cholesterol. It is the earliest detectable indicator of inflammatory damage to the vascular endothelium during that process, and the earliest risk marker for arteriosclerosis: oxidized low-density lipoprotein [1].

LDL is responsible for transporting cholesterol around the body, but once oxidized — under the influence of free radicals and oxidative stress — it does far greater damage to the vascular endothelium. It is that modification which casts it as the prime culprit in atherosclerosis.

"OxLDL represents the main culprit in current theories of atherosclerosis"[2]

The link between oxidized LDL and cardiovascular disease has been confirmed in a large body of research. The presence of oxLDL is related to the development of atherosclerosis, particularly plaque formation in the vessel wall and arterial hardening. As oxLDL accumulates in the vessel wall it triggers an inflammatory response, drawing white blood cells into the wall and forming plaque. That plaque gradually grows, obstructing the vessel and ultimately leading to cardiovascular disease such as heart attack and stroke.

So stop putting all the focus on cholesterol. Your blood sugar and your inflammation are what really matter. High blood sugar and an excess of free radicals are the cause of LDL accumulating in the vessels — not high cholesterol. Once that causal relationship is clear, you can see that cholesterol is there to repair inflamed vascular cells. Accumulated cholesterol is the result, not the cause.

Let us reposition cholesterol in our minds. It is not your enemy but your body's ally. Oxidized LDL is the culprit running riot through your vessels. So stop complaining that your cholesterol will not leave you alone, and focus instead on controlling blood sugar, lowering inflammation and maintaining good vascular health. That is how you make oxidized LDL disappear from your body.

"Protecting vascular health is the key to protecting health overall"

The hidden culprits behind arteriosclerosis (part two)

References

[1]Overview of OxLDL and Its Impact on Cardiovascular Health: Focus on Atherosclerosis Front Pharmacol. 2020; 11: 613780.

[2] REVIEW article Front. Cardiovasc. Med., 01 June 2022 Sec. Cardiovascular Therapeutics Volume 9 - 2022