Cholesterol & Atherosclerotic Heart Disease

Cholesterol is a public health concern. Since 1968 there has been a decline of about three percent per year in mortality rates for coronary heart disease (CHD), however, it still remains the major cause of death in the United States. The Adult Treatment Panel II of the National Cholesterol Education Program (NCEP) recognizes elevated serum total cholesterol levels, particularly with high levels of low-density lipoprotein (LDL) cholesterol, and low levels of high-density lipoprotein (HDL) as among the major risk factors contributing to CHD (12:171-173).

The 1990 data shows that approximately 52 million Americans 20 years or more are candidates for dietary intervention to reduce LDL levels by ten percent; seven percent may be candidates for cholesterol-lowering drugs. This data reflects around four million adults with CHD (half aged 65 years and older), and approximately 8.7 million adults without established CHD (3.1 million aged 65 years and older) (14:3009).

The Healthy People 2000 objectives for the nation in 1992 included recommendations for lowering CHD to include a dietary cholesterol intake not to exceed 300 mg/day. Also included was dietary fat intakes of 30 percent of total energy or less, saturated fat intakes of less than 10 percent total energy, increased complex carbohyd

. . .
membranes, and for the synthesis of sex hormones, corticosteroids, and vitamin D. It is excreted as bile acid that aids in the breakdown of dietary fat and absorption of fat-soluble vitamins. An excess serum cholesterol is associated with CHD development, which decreased leads to reductions in CHD and regression of atherosclerotic plaques. Reasons that many trials do not show a decrease in CHD mortality with the lowering of cholesterol, is that they were not statistically powered to do so in the first place. A meta-analyses of primary and secondary prevention trials was conducted to increase statistical power by combining data; no change was found in total mortality. Meta-analysis of secondary intervention trials showed a reduction in total mortality. Studies have also shown increased CHD. Thus evidence is inconsistent (5:495-496). The lowering of serum cholesterol is not accepted by everyone as a safe or effective way to decrease CHD incidence. Furthermore, some cholesterol-lowering interventions are associated with increased mortality from cancer, stroke, and injury. For example sustained-release niacin is found to be more hepatotoxic that was originally assumed. "Fibric acid derivatives and hepatic hydroxy-methyl glut
. . .

Some common words found in the essay are:
Schaefer Cupples, Schuep Klag, Controversy Cholesterol, Studies Vitamin, Program NCEP, Heller Denke, Reviews Diet, CHD Subjects, Blood Institute, Pathology Atherosclerotic, cholesterol levels, fatty acids, serum cholesterol, heart disease, total cholesterol, ldl cholesterol, myocardial infarction, risk factors, coronary artery disease, artery disease, total fat, serum cholesterol levels, trans fatty acids, total cholesterol levels, ldl cholesterol levels,
Approximate Word count = 3951
Approximate Pages = 16 (250 words per page)

More Essays on Cholesterol & Atherosclerotic Heart Disease