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Cholesterol isn’t the problem in Heart Disease; Inflammation is

Inflammation grabbed the attention of researchers a couple of decades ago as a primary culprit in the progression of cardiovascular diseases.

July 24, 2023

Inflammation grabbed the attention of researchers a couple of decades ago as a primary culprit in the progression of cardiovascular diseases.

Inflammation grabbed the attention of researchers a couple of decades ago as a primary culprit in the progression of cardiovascular diseases. Recent research has revealed that inflammation plays a crucial role in the development of chronic diseases, including heart disease, atherosclerosis and coronary artery disease. With the Seven Countries Study, dietary cholesterol and the levels of serum cholesterol in relation to the development of chronic diseases have been demonized to some extent. However, the principles of the Mediterranean diet and relevant data linked to the examples of people living in the five blue zones demonstrate that the key to longevity and the prevention of chronic disease development is not the reduction of dietary or serum cholesterol but the control of systemic inflammation.

How does oxidized LDL cause the building up of plaque and inflammation?

Long vilified as the chief trigger for heart disease, cholesterol is actually an essential component in almost every cell of our body and it has a very significant role in the promotion of health and our well-being. 80% of the heart attacks occur in the people with normal cholesterol level but once our native LDL cholesterol is oxidized, the inflammatory process is triggered and eventually leads to the development of atherosclerotic plaques. Our immune system may mistake oxidized cholesterol for bacteria and then tries to fight it off, which can cause inflammation inside the arterial wall. This can lead to atherosclerosis or heart disease. Oxidized LDL is considered as one of the major contributors of atherosclerosis lesion.  The macrophage has the ability to recognize ox-LDL leading to the formation of foam cells, a characteristic feature of atherosclerotic lesions. It has been shown that the highly oxidized LDL is resistant to lysosomal degradation, leading to its accumulation in the macrophages; as a result, foam cells with pro-inflammatory properties are formed. Surprisingly, native LDL is not taken up by macrophages.

Steps in atherosclerotic plaque formation.

  • Low density lipoprotein (LDL) accumulation in the intima
  • Oxidation of LDL
  • Recruitment of monocytes-macrophages
  • Uptake of oxidized LDL by macrophage scavenger receptors and transformation of macrophages into foam cells
  • Formation of a fibrous cap containing smooth muscle cells, which permits stabilization of the plaque.

Prevention and Cure

Adopting and adapting oneself to an anti-inflammation diet is the best strategy to counter the raging cardiovascular incidences in our country.

Inflammation grabbed the attention of researchers a couple of decades ago as a primary culprit in the progression of cardiovascular diseases.

Inflammation grabbed the attention of researchers a couple of decades ago as a primary culprit in the progression of cardiovascular diseases. Recent research has revealed that inflammation plays a crucial role in the development of chronic diseases, including heart disease, atherosclerosis and coronary artery disease. With the Seven Countries Study, dietary cholesterol and the levels of serum cholesterol in relation to the development of chronic diseases have been demonized to some extent. However, the principles of the Mediterranean diet and relevant data linked to the examples of people living in the five blue zones demonstrate that the key to longevity and the prevention of chronic disease development is not the reduction of dietary or serum cholesterol but the control of systemic inflammation.

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