Heart Disease and Cholesterol
By Ann-Marie Waters, Associate Editor.
What is cholesterol?
Cholesterol is an essential fat (known as a lipid) which is produced by the liver from the fatty foods we consume and is vital for health and normal body functioning. Although they are essential compounds, an excessively high level of lipids in your blood – a condition known as ‘hyperlipidemia’ can be disastrous to your long term heart health. Your risk of developing heart disease is increased, and it could lead to you suffering a heart attack or stroke.
What is High Cholesterol?
High cholesterol (Hypercholesterolemia) causes fatty deposits (known as plaques) to build up inside your blood vessels. Statistics show that approximately 2 in 3 adults possess cholesterol readings that are higher than the recommended level. High cholesterol causes these plaques to build up inside your blood vessels resulting in narrowing of the arteries, as you can see from the following graphic:
Symptoms of High Cholesterol?
A high cholesterol level may only become apparent if you develop symptoms of heart disease. Some people show physical symptoms such as yellowy patches (known as (xanthomas) which may develop around your eyes or elsewhere on your skin – these yellowy patches are ‘cholesterol deposits’ and indicate that you have higher than normal cholesterol levels in your blood as folllows:
Types of Cholesterol
There are three types of cholesterol – HDL (high-density lipoprotein), LDL (low-density lipoprotein), and VLDL (very low-density lipoprotein).
HDL (high-density lipoprotein
HDL is often referred to as ‘good cholesterol’, as it is thought to prevent arterial disease. This is because it takes cholesterol away from the cells and back to the liver, it is then either – broken down or is passed from the body as a waste product.
LDL (low-density lipoprotein
LDL is often referred to as bad cholesterol as it is known to increase arterial disease (build up of plaque in the arteries)) It carries cholesterol from the liver to the cells resulting in a harmful build up – thus causing the cells to have too much to break down – hence resulting in a build up of plaque.
VLDL (very low-density lipoprotein)
VLDL is also referred to as a ‘bad cholesterol’ as it contains the highest amount of ‘triglycerid’ (a blood fat); Triglycerides are found in dairy products, cooking oils, and red meat. Like LDL – VLDL cholesterol is considered as a type of bad cholesterol as elevated levels are also associated with coronary heart disease.
What are considered to be healthy cholesterol levels?
The ‘Joint British Societies’ which consists of a group of UK experts in cardiovascular disease recommend the following cholesterol limits for people who have coronary heart disease or who are at risk of developing it:
- Total cholesterol level – should be less than 4.0mmol/l
- LDL cholesterol level – should be less than 2.0mmol/l.
Whereas the United Kingdom National Institute for Health and Clinical Excellence (NICE) publish the following guidance for doctors:
- Total cholesterol level – less than 5.0mmol/l
- LDL cholesterol level – less than3.0mmol/l
However – the average cholesterol level in the UK is above normal, i.e. – 5.5mmol/l for men and 5.6mmol/l for women. Do these levels mean that you will go on to develop heart disease? Not entirely, as cholesterol levels need to be considered in accordance with an individual’s overall risk of heart disease. I.e. whether they have a genetic predisposition (one in 500 people has high cholesterol because of an inherited problem called familial hyperlipidaemia) smoke, have high blood pressure, are overweight, or have diabetes. Also, it is the balance of different types of lipoproteins that are present in the blood rather than the total cholesterol level that is really important.
How can I prevent having high cholesterol levels?
The first vital steps you can take in preventing a high cholesterol level or lowering it is to:
- Eat healthy
- Take regular exercise.
Healthy eating means cutting down on saturated and Trans fats. These should be re placed with unsaturated fats. There are also some foods that may help lower blood cholesterol levels such as – walnuts, oats, garlic, cinnamon, and soya. For more advice on healthy eating you can visit the British Heart Foundation website.
Can I fly after a Heart Attack, TIA, or Stroke?
By Ann-Marie Waters, Associate Editor.
There is no blanket ban on flying after a heart attack, TIA (transient ischaemic attack) or stroke but each airline has it’s own regulations regarding eligibility. The first step you need to take is to contact the PMCU (passenger medical clearance unit) they will advise you on your fitness to fly and assist you in filling out the necessary forms. Your medical clearance will be then considered on completion of the following medical information (MEDIF) forms. Part 1 is completed by yourself and part 2 and 3 by your Doctor. You need to return your medical form at least 3 weeks prior to your prospective flight to ensure that you receive medical clearance in time.
How can being in an aircraft cabin affect my illness or increase my risk?
The oxygen pressure in the aircraft cabin during flight is lower than at sea level. Blood Haemoglobin concentrations rise through a fall in the plasma volume due to dehydration. Haemoglobin concentrations may rise to 200 g/l and this increased viscosity of the blood along with increased coagulability can increase the risk of stroke and venous thromboembolism (blood clot). Also sitting in one position in the aircraft cabin over a long period and not drinking enough fluids (dehydration) can cause blood to coagulate (thicken) thus increasing the risk of blood clots forming. Therefore – getting up regularly, stretching and moving your legs and feet, and drinking plenty of fluids (preferably not alcohol as this causes dehydration!) will help to decrease your risk.
