Cholesterol is a natural substance found in the blood. It is essential for the normal functioning of the body’s cells and for the production of hormones, vitamin D, and bile acids which help the body digest fat.

However, high levels of cholesterol can increase the risk of developing heart disease and stroke, which are the leading causes of death worldwide.

Types of Cholesterol

There are two types of cholesterol: low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.

LDL cholesterol is often referred to as “bad cholesterol” because it can lead to the buildup of plaque in the arteries, which can lead to heart disease and stroke. HDL cholesterol is often referred to as “good cholesterol” because it helps remove excess cholesterol from the blood, reducing the risk of heart disease and stroke.

The Cholesterol Paradox

The cholesterol paradox refers to the phenomenon observed in some studies, where higher levels of LDL cholesterol are associated with lower rates of mortality for certain populations, like the elderly or people with heart failure.

This contradiction may seem counterintuitive, considering how high levels of LDL cholesterol are known to increase the risk of heart disease and stroke. However, the cholesterol paradox can be explained by the hypothesis that cholesterol may not always be the direct cause of heart disease and stroke.

Inflammation and Oxidative Stress

Experts now believe that the underlying cause of heart disease and stroke is chronic inflammation and oxidative stress. Inflammation causes the blood vessels to become narrow and stiff, which impairs blood flow to the heart and brain.

Oxidative stress occurs when there is an imbalance between free radicals and antioxidants in the body, leading to cellular damage and dysfunction.

Cholesterol plays a role in both inflammation and oxidative stress. LDL cholesterol can contribute to inflammation by promoting the accumulation of immune cells in the blood vessels.

Oxidized LDL cholesterol, which occurs when LDL cholesterol particles are damaged by free radicals, can also contribute to oxidative stress by promoting the production of even more free radicals.

The Importance of Lowering LDL Cholesterol Levels

Even though the cholesterol paradox challenges the traditional view of cholesterol as the direct cause of heart disease and stroke, there is still overwhelming evidence that lowering LDL cholesterol levels can reduce the risk of these diseases.

Statins are a class of drugs that are commonly prescribed to lower LDL cholesterol levels by blocking an enzyme involved in cholesterol production.

However, statins are not without their drawbacks. They can cause side effects such as muscle pain, liver damage, and increased risk of type 2 diabetes.

Therefore, it is important to adopt lifestyle changes to lower LDL cholesterol levels, such as a healthy diet, regular exercise, and avoiding smoking and excessive alcohol consumption.

The Role of Genetics

Genetics also plays a role in how the body handles cholesterol. Inherited genetic mutations, such as familial hypercholesterolemia, can cause abnormally high levels of LDL cholesterol even in people who follow a healthy lifestyle.

In these cases, medication may be necessary to lower LDL cholesterol levels and reduce the risk of heart disease and stroke.

The Bottom Line

Although the cholesterol paradox challenges the traditional view of cholesterol as the direct cause of heart disease and stroke, it is still important to pay attention to cholesterol levels and take steps to lower LDL cholesterol levels.

Chronic inflammation and oxidative stress, which are underlying causes of these diseases, are linked to high levels of LDL cholesterol. Reducing LDL cholesterol levels through lifestyle changes and medication when necessary can reduce the risk of heart disease and stroke.