DIFINITIONA lipoprotein is a biochemical assembly that contains both proteins

and lipids water-bound to the proteins. Many enzymes, transporters,

structural proteins, antigens, adhesins, and toxins are lipoproteins.

Examples include the high-density (HDL) and low-density (LDL)

lipoproteins, which enable fats to be carried in the blood stream, the

transmembrane proteins of the mitochondrion and the chloroplast,

and bacterial lipoproteins.

Function

The function of lipoprotein particles is to transport lipids (fats) (such as

triacylglycerol) around the body in the blood.

All cells use and rely on fats and cholesterol as building-blocks to create the

multiple membranes that cells use both to control internal water content and

internal water-soluble elements and to organize their internal structure and

protein enzymatic systems.

The lipoprotein particles have hydrophilic groups of phospholipids, cholesterol,

and apoproteins directed outward. Such characteristics make them soluble in the

salt water-based blood pool. Triglyceride-fats and cholesterol esters are carried

internally, shielded from the water by the phospholipid monolayer and the

apoproteins.

The interaction of the proteins forming the surface of the particles (a) with

enzymes in the blood, (b) with each other, and (c) with specific proteins on the

surfaces of cells determine whether triglycerides and cholesterol will be added to

or removed from the lipoprotein transport particles.

Transmembrane lipoproteins

The lipids are often an essential part of the complex, even if they seem to have no

catalytic activity by themselves. To isolate transmembrane lipoproteins from their

associated membranes, detergents are often needed

Classification

[ By density

Lipoproteins may be classified as follows, listed from larger and less dense to

smaller and denser. Lipoproteins are larger and less dense, if they consist of more

fat than of protein. They are classified on the basis of electrophoresis and

ultracentrifugation.

Chylomicrons carry triglycerides (fat) from the intestines to the liver, to skeletal

muscle, and to adipose tissue.

Very-low-density lipoproteins (VLDL) carry (newly synthesised) triacylglycerol from

the liver to adipose tissue.

Intermediate-density lipoproteins (IDL) are intermediate between VLDL and LDL.

They are not usually detectable in the blood.

Low-density lipoproteins (LDL) carry cholesterol from the liver to cells of the body.

LDLs are sometimes referred to as the "bad cholesterol" lipoprotein.

High-density lipoproteins (HDL) collect cholesterol from the body's tissues, and

bring it back to the liver. HDLs are sometimes referred to as the "good cholesterol"

lipoprotein.

Density (g/mL)ClassDiameter (nm) % protein % cholesterol %

phospholipid % triacylglycerol

>1.063HDL5–153330294

1.019–1.063LDL18–282550218

1.006–1.019IDL25–5018292231

0.95–1.006VLDL30–8010221850

<0.95Chylomicrons100-1000>28784

[2]

Alpha and beta

It is also possible to classify lipoproteins as "alpha" and "beta", according to the

classification of proteins in serum protein electrophoresis. This terminology is

sometimes used in describing lipid disorders such as Abetalipoproteinemia.

Lipoprotein(a)

Lipoprotein(a) – Lp(a), Cardiology diagnostic tests

<14 mg/dL : Normal

14-19 mg/dL? :

>19 mg/dL : High risk].

What Is Atherosclerosis?

Atherosclerosis (ath-er-o-skler-O-sis) is a disease in which plaque (plak) builds up

inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to your

heart and other parts of your body.

Plaque is made up of fat, cholesterol, calcium, and other substances found in the

blood. Over time, plaque hardens and narrows your arteries. This limits the flow of

oxygen-rich blood to your organs and other parts of your body.

Atherosclerosis can lead to serious problems, including heart attack, stroke, or

even death.

Atherosclerosis

Figure A shows a normal artery with normal blood flow. Figure B shows an artery

with plaque buildup.

Atherosclerosis-Related Diseases

Atherosclerosis can affect any artery in the body, including arteries in the heart,

brain, arms, legs, pelvis, and kidneys. As a result, different diseases may develop

based on which arteries are affected.

Coronary Heart Disease

Coronary heart disease (CHD), also called coronary artery disease, is the #1 killer of

both men and women in the United States. CHD occurs if plaque builds up in the

coronary arteries. These arteries supply oxygen-rich blood to your heart.

Plaque narrows the coronary arteries and reduces blood flow to your heart muscle.

Plaque buildup also makes it more likely that blood clots will form in your arteries.

Blood clots can partially or completely block blood flow.

If blood flow to your heart muscle is reduced or blocked, you may have angina

(chest pain or discomfort) or a heart attack.

Plaque also can form in the heart's smallest arteries. This disease is called coronary

microvascular disease (MVD). In coronary MVD, plaque doesn't cause blockages in

the arteries as it does in CHD.

