�With heart disease maintaining top charge as the leading lawsuit of death in the United States, a team of University of California, San Diego School of Medicine physician-researchers is proposing that aggressive intervention to lower cholesterol levels as early as childhood is the best approach available today to reducing the incidence of coronary bosom disease.
In a review article promulgated in the August 5, 2008 emergence of the American Heart Association journal Circulation, pioneering lipid investigator Daniel Steinberg, M.D., Ph.D., professor emeritus of medicine at UC San Diego, and colleagues Christopher Glass, M.D., Ph.D. and Joseph Witztum, M.D., both UC San Diego professors of medicine, call current approaches to lowering cholesterol to prevent heart disease "besides little, besides late."
They state that with a large consistence of evidence proving that low cholesterin levels equate with down in the mouth rates of heart disease, "...our long-term goal should be to alter our lifestyle accordingly, beginning in infancy or early childhood" and that "�instituting a low-saturated fat, low-cholesterol diet in infancy (7 months) is perfectly safe, without adverse effects�"
According to Steinberg, progress has been made in the treatment of coronary pump disease in adults with cholesterol lowering drugs like statins. However, while studies show a 30% reduction in death and disability from spunk disease in patients tempered with statins, 70% of patients have cardiac events while on statin therapy. Promising new therapies ar under development, but with an alarming rate of coronary core disease in the U.S. today, action to restrict the epidemic is needful today.
In fact, they propose that lowering low-density lipoproteins (the so-called "bad cholesterol") to less than 50 mg./dl. regular in children and loretta Young adults is a safe and potentially life-saving measure, through modus vivendi (diet and exercise) changes if possible. Drug treatment may likewise be necessary in those at very high jeopardy.
"Our review of the literature convinces us that more aggressive and originally intervention volition probably keep considerably more than than 30% of coronary heart disease," said Steinberg. "Studies indicate that fat person streak lesions in the arteries that are a precursor to atherosclerosis and heart disease begin in childhood, and advanced lesions are non uncommon by age 30. Why not nip things in the bud?" Such early signs of heart disease should be taken as badly as early signs of cancer or diabetes, he said.
Physicians have been slow to measure cholesterin, much less prescribe cholesterin lowering regimens in children and young adults wHO are otherwise healthy. However, the UC San Diego team notes that studies of Japanese men in the fifties showed that consuming a low-fat diet from babyhood resulted in lifelong humble cholesterol levels, and their death rate from affectionateness disease was only 10% of the rate of cardiac-related death in the U.S. Even with risk factors such as butt smoking and diabetes, pith disease deaths remained significantly lower in Japanese work force with life levels of low cholesterin. This protective effect was lost in Japanese wHO migrated to the United States and adopted a Western diet leading to higher blood cholesterol levels.
Interventions today typically begin in adults diagnosed with high cholesterol levels or other peril factors or symptoms of coronary artery disease. However, initiating cholesterol-lowering interventions in 50-year-old adults, even if successful, is unlikely to reverse conventional arterial disease and volition therefore make limited impingement on the occurrence of adverse events related to coronary heart disease.
Citing the success of lowering cholesterol levels in children diagnosed with familial hypercholesteremia, the UC San Diego team suggests that programs to lower cholesterol in the population at bombastic from childhood on, with the ideal LDL degree set at 50 mg./dl. or less (in those at highest endangerment), will have a semipermanent beneficial impression and lower the countrywide rates of coronary artery disease. They do non advocate victimisation drug therapy to extend to these levels, especially in children with no other risk factors, but to achieve these low levels through "TLC," or "remedial lifestyle changes," such as diet and exercise.
The National Institutes of Health (NIH) has declared "war" against the parallel epidemics of corpulency and diabetes. The researchers conclude that "The weapons for those wars-education and behavior modification-are the same as those needed for a 'war' on coronary heart disease."
They propose that "A concerted national effort might dramatically reduce morbidity and mortality referable to ternary major chronic diseases�It would take generations to attain and it would take an all-out commitment of money and manpower to reeducate and modify the behavior of a land. Is that impossible? No. We have already shown that regular a honestly addictive behaviour like coffin nail smoking can be overcome (eventually)."
Leslie Franz
University of California - San Diego
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