Effective cholesterol absorption from intestine may increase risk of serious cardiac events, finds study
The way in which the body processes cholesterol affects the risk of cardiovascular diseases. LDL cholesterol is obtained from saturated fats in food and from hepatic cholesterol synthesis. Its accumulation in therarterial wallscan obstructs blood flow.
Long-term monitoring revealed that high cholesterol absorption predicted myocardial infarctions and cardiac mortality in patients who had previously had an acute coronary artery event.
The worst prognosis was seen in patients with the highest cholesterol absorption, while low cholesterol absorption was associated with a better prognosis.
Some people absorb cholesterol particularly effectively from the intestine
Cholesterol ends up in the body in two ways: either the body produces it or it is absorbed from food in the intestine. In roughly one-third of the population, cholesterol is absorbed exceptionally effectively from the intestine due to a genetic predisposition, and they, in particular, should follow diets that are as low as possible in cholesterol.
If a great deal of cholesterol is absorbed from the intestine, the liver produces less of it, and the cholesterol level in the blood will not indicate the total extent of cholesterol absorption.
Cholesterol absorption can be measured from blood samples in scientific studies, but the method is expensive and complicated. In practice, the absorption of cholesterol from the intestine can be prevented with drugs, and they are often used alongside statin therapy.
High cholesterol absorption is particularly harmful
When cholesterol absorption is high, the structure of LDL particles becomes particularly harmful. In such cases, the composition of LDL particles changes, and they bind tightly to the extracellular matrix of the arterial walls and easily stick to each other.
These changes can increase the accumulation of cholesterol carried by LDL particles in the arterial walls and accelerate the development of atherosclerosis, or arterial disease, without necessarily increasing the amount of LDL cholesterol in the blood.
At the moment, no simple test can identify people whose cholesterol absorption is higher. Consequently, everyone should follow a healthy diet.
Reference:
Katariina Öörni, Lauri Äikäs, Maija Ruuth, Feven Tigistu-Sahle, Reijo Käkelä, Ingmar Wester, Helena Gylling, Piia Simonen; Effective cholesterol absorption from the intestine may increase the risk of serious cardiac events; Journal: Journal of Internal Medicine; DOI 10.1111/joim.70085