Flying after a Heart Attack
Generally – you can fly within 2 weeks after a heart attack but this will solely depend on your recovery time and progress, and whether you have suffered any further complications since the attack.
Flying after a Transient Ischemic Attack (TIA)
If you have suffered a transient ischaemic attack (TIA) you may be allowed to fly after a 10 day period but this is provided that you have made a complete recovery, and been given complete medical clearance.
Flying after a Stroke
Generally Doctors recommend waiting for at least 3 months before flying after suffering a stroke. This is due to a vulnerability and increased risk of developing deep venous thrombosis (DVT) or pulmonary embolism (PE). DVT is a condition in which a blood clot forms in a large vein in a muscle – this is normally in the leg or pelvic region. A serious risk occurs when a fragment of this clot breaks off and becomes lodged in a blood vessel which supply’s the lungs – resulting in a pulmonary embolism (PE).
People who have not suffered from a heart attack, TIA, or stroke are still at risk from developing a DVT during a flight. This risk can be decreased by wearing ‘compression stockings’ (also known as TED or thrombo-embolic deterrent stockings).
These are worn to maintain good circulation and reduce the risk of blood clots forming in leg veins. For further information about flight stockings you can obtain a factsheet from your health care provider.
Heart healthy red pepper soup with lime recipe
By Ann-Marie Waters, Associate Editor.
If you’re interested in looking after your heart health, and love tasty, delicious, home cooked food, why not try this quick and easy recipe for red pepper soup with lime ?
All sweet peppers (capsicums) contain a rich source of vitamins A, C, and K. However red peppers have the highest quantities of these anti-oxidant compounds that provide powerful anti-aging and immune system benefits. Red peppers are also a good source of the carotenoid called lycopene, which is believed to help in the prevention of prostate and bladder cancer as well as cancer of the cervix and pancreas.
This soup is low in calories, saturated fat, and salt, but high in fiber, with the added benefit of zero cholesterol!
Dietary Information:
Nutritional value per portion (serves 4-6)
- Energy – 87 calories
- Fat – 1.57g
- Saturated fat – 0.12g
- Cholesterol – 0
- Fibre – 3.40g.
Ingredients:
- 4 red peppers, seeded and chopped
- 1 large onion chopped
- 5ml/ 1tsp olive oil
- 1small red chilli, sliced
- 45ml/3 tbsp tomato puree
- 900ml/1.5 pints vegetable stock
- Finely grated rind and juice of 1 lime
- Black pepper
- Shreds of lime rind – to garnish.
Method:
1. Cook the onions and red peppers gently in the oil, in a covered saucepan for approximately 5 minutes.
2. Stir in the garlic then add the chilli with the tomato puree. Stir in half the stock then add to the boil. Cover the pan and simmer for 10 minutes.
3. Cool slightly, then puree in a food processor or blender. Return to the pan and add the remaining stock, lime juice and seasoning.
4. Bring the soup back to the boil and serve at once with a few strips of lime rind.
Authors tip:
I use Kallo organic very low salt vegetable stock cubes in place of conventional stock cubes.
Most well-known supermarkets stock these now. Lowering your dietary salt intake is important in helping to maintain healthy arteries, and prevent Atherosclerosis.
Atherectomy – leading edge device unclogs blocked arteries
by Ann-Marie Waters, Associate Editor.
An ultrasonic device tiny enough to navigate the arteries of the human heart, could enable doctors to perform a far safer job of cleaning cholesterol-laden plaque from the walls of the blood-vessels of heart disease patients.
The remote control device – developed by cardiologist Paul G. Yock from Stanford University school of medicine, is set to aid cardiologists from around the world in performing a technique known as ‘atherectomy’ (the removal of plaque from arteries supplying blood to the heart). The ultrasound guide is crucial in the prevention of cardiologists mistakenly cutting into normal blood vessel walls during the operation.
The new device emits sound waves that measure the thickness of the arterial plaque on the vessel wall – if it detects a large amount of plaque then an integral carbide cutting blade slides up the opening of the drill and shaves off a section of the plaque.
The drill can be used in patients with ‘peripheral arterial disease’ a painful condition of the legs commonly known as PAD. Dr. Paul Capito used the drill known as the Jetstream Pathway PV Atherectomy System for the first time on Oct 22nd 2008.
The most common symptom of PAD is pain in the calf muscles, thighs, or buttocks which is triggered by exertion such as walking and exercise. The sufferer’s arteries become narrower through the build up of plaque, preventing sufficient oxygenated blood from reaching the legs. The biggest risk factor for PAD is smoking. Other risk factors are: a lack of exercise, carrying excess weight, diabetes, and high blood pressure.
The potential benefits of this device are already becoming apparent. A recent trial in Germany concluded that 12 patients who used the device found that there was no recurrence of arterial blockages after six months. The procedure is also less invasive than conventional methods and can be repeated at a later date if necessary.