Changing the Cholesterol Landscape
Reversal of Atherosclerosis in order to avoid CHD is a tricky business. Most can achieve it with a severe vegetarian diet a la Ornish, Esselstyn, etc, but some can only achieve arrest, and of course the vast majority of people aren't even aware that it can be done at all.
A new class of drugs could change that. Torcetrapib is one of a new series of drugs that will come online in the next 3-5 years. This drug is the first to directly increase HDL levels by interfering with a protein that decides whether LDL or HDL will be formed. Currently all methods of raising HDL are indirect, and usually involve lowering triglycerides.
Interestingly, the research for this new class of drugs started by examining people with very high HDL levels to see why they were the way they were, and this is the first result.
Here is why it may change the cholesterol landscape:
Right now Ornish type diets starve the body of saturated fat, and eliminate dietary cholesterol. This has the result in most people of drastically lowering LDL levels. TC/HDL ratios are significantly improved too, but HDL is often lowered along with LDL.
Dr. Caldwell Esselstyn's experiment showed that using diet and drugs to arrest and reverse atherosclerosis by lowering total cholesterol below 150mg/dl effected reversal, but HDL levels were below the normal range.
The reversal effect of such a regimen provides a maximum 2-5% per cent arterial diameter increase after one year, and in some cases only an arrest of progression is seen.
What if the Reverse Cholesterol Transport (RCT) mechanism that is HDL could be significantly enhanced at the same time that significant levels of LDL reduction occured? Might not the reversal effect be significantly enhanced?
I propose that this, "Drano Effect", might be accomplished with a cocktail therapy approach combining Ornish diet, nutriceuticals, and pharmaceuticals to effect a significant clearing of atherosclerotic plaque.
Who after all, would care to postulate that the reversal seen in Dr. Esselstyn's trial wouldn't have been enhanced if the average HDL level had been 74 instead of 37?
A tool that directly enhances HDL may not cure on its own, but enhancing the RCT mechanism in conjunction with existing therapies might engender regression levels previously unseen.
A new class of drugs could change that. Torcetrapib is one of a new series of drugs that will come online in the next 3-5 years. This drug is the first to directly increase HDL levels by interfering with a protein that decides whether LDL or HDL will be formed. Currently all methods of raising HDL are indirect, and usually involve lowering triglycerides.
Interestingly, the research for this new class of drugs started by examining people with very high HDL levels to see why they were the way they were, and this is the first result.
Here is why it may change the cholesterol landscape:
Right now Ornish type diets starve the body of saturated fat, and eliminate dietary cholesterol. This has the result in most people of drastically lowering LDL levels. TC/HDL ratios are significantly improved too, but HDL is often lowered along with LDL.
Dr. Caldwell Esselstyn's experiment showed that using diet and drugs to arrest and reverse atherosclerosis by lowering total cholesterol below 150mg/dl effected reversal, but HDL levels were below the normal range.
The reversal effect of such a regimen provides a maximum 2-5% per cent arterial diameter increase after one year, and in some cases only an arrest of progression is seen.
What if the Reverse Cholesterol Transport (RCT) mechanism that is HDL could be significantly enhanced at the same time that significant levels of LDL reduction occured? Might not the reversal effect be significantly enhanced?
I propose that this, "Drano Effect", might be accomplished with a cocktail therapy approach combining Ornish diet, nutriceuticals, and pharmaceuticals to effect a significant clearing of atherosclerotic plaque.
Who after all, would care to postulate that the reversal seen in Dr. Esselstyn's trial wouldn't have been enhanced if the average HDL level had been 74 instead of 37?
A tool that directly enhances HDL may not cure on its own, but enhancing the RCT mechanism in conjunction with existing therapies might engender regression levels previously unseen.
posted by Mark Tyler at 8:43 AM
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