Carotid Artery Disease

Carotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on each

side of your neck (the carotid arteries). These arteries supply oxygen-rich blood to

your brain. If blood flow to your brain is reduced or blocked, you may have a

stroke.

Peripheral Arterial Disease

Peripheral arterial disease (P.A.D.) occurs if plaque builds up in the major arteries

that supply oxygen-rich blood to your legs, arms, and pelvis.

If blood flow to these parts of your body is reduced or blocked, you may have

numbness, pain, and, sometimes, dangerous infections.

Chronic Kidney Disease

Chronic kidney disease can occur if plaque builds up in the renal arteries. These

arteries supply oxygen-rich blood to your kidneys.

Over time, chronic kidney disease causes a slow loss of kidney function. The main

function of the kidneys is to remove waste and extra water from the body.

Overview

The cause of atherosclerosis isn't known. However, certain traits, conditions, or

habits may raise your risk for the disease. These conditions are known as risk

factors.

You can control some risk factors, such as lack of physical activity, smoking, and an

unhealthy diet. Others you can't control, such as age and a family history of heart

disease.

Some people who have atherosclerosis have no signs or symptoms. They may not

be diagnosed until after a heart attack or stroke.

The main treatment for atherosclerosis is lifestyle changes. You also may need

medicines and medical procedures. These treatments, along with ongoing medical

care, can help you live a healthier life.

Outlook

Improved treatments have reduced the number of deaths from atherosclerosis-

related diseases. These treatments also have improved the quality of life for

people who have these diseases. However, atherosclerosis remains a common

health problem.

You may be able to prevent or delay atherosclerosis and the diseases it can cause.

Making lifestyle changes and getting ongoing care can help you avoid the problems

of atherosclerosis and live a long, healthy life

TREATMENT OF atherosclerosis

Cholesterol medications. Aggressively lowering your low-density lipoprotein (LDL)

cholesterol, the "bad" cholesterol, can slow, stop or even reverse the buildup of

fatty deposits in your arteries. Boosting your high-density lipoprotein (HDL)

cholesterol, the "good" cholesterol, may help, too. Your doctor can choose from a

range of cholesterol medications, including drugs known as statins and fibrates.

Anti-platelet medications. Your doctor may prescribe anti-platelet medications,

such as aspirin, to reduce the likelihood that platelets will clump in narrowed

arteries, form a blood clot and cause further blockage.

Beta blocker medications. These medications are commonly used for coronary

artery disease. They lower your heart rate and blood pressure, reducing the

demand on your heart and often relieve symptoms of chest pain. Beta blockers

reduce the risk of heart attacks and heart rhythm problems.

Angiotensin-converting enzyme (ACE) inhibitors. These medications can help slow

the progression of atherosclerosis by lowering blood pressure and producing other

beneficial effects on the heart arteries. ACE inhibitors can also reduce the risk of

recurrent heart attacks.

Calcium channel blockers. These medications lower blood pressure and are

sometimes used to treat angina.

Water pills (diuretics). High blood pressure is a major risk factor for

atherosclerosis. Diuretics lower blood pressure.

Other medications. Your doctor may suggest certain medications to control specific

risk factors for atherosclerosis, such as diabetes. Sometimes specific medications

to treat symptoms of atherosclerosis, such as leg pain during exercise, are

prescribed.

Sometimes more aggressive treatment is needed. If you have severe symptoms or

a blockage that threatens muscle or skin tissue survival, you may be a candidate

for one of the following surgical procedures:

Angioplasty. In this procedure, your doctor inserts a long, thin tube (catheter) into

the blocked or narrowed part of your artery. A second catheter with a deflated

balloon on its tip is then passed through the catheter to the narrowed area. The

balloon is then inflated, compressing the deposits against your artery walls. A

mesh tube (stent) is usually left in the artery to help keep the artery open.

Endarterectomy. In some cases, fatty deposits must be surgically removed from the

walls of a narrowed artery. When the procedure is done on arteries in the neck

(the carotid arteries), it's known as carotid endarterectomy.

Thrombolytic therapy. If you have an artery that's blocked by a blood clot, your

doctor may insert a clot-dissolving drug into your artery at the point of the clot to

break it up.

Bypass surgery. Your doctor may create a graft bypass using a vessel from another

part of your body or a tube made of synthetic fabric. This allows blood to flow

around the blocked or narrowed artery

HOW TO PROTECT YOUR HEART?

