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Cardiovascular disease: a closer look at cholesterol

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Every 12 minutes one Australian dies as a result of cardiovascular disease (CVD). Practitioners, and the general public, must develop a better understanding of what science is now revealing as key aetiologies for the development of this illness. This is not just a disease of high cholesterol and elevated blood pressure (BP). Atherosclerosis progression is now recognised to be influenced by factors including (but not limited to) nutritional deficiencies, systemic inflammation, oxidative stress, a dysbiotic gut, immune dysfunction (including autoimmune-type processes) and infections, together with the well known dietary and lifestyle issues.

A more advanced lipid profile may be an ideal approach to better determine the targets for disease treatment/prevention. Further to the standard measurements of triglycerides (TGs), high density lipoproteins (HDLs), low density lipoproteins (LDLs) and total cholesterol, other markers such as lipoprotein sub-fractions, apolipoproteins (Apo), C-reactive protein (CRP), fibrinogen, homocysteine and glycosylated haemoglobin (HbA1c) can be investigated. Complementary interventions which are proving successful in managing certain aspects of CVD include CoQ10/ubiquinol, fish oil, tocotrienols and tocopherols, resveratrol, curcumin and quercetin.

In this infographic we take a closer look at cholesterol and lipoprotein sub-fractions and research which supports the use of omega-3 fatty acids and vitamin E (mixed tocopherols and tocotrienols) in cardiovascular disease management.


    1. Australian Bureau of Statistics. Causes of death 2013 (3303.0). [Full text]
    2. Ferrari R, Hearse DJ. New approaches in atherothrombosis. Dialogues in Cardiovascular Medicine 2007;12(4):233-308. [PDF]
    3. Farid AS, Horii Y. Modulation of paraoxonases during infectious diseases and its potential impact on atherosclerosis. Lipids in Health and Disease 2012;11;92. DOI: 10.1186/1476-511X-11-92. [Full text]
    4. Nestel PJ. Fish oil and cardiovascular disease: lipids and arterial function. Am J Clin Nutr 2000;71(1):228S-231S. [Full text]
    5. Miyoshi T, Noda Y, Ohno Y, et al. Omega-3 fatty acids improve postprandial lipemia and associated endothelial dysfunction in healthy individuals - a randomized cross-over trial. Biomed Pharmacother 2014;68(8):1071-1077. [Abstract]
    6. Bays HE, Ballantyne CM, Braeckman RA, et al. Icosapent ethyl, a pure ester of eicosapentaenoic acid: Effects on circulating markers of inflammation from the MARINE and ANCHOR studies. Am J Cardiovasc Drugs 2013;13:37-46. [PDF]
    7. Kar S. Omacor and omega-3 fatty acids for treatment of coronary artery disease and the pleiotropic effects. Am J Ther. 2014;21(1):56-66. [Abstract]
    8. Skulas-Ray AC, Alaupovic P, Kris-Etherton PM, et al. Dose-response effects of marine omega-3 fatty acids on apolipoproteins, apolipoprotein-defined lipoprotein subclasses, and Lp-PLA2 in individuals with moderate hypertriglyceridemia. J Clin Lipidol 2015;9(3):360-367. [Abstract]
    9. Kasbi Chadli F, Nazih H, Krempf M, et al. Omega 3 fatty acids promote macrophage reverse cholesterol transport in hamster fed high fat diet. PLoS One 2013;8(4):e61109. [Full text]
    10. Naito Y, Shimozawab M, Kurodab M, et al. Tocotrienols reduce 25-hydroxycholesterol-induced monocyte–endothelial cell interaction by inhibiting the surface expression of adhesion molecules. Atherosclerosis 2005;180(1):19-25. [Abstract]
    11. Tomeo AC, Geller M, Watkins TR, et al. Antioxidant effects of tocotrienols in patients with hyperlipidemia and carotid stenosis. Lipids 1995;30(12):1179-1183. [Abstract]
    12. Li F, Tan W, Kang Z, et al. Tocotrienol enriched palm oil prevents atherosclerosis through modulating the activities of peroxisome proliferators-activated receptors. Atherosclerosis 2010b;211: 278–282. [Abstract]
    13. St-Pierre AC, Ruel IL, Cantin B, et al. Comparison of various electrophoretic characteristics of LDL particles and their relationship to the risk of ischemic heart disease. Circulation 2001;104(19):2295-2299. [Full text]
    14. Kwiterovich PO, Jr. Clinical relevance of the biochemical, metabolic, and genetic factors that influence low-density lipoprotein heterogeneity. Am J Cardiol 2002;90(8A):30i-47i. [Abstract]

  1. Lamarche B, Tchernof A, Moorjani S, et al. Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men. Prospective results from the Quebec Cardiovascular Study. Circulation 1997;95(1):69-75. [Full text]

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Melissa Lee
Melissa is a designer turned nutritionist, who has combined the two modalities to create purposeful designs for various health publications and websites. Having initially studied Multimedia Systems Design, she then went on to complete a BHSc in Nutritional Medicine which led to her involvement in the integrative medicine industry and eventually to FX Medicine.