Cholesterol Screening

Excerpt

Atherosclerotic cardiovascular disease (ASCVD) is one of the worldwide leading cause of cardiovascular morbidity and mortality. In 2013 coronary artery disease and cerebrovascular disease were the first and third causes of death, which attributed to 84.5% cardiovascular death and 28.2% of all-cause mortality, respectively. Experts predict these numbers to increase in the future due to the transformation of the human lifestyle, particularly fast-food diet, and sedentary living. It also contributed to substantial morbidity because coronary heart disease (CHD) is one of the most important etiology of heart failure, specifically ischemic cardiomyopathy. Due to better healthcare systems and technology, many CHD patients that experienced acute ischemic events survived but later developed heart failure. The relationship between cholesterol and heart disease is well-established. Therefore, following appropriate guidelines for screening is of paramount importance.

Cholesterol is a sterol compound found in most human body tissues. From a physiologic standpoint, cholesterol and its derivatives are vitally crucial for cell membranes and myriad metabolic processes in the body. Also, cholesterol is used to make hormones, fat-soluble vitamins, and bile acids. The primary source of cholesterol is from animal-based foods, such as eggs, dairy, and cheese. Based on density, cholesterol can classify as high-density lipoproteins (HDL), low-density lipoproteins (LDL), or very-low-density lipoproteins (VLDL). Triglycerides are also part of the blood-lipid profile. Of note, LDL, VLDL, and triglycerides have been correlated to increased risk of CHD, while the reverse appears to be true for HDL. Thus, higher HDL levels confer a protective effect on CHD and all-cause mortality.

Framingham Heart Study, a landmark study, is the first to demonstrate unequivocally that higher LDL concentrations were associated with a higher risk of ASCVD.