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After six weeks, The National Cholesterol Education Program recommends checking the LDL cholesterol response to the changes; if the LDL cholesterol goal has not been achieved, other therapeutic options for LDL lowering can be implemented. These include: 2 grams per day of plant stanols or sterols and 10–25 grams per day of soluble fiber.
Level of the good cholesterol HDL is also increased. Fibrates may decrease LDL, though generally to a lesser degree than statins. Similar to statins, the risk of muscle damage exists. Nicotinic acid, like fibrates, is also well suited for lowering triglycerides by 20–50%. It may also lower LDL by 5–25% and increase HDL by 15–35%.
Remnant cholesterol has about twice the association with ischemic heart disease as LDL cholesterol. [14] Although remnant cholesterol tends to be higher in people who are overweight (high body mass index ), normal-weight persons with high remnant cholesterol tend to have a higher risk of myocardial infarction.
Lipoproteins transfer lipids around the body in the extracellular fluid, making fats available to body cells for receptor-mediated endocytosis. [2] [3] Lipoproteins are complex particles composed of multiple proteins, typically 80–100 proteins per particle (organized by a single apolipoprotein B for LDL and the larger particles).
Hypercholesterolemia, also called high cholesterol, is the presence of high levels of cholesterol in the blood. [1] It is a form of hyperlipidemia (high levels of lipids in the blood), hyperlipoproteinemia (high levels of lipoproteins in the blood), and dyslipidemia (any abnormalities of lipid and lipoprotein levels in the blood).
The 1977 Dietary Goals for the United States were not based on a consensus among scientists and for this reason were criticized by agriculture and food manufacturing interests, and also by some scientists. [14] A second version of the report was published in 1980, with less stringent changes from the standard American diet.
The goal of maintaining optimal lipid levels throughout life is to keep the concentration of circulating LDL and other apo B–containing lipoproteins low to minimize the number of particles that become retained in the arterial wall and thereby minimize the rate of progression of atherosclerotic plaques.
Cholesterol is the principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [3] [4]Cholesterol is biosynthesized by all animal cells [citation needed] and is an essential structural and signaling component of animal cell membranes.