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| Elevated LDL/HDL Ratio |
Last updated: Jun 30, 2009 |
Conditions that suggest it | Contributing risk factors | Other conditions that may be present | Recommendations
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HDL and LDL are two different kinds of cholesterol that are measured as an index of a patient's risk for cardiovascular disease. HDL stands for high-density lipoprotein and LDL stands for low-density lipoprotein. Total cholesterol measures the combination of HDL, LDL and VLDL.
Unlike men, a high LDL ("bad cholesterol") level is not as strong a predictor of future trouble for women, although there is still considerable debate on this. Some experts believe LDL is not to be worried about for most women, except for particular sub-groups of women who are affected. As one might expect, until the situation is clarified, the importance of LDL for women is in question.
Low HDL levels in men and women should be raised, while LDL levels, at least in men, should be lowered. Further, more detailed lab testing that breaks down LDL into subfractions, is advised for anyone with a high cardiovascular disease risk.
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Conditions that suggest Elevated LDL/HDL Ratio: | |  | | | | Circulation | Atherosclerosis | LDL is the cholesterol type most commonly thought of as a strong risk factor for atherosclerosis and heart disease. Oxidized LDL and the fraction called Lp-a produce a greater risk. Since HDL cholesterol reduces the risk, low HDL levels are not desirable. |
| Organ Health |
Gallbladder Disease | Gallstone formation does not correlate with blood cholesterol levels, but persons with low HDL cholesterol (the so-called good cholesterol) levels or high triglyceride levels are at increased risk. |
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Risk factors for Elevated LDL/HDL Ratio: | |  | | | | Lab Values - Chemistries | (Very) low HDL level
(Borderline) high LDL
Counter-indicators:
Optimal (?) LDL or normal LDL
Excellent/average HDL level | Nutrients |
Manganese Requirement |
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Elevated LDL/HDL Ratio suggests the following may be present:
Recommendations for Elevated LDL/HDL Ratio: | |  | | | | Botanical | Grape Seed Extract (Pycnogenol) | See the link between Elevated Total Cholesterol and Grape Seed Extract. |
| Diet |
Weight Loss | Even a modest weight loss of 10 pounds (4.5 Kg) is associated with a 16% decrease in total cholesterol, a 12% decrease in LDL cholesterol and an 18% increase in HDL cholesterol. |
Nut and Seed Consumption | "Solid data has shown that eating one to three daily portions of almonds (28 to 84 grams) can help lower LDL cholesterol levels," said study co-author Rick Mattes, Ph.D., R.D. from Purdue University in West Lafayette, USA. "But many health care providers have been hesitant to recommend almonds as a daily snack because they're a relatively high-calorie food and could contribute to weight gain. This study challenges that assumption." [British Journal of Nutrition Sept. 2007]
In the study, women were instructed to eat 344 calories worth of almonds (around 56 grams) every day for one 10-week period, and then eat their customary diet for another 10 weeks. The women did not gain weight during the period they consumed almonds. |
Hydrogenated Fats / Trans Fatty Acids Avoidance | Trans fat has also been shown in studies to raise the levels of LDL or "bad cholesterol" and may also increase total serum cholesterol. In one Dutch study, blood levels of HDL or "good cholesterol" were lowered by 20% compared to when the same subjects ate a diet rich in saturated fats. |
Olive Oil | Extract |
Policosanol/Octacosanol | Policosanol can lower LDL cholesterol as much as 20% and raise protective HDL cholesterol by 10%.
In one study, patients with LDL-cholesterol greater than 160 mg/dl were randomized in double-blind fashion to receive policosanol (10 milligrams daily), lovastatin (20 milligrams daily) or simvastatin (10 milligrams daily). After eight weeks of therapy, LDL-cholesterol was reduced 24% in the policosanol groups, 22% in the lovastatin group and 15% with simvastatin. HDL-cholesterol increased significantly in the policosanol group but not in the other two groups. Policosanol was judged to be "a safe and effective cholesterol reducing agent." |
Plant Sterols / Sterolins (Phytosterols) | Mineral |
Chromium | Vitamins |
Vitamin B3 (Niacin) | In patients with CAD and well-controlled LDL levels, elevation of HDL with niacin improved endothelial function. HDL levels increased from 30 to 40mg/dL in the niacin-treated patients but not the controls.. [American Heart Journal 08/26/2002]
Niaspan is a newer form of niacin that does not appear to cause the liver problems associated with the older sustained-release preparations.
Drug companies are getting in on the benefits of niacin, by combining it with statin drugs, or using it alone in products like Niaspan, Niacor (Nicolar) and Slo-Niacin |
Vitamin E | Vitamin E causes an increase in HDL levels. In a separate study, tocotrienol use did not improve lipid measures over a 28 day period. [Am J Clin Nutr 2002;76(6): pp.1237-43]
However, in other studies, tocotrienols have been shown to reduce the level of LDL and apolipoprotein B, both of which are important risk factors for atherosclerosis and cardiovascular disease.
Some studies have demonstrated a significant reduction of both total and LDL cholesterol with tocotrienols administered to patients with high serum lipids. In a double blind, crossover study on 25 patients with high cholesterol levels, the patients in the treatment group were given 4 capsules daily of 50 mg tocotrienols mixed with palm oil, while the control group received only corn oil. At the end of the 8-week trial period, total cholesterol and LDL cholesterol had decreased significantly (15% and 8%) in the 15 subjects given the palm tocotrienols. There was no change in the control group. [Am J Clin Nutr 1991 Apr;53(4 Suppl): pp.1021S-1026S]
Total cholesterol and LDL-cholesterol were reduced even more (17 % and 24 % respectively) when tocotrienols were added to a low fat, low cholesterol diet and alcohol-free regimen in another double-blind, longer-lasting trial (12 weeks). [Journal of Nutritional Biochemistry1997, 8/5 pp.290-298] Other important cardiovascular risk factors were reduced by tocotrienols. Apoli-poprotein B and lipoprotein(a), strong predictors of cardiovascular disease [N Engl J Med 1983 Aug 18;309(7): pp.385-9], as well as thromboxane B2 and platelet factor 4 were all significantly lowered in the tocotrienol-treated group (15%, 17%, 31% and 14% respectively). |
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KEY |  | Weak or unproven link |  |  | Strong or generally accepted link |  |  | Proven definite or direct link |  |  | Strongly counter-indicative |  |  | May do some good |  |  | Likely to help |  |  | Highly recommended |
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