Interviewer: Doctor, one of the chapters in oneof your books, "Fantastic Voyage", talks about the real cause ofhearth disease. Cholesterol has always been the main focus. Is that stillaccurate, or is that accurate?
Terry Grossman, M.D.: Well, it use to be thoughtthat . . . this is called the cholesterol hypothesis. But it now appears thatat least 40% or 50% of people who have heart attacks have normal or lowcholesterol levels. So if you were to plot the risk of having a heart attackagainst your cholesterol level- if cholesterol were the cause, then we wouldexpect the higher your cholesterol level the higher risk of heart attack. Butthat's not the case. If you were to plot that, it's actually a scattergram.There's no correlation whatsoever. So yes, having a very high cholesterol levelprobably will increase your risk, but there are a lot of other things that aregoing on, and one of the big ones is inflammation. And that's what we talkabout in books- is if you can keep the inflammation in your body down, thechance of your having a heart attack is much lower.
We're also becoming much more sophisticated inour understanding of the lining of the inside of the arteries, what's referredto as the endothelium. And now we have new tests that can measure the health ofour endothelium, the cells that line the arteries. And there are certainspecific things we can do; tests we can do to find out if we're at risk, andthen take some lifestyle changes, supplements, things like that to address thatproblem, and then reduce our chance of developing a heart attack almost tozero.
Interviewer: You mentioned inflammation andkeeping that down. How does someone know where their level might be, and ifthat's something that they need to do?
Terry Grossman, M.D.: Well there are severaltests that are available, common blood tests. The gold standard is referred toas the high-sensitivity CRP, C-reactive protein. That's just a simple bloodtest that's not very expensive and can be done by any doctor. And that test, ifit's elevated, will suggest there is increased inflammation in the body. So ifyou do that and you find out that your CRP level is high, then you definitelywant to take steps to lower that, because high CRP equals high or increasedrisk of heart disease.
Interviewer: And what can people do to lowerinflammation?
Terry Grossman, M.D.: Well, number one is findout where it's coming from. For instance, one of the sources of inflammationthat far too many people have is dental. Gingivitis, the gum infections. Soseeing the dentist regularly and treating gingivitis, periodontal disease iscritically important. Things along those lines. And then there'santi-inflammatories. We know that, for instance, that curry - eating curry -has turmeric in it. Turmeric has a compound called Curcumin in it, which hasprofound anti-inflammatories. People who eat curry regularly have a lowerincidence of cancer, have a lower incidence of Alzheimer's disease, lowerincidence of heart disease. So there are things we can do with our lifestyle,that if we find we have inflammation, that we can take these naturalanti-inflammatories to reduce it.
Do cholesterol levels and heart attack risks go hand in hand? Not necessarily says Dr. Terry Grossman. There may be better markers for heart disease risk than just cholesterol level. Find out what tests you might want to consider getting instead of relying on just cholesterol.
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