Saturday, May 21, 2011 | 9:23 am

The patches of atherosclerosis which protrude into the interior of arteries are accumulations of fats, cholesterol, and calcium, and scar tissue induced by such foreign substances. These patches, or plaques, are not entirely on the surface of the vessel but usually extend deep into the wall of the artery, so much so that if one were removed, the vessel wall would be thinner and weaker in that location.

Arterial plaques apparently begin to develop at an early age. During the Korean War, autopsies performed on United States soldiers who died of combat wounds revealed that 20 percent of these men in their early twenties already had significant amounts of atherosclerosis in their coronary arteries. Plaques have even been found in the coronary arteries of children under ten years of age. Women tend to develop these lesions at a later age than men, being protected by some unknown factor (female hormone – estrogen?) until after their menopause, at which time they accelerate the development of atherosclerotic plaques and almost catch up to men in the frequency of heart attacks. Heart attacks do occur in men in their twenties and early thirties, but are much more common in the forty to fifty age group.

Certain things appear to accelerate the development of atherosclerosis. Cigarette smokers have a definite increased risk. People who are overweight and sedentary have a greater risk. High blood pressure and diabetes are both factors that increase the risk and the likelihood of developing the disease at a younger age.

The word cholesterol is beginning to produce the same effect on some people as the mention of “Internal Revenue.” The two terms are probably equally maligned and misunderstood by the public. Cholesterol is a type of fat found in certain foods and also produced in the human body. Cholesterol has many important functions in the body, the most important being to supply the basic structure upon which body hormones are produced. Hormones are internal secretions which are essential for bodily function. Sex distinction is one hormonal effect.

In some diseases, such as hypothyroidism (inadequate production of thyroid hormone), an excess of cholesterol is produced by the body and there is also found an accelerated development of atherosclerosis. Certain scientific studies, particularly in Sweden, have demonstrated that an increased cholesterol content of the diet is associated with a higher death rate from myocardial infarction or heart attacks. From these facts and other information a hypothesis has developed that maybe cholesterol is an important culprit in the cause of atherosclerosis. Large-scale studies are underway in the United States at this time to attempt to define the relationship between diet, cholesterol, heart attacks, and death from blood vessel diseases, and to arrive at methods to achieve dietary and drug control of blood cholesterol levels.

Many questions remain to be answered. Several tentative conclusions can be drawn that time may substantiate. First, since the disease process appears to start very early in life, it makes a great deal more sense to consider altering the diet (and thereby, perhaps, the blood cholesterol) in children and young adults rather than in oldsters in whom the disease is far advanced and possibly irreversible. Second, certain persons are not able to handle cholesterol and fats as well as others, and blood tests are available which may be able to identify these higher-risk persons. These people may be benefited by more vigorous dietary plans or even certain drugs. Third, there are many other factors involved in the development of atherosclerosis besides cholesterol and diet, and undue emphasis cannot be placed on this single factor.

If a person has high blood cholesterol and other body fats, a low cholesterol diet may help correct the condition. The usual diet precludes egg yolks, butter, milk, cream, cheese, ice cream, meat fat, and shellfish. Some people, however, appear to produce cholesterol within their own bodies from simple sugars, such as those found in sugar, fruit, and alcoholic drinks. In general, obesity is associated with a higher cholesterol level, and one universal way to reduce blood cholesterol is through weight reduction to lean body size. A physician can best help the patient determine the group he fits in.


(posted in Cardio & Blood-Cholesterol)

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