The Cholesterol Cutoff
Recently, while changing clothes after a workout in the gym, I could not resist listening in as two men exchanged numbers in what sounded like a boasting fest. Was it about their golf scores or some other index of athletic accomplishment? Were they comparing earnings on their stock portfolios or citing the IQ scores of their children? No. They were talking about their serum cholesterol readings. A low cholesterol value is not only a number people know, it is also a source of pride. One man had lowered his LDL cholesterol through vigorous exercise and the use of medication. He attributed his regular visits to the gym as part of this quest. This chapter explores the benefits and other consequences of our obsession with cholesterol.
Cholesterol is a waxy substance found in the cell walls of most animals. It is necessary for a variety of reasons, including the production of sexual and other hormones and building and maintaining cell membranes. It is not an exaggeration to say that...
KeywordsTotal Cholesterol Heart Attack High Cholesterol Blood Cholesterol National Cholesterol Education Program
- 1.Keys AB. Coronary heart disease in seven countries. New York: American Heart Association; 1970.Google Scholar
- 2.Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. May 12 1998;97(18):1837–1847.Google Scholar
- 6.MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet. Jul 6 2002;360(9326):7–22.Google Scholar
- 11.Muldoon MF, Manuck SB, Matthews KA. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials. Brit Phycol J. Aug 11 1990;301(6747):309–314.Google Scholar
- 12.Golomb BA. Cholesterol and violence: is there a connection? Ann Intern Med. 1998;128(6):478–487.Google Scholar
- 13.Caro J, Klittich W, McGuire A, et al. The West of Scotland coronary prevention study: economic benefit analysis of primary prevention with pravastatin [see comments]. Brit Phycol J (Clinical Research Ed.). 1997;315(7122):1577–1582.Google Scholar
- 18.Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. May 16 2001;285(19):2486–2497.Google Scholar
- 22.Kaplan RM, Ong M. Rationale and Public Health Implications of Changing CHD Risk Factor Definitions. Annu Rev Public Health. 2007;28:312–344.Google Scholar
- 24.Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs usual care: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT). JAMA. Dec 18 2002;288(23):2998–3007.Google Scholar
- 25.Sever PS, Dahlof B, Poulter NR, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial – Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. Apr 5 2003;361(9364):1149–1158.CrossRefGoogle Scholar
- 27.Khaleghi M, Kaplan RM. Effects of Changing Illness Thresholds on Healthcare Costs and Health Outcomes. Unpublished paper, University of California, San Diego, 2007.Google Scholar