It all started with 'high cholesterol', then came the 'good' and the 'bad' cholesterols. Now we have the last member of the notorious trio: the 'ugly cholesterol'.
The risk of ischaemic heart disease -- the leading cause of death worldwide -- is three times higher in persons with high levels of the so-called 'ugly' cholesterol. This is the finding of a new study of 73,000 Danes, which is shedding light on a long debate on this topic. The results have just been published in the Journal of the American College of Cardiology.
Most individuals believe that high cholesterol is life-threatening (despite all the evidence to the contrary). And many 'know' which type of cholesterol is the most frequent killer -- the 'bad' one, LDL -- or is it just the small, dense LDL and not the fluffy stuff.
Up until now, cholesterol has been divided into 'the good' HDL cholesterol, 'the bad' LDL cholesterol, with all the other sub-fractions, IDL, VLDL, etc, not getting a look in.
But now another 'cholesterol' has turned up in the mix: 'the ugly' cholesterol AKA 'remnant cholesterol'. And this one, it seems, is the really bad guy.
Professor Børge Nordestgaard, Chief Physician at Copenhagen University Hospital and Clinical Professor at the Faculty of Health and Medical Sciences at University of Copenhagen says:
"LDL cholesterol or 'the bad' cholesterol' is of course bad, but our new study reveals that the ugly cholesterol likewise is the direct cause of atherosclerosis resulting in ischemic heart disease and early death. By examining 73,000 persons, we found that an increase in the ugly cholesterol triples the risk of ischemic heart disease, which is caused by lack of oxygen to the heart muscle due to narrowing or blocking of the coronary arteries"
"I hope that this new knowledge will lead to better preventive treatment including lifestyle changes, as more than one in five individuals in affluent countries suffers from high ugly cholesterol. We also hope that the pharmaceutical industry will develop new drugs targeted specifically at raised ugly cholesterol levels"
So, what is ugly cholesterol?
"Ugly cholesterol is the result of high blood levels of normal fat (triglycerides)," says Børge Nordestgaard. "The most important cause of high ugly cholesterol is overweight and obesity. Persons with high ugly cholesterol should therefore be advised to lose weight, but drugs such as statins and fibrates may also lower levels of ugly cholesterol in the blood."
Samples from 73,000 Danes with mutations
Anette Varbo, physician and PhD student at Copenhagen University Hospital, Was part of the research team behind the new findings. She says that the findings shed light on a long-standing debate among researchers on the so-called triglycerides, atherosclerosis and cholesterol. She says:
"To be able to examine the relationship between ugly cholesterol and heart disease, we have used blood samples from persons having a mutation which means that they suffer from high ugly cholesterol their entire life. The research findings do therefore not depend on their lifestyle patterns in general. Unhealthy lifestyle factors such as smoking, fatty foods and overweight all increase the risk of heart disease, and the blood samples from persons having these mutations thus give the most accurate results"
So, another good reason to watch your weight, it seems. And the best way to do that is with a low-carb, high-fat diet.
Patents on statins are running out. What's the betting that BigPharma will now search for new drugs, or revamp existing ones for this 'new' use. And when those patents run out, no doubt there will be another 'cholesterol' discovered, and then another, and so on . . . until we have The Magnificent Seven.
1. Anette Varbo, Marianne Benn, Anne Tybjærg-Hansen, Anders B. Jørgensen, Ruth Frikke-Schmidt, Børge G. Nordestgaard. Remnant Cholesterol as a Causal Risk Factor for Ischemic Heart Disease. Journal of the American College of Cardiology, 2012; DOI: 10.1016/j.jacc.2012.08.1026