Cholesterol tests: what we miss all the time

UNITED STATES, WASHINGTON (OBSERVATORY) — When talking about the dangers of cholesterol, they usually mean the so-called “bad cholesterol” or low density lipoproteins (LDL).

However, new studies by specialists at the University Hospital of Copenhagen show that one more indicator, the so-called “residual cholesterol,” which is no less dangerous, should be measured and taken into account.

Indeed, the cholesterol concept has recently undergone some changes. Now they take into account not only “bad” and “good”, but also “bad” cholesterol (good, bad and ugly). The latter, like LDL cholesterol, is associated with an increased risk of myocardial infarction and stroke.

Using modern technology known as metabolomics, scientists have proven that the cholesterol content in fatty particles of blood consists of equal proportions of all three types of cholesterol.

Where did the third come from? Everything is simple. “Evil” or “residual” cholesterol refers to the cholesterol content in triglyceride-rich lipoproteins or residual particles. Currently, the easiest way to determine the level of “evil” cholesterol is by analyzing blood triglycerides.

In 2018, a large international controlled clinical trial was published, which showed that with a decrease in triglycerides (and, consequently, residual cholesterol) with drugs, the risk of cardiovascular disease decreased by an average of 25%.

“These results indicate that the prevention of myocardial infarction and stroke should be aimed not only at lowering the level of bad LDL cholesterol, but also at lowering residual cholesterol or triglycerides. Until now, both cardiologists and general practitioners have focused on LDL cholesterol, but in the future we should change tactics, ”says Professor Borge Nordestgaard from the University of Copenhagen

According to Nordestgaard, the most important thing that can be done to achieve the lowest possible level of residual cholesterol and triglycerides in the blood without the use of drugs is to maintain a normal body weight.


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