This Rogue Form of Cholesterol Is Often Overlooked… and Deadly

oxLDL: Your best predictor for heart disease

Heart With StethoscopeThis article originally appeared on Live in the Now.

If your cholesterol levels are normal, you probably think you’re safe from a heart attack. Well, it might surprise you to learn that may not be the case.

A large national study released awhile back found that nearly 75% of patients hospitalized for heart attack had LDL cholesterol levels that fell squarely within the recommended targets. What’s more, almost half of these patients had ideal levels of LDL.

The truth is, LDL isn’t some sort of deadly poison circulating through your bloodstream.

Rather, these low density lipoproteins (LDL) transport cholesterol from your liver to the cells in your body where it’s needed for all sorts of functions. Cholesterol is necessary for making hormones. It helps your body make vitamin D and protects cell membranes.

In other words, LDL cholesterol, in its natural state, is critical to your good health.

Cholesterol May Not Be the Enemy, But This Type of Cholesterol Shouldn’t Be Ignored

The question, of course, is why are people with healthy cholesterol levels having all of these heart attacks?

It turns out that there’s a form of rogue LDL that doctors often overlook. It’s called oxidized LDL, or oxLDL. These damaged LDL particles are the ones that are deadly.

They easily slip into the inner linings of your arteries where they set up house. This triggers an inflammatory reaction, causing white blood cells (macrophages) to rush in to clean up these pockets of harmful oxLDL.

But there’s a problem. As the white blood cells accumulate, they tend to clump together and stick to the walls of your blood vessels. Over time, they develop into a plaque that narrows your arteries and makes them less flexible.

This, of course, reduces blood flow and could lead to a stroke or heart attack.

And here’s the real kicker: A typical LDL test can’t tell the difference between healthy LDL cholesterol and oxLDL.

oxLDL: Your Best Predictor for Heart Disease

When it comes to your risk of heart disease, your most important number is oxLDL. It can literally predict certain health outcomes.

For example, people with the highest levels of oxLDL have a four times higher chance of heart disease than those with the lowest levels. And the higher your levels, the more severe the disease.

You can find out what your oxLDL level is by asking your doctor to test you for it. All it takes is a blood sample, so it’s relatively non-invasive.

If your number falls below 60U/L you’re in good shape. Sixty to 69 places you at moderate risk, and if the number is 70U/L or higher, your risk of heart disease is highly elevated.

What to Do If Your Levels Are High

Foods that are fried, processed or sugary all contribute to the development of damaged LDL cholesterol. So does smoking and excess alcohol consumption. Diabetics also tend to have more oxLDL than people without the disease.

With this in mind, your best bet is to eat more antioxidant-rich fruits and vegetables that can help reverse some of the damage. In as little as two weeks a diet high in these plant-based foods can increase resistance to LDL oxidation up to 28%.

Adding more healthy, omega-3 fish to your diet can help protect against oxLDL, too. Eicosapentanoic acid (EPA), in particular, appears to prevent LDL oxidation and help clear oxLDL from the body.

Other heart-healthy habits, like regular physical activity, controlling your stress levels and getting at least seven hours of sleep each night can also help shield your LDL cholesterol from oxidation.

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Meisinger C, et al. Plasma oxidized low-density lipoprotein, a strong predictor for acute coronary heart disease events in apparently healthy, middle-aged men from the general population. Circulation. 2005 Aug 2;112(5):651-7.

Ehara D et al. Elevated levels of oxidized low density lipoprotein show a positive relationship with the severity of acute coronary syndromes. Circulation. 2001;103:1955-1960.

OxLDL. Cleveland Heartlab. Feb 2013.

Hininger I, et al. Effect of increased fruit and vegetable intake on the susceptibility of lipoprotein to oxidation in smokers. Eur J Clin Nutr. 1997 Sep;51(9):601-6.

Garrido-Sánchez L, et al. Inverse relation between levels of anti-oxidized-LDL antibodies and eicosapentanoic acid (EPA). Br J Nutr. 2008 Sep;100(3):585-9.

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