1 .Limit how much saturated and trans fats you eat that contribute to

a buildup of plaque in your arteries

Types of Fat Recommendation

Saturated Fat Less than 7 percent of your total daily calories

Trans Fat Less than 1 percent of your total daily calories

Cholesterol Less than 300 milligrams a day for healthy adults; less than

200 milligrams a day for adults with high levels of low-density

lipoprotein (LDL), or "bad," cholesterol or those who are taking

cholesterol-lowering medication

The best way to limit saturated and trans fats is to limit the amount of

solid fats such as butter, margarine, and shortening. These are

commonly used and included into our foods. Avoid fried foods or use

substitutes where ever possible. For example use low-fat sour cream or

salsa on a baked potato instead of butter and sour-cream, or avoid

frying meats but rather broil, bake or barbeque instead. Use Olive oil

instead of shortening, and avoid deep fried foods or battered fried

foods..

Do check the food labels, especially those that are labeled "reduced

fat" because you may find that these items are substituting fat with

oils that contain trans fats. "Partially hydrogenated" is a typical phrase

that indicates trans fat so use this a a clue when reading those labels.

The healthier solution is to choose foods that contain

monounsaturated fats, such as olive or canola oil. Polyunsaturated fats

are found in nuts and seeds, which are also good choices. Both of these

types of fat may help to lower your total blood cholesterol - but with

moderation because these are still "fats."

2 .Choose from sources of low-fat proteins

Lean meats, skinless poultry and fish, or low-fat dairy products and egg

whites are your best sources of low-fat protein. Legumes (beans, peas

and lentils) are also great sources and contain less fat and no

cholesterol which makes them great alternatives to meat.

3 .More fruits and vegetables

Fruits and vegetables are is a great source for vitamins and minerals;

they are lower in calories and rich in fiber. Fruits and vegetables also

contain substances that help prevent cardiovascular disease. Eating

more fruits and vegetables will fill you up more, helping you to eat less

high-fat foods and snacks.

Eating more fruits and vegetables is actually easier than you think.

Choose recipes that include fruits and vegetables in them, keep apples,

grapes, peaches on hand and try new foods such as stir-fry, fruit salads,

or even canned fruits and vegetables (with lower sodium and sugar

content) Avoid drenching your fruits and vegetables in butter,

dressings, sugar, and sauces because these will add back fats and

calories which will in the end, defeat your purpose. Also try to avoid

breaded and fried vegetables, canned fruits in heavy syrup, and

coconut.

4 .Select whole grains

Whole grains are a great source of fiber, vitamins, minerals and iron.

The nutrients found in whole grains also help regulate blood pressure

and maintain your heart’s health.

Choose breads, pasta and cereals made from 100 percent whole grain

and avoid refined white flour. Select high-fiber breakfast cereals or

oatmeal instead of sugary cereals, muffins or doughnuts.

Flaxseed is another whole grain to add to your diet. Ground flaxseed is

high in omega-3 fatty acids which lower your total blood cholesterol.

You can easily add ground flaxseed to your foods by stirring in a

teaspoon over hot cereal, applesauce or yogurt.

5 .Reduce salt intake

Everyone uses it, it’s hard to avoid – eating a lot of salt can contribute

to high blood pressure. Reducing the salt in your food is an important

part of a heart-healthy diet. The American Heart Association

recommends that healthy adults eat less than 2,300 milligrams of

sodium a day which is about 1 teaspoon.

Salt is added to many foods that are canned, processed, frozen and

prepared. Snacks, chips, crackers, soups, frozen dinners all add salt to

improve flavor. The best way to reduce salt intake is to eat fresh foods

and making your own soups. Another way is to replace salt with salt

substitutes, herbs and spices or choose reduced-salt condiments or

prepared / processed foods.

6 .Eat in moderation

Yes, diet means eating in moderation. Overloading your plate, eating

till you feel stuffed or taking seconds leads to consuming more calories

and fat than you actually need. Eating out lends to eating more than

you should and often are foods that shouldn’t be consumed on a

regular basis. Use methods to keep track of your food intake, you’ll be

surprised by how much you consume and of what types of food you

eat regularly.

A heart-healthy diet also is about maintaining a balance, control and

moderation. Eating enough fruits and vegetables and not overindulging

with filler calories keeps our bodies healthy, not just our heart. It’s ok

to treat yourself to your favorite ice-cream or candy, just moderate

that to once a week and even then moderate the amount you

consume. Don’t let your favorite treat indulgence become an excuse to

abandon your healthy-eating plan but rather adopt healthy eating

habits as the norm.

7 .Create daily menus and plan.

Put your plans in action by creating daily menus. Using the strategies

listed above, emphasize vegetables, fruits and whole grains, choose

lean protein and limit high-fat and salty foods. Planning your meals

helps you to plan when you go to the store – having money as well.

Variety also helps make mealtime and snacks interesting .

Use these seven tips as a guide into a heart-healthy way to prevent

heart disease and you’ll be surprised how quickly you’ll be able to

regain control of your cholesterol. You’ll also be pleased by how easy it

can be to lose weight, as well. Incorporate healthy habits to create a

healthy life style.

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