LDL seems always to get blamed for heart attack and stroke. Why? The medical standards for heart attack prevention tend to focus on LDL. Why? This is one place where common sense fails the medical profession. If you analyze plaque, it's mostly made up of LDL (Low-Density Lipoprotein, or "bad cholesterol"). So, it must be too much LDL if there is a build-up, right? Wrong. High LDL can cause plaques and heart attacks, but they often don't. There is a specific gene pool that has this. They are people with FH or Familial Hypercholesterolemia. This is not that common. The more significant issue is CV inflammation. With CV inflammation, you get a couple of critical problems: 1. The artery's intima or endothelial lining gets cracks and holes in it. When that happens, LDL slips through and lodges underneath it; 2. the immune system attacks the plaque. This causes liquified plaque with a lot of inflammatory enzymes. If this liquid plaque seeps back into the bloodstream, it causes clotting. Clots are almost always the cause of heart attacks and strokes. It's not slow clogging of the artery, crowding out the blood flow with plaque. That seems intuitive. But it's not what happens. CV Inflammation usually happens due to high blood sugar and insulin. There are other causes: smoking Lp(a), etc.
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