Cholesterol Controversy: Is It Really a Contributor to Heart Disease?

A new editorial published in the British Journal of Medicine suggests that foods high in cholesterol and saturated fat are not major contributors to heart disease, but instead inflammation is the key factor behind cardiovascular conditions. 

The authors of the editorial are three cardiologists from the United States,England and Switzerland. In their essay, the doctors argue that heart disease education should be shifted away from the traditional teachings of instructing patients to eat a low-fat diet and reducing LDL cholesterol numbers to finding the cause of inflammation in the body and reducing it.

Inflammation is the body’s natural defense against infection and illness.

This viewpoint is making waves with the rest of medicine. Many doctors and medical researchers maintain that these two factors must still be considered when treating patients for heart disease.

Writers of the piece also suggest that the focus should not be on reducing cholesterol, but instead making incremental lifestyle changes like increasing exercise and activity, to 150 minutes a week, quitting smoking, reducing stress and switching to a Mediterranean diet of plenty of fruits and vegetables, fish, chicken, olive oil and nuts.

The piece also suggests that the long-held belief that plaque buildup clogs the arteries is not factual and suggests that plaque removal may not reduce a patient’s risk of heart attack or the chance the patient may die from a heart attack. 

Inactivity, smoking, stress and eating processed foods lend to increased levels of inflammation. The link between inflammation and heart attacks as explained in the editorial is not a discovery. Researchers have made the connection between inflammation and heart attacks in previous studies and have found that inflammation is a factor in one-third of all heart attacks.

Inflammation has been shown to affect a form of arterial plaque known as vulnerable plaque. Vulnerable plaque is a soft plaque that can break away from the arterial walls and cause blockages that lead to heart attack or stroke.

Arterial plaque is made up of cholesterol, fat, calcium and other substances that build up in the blood and harden in arterial walls. This build up can lead to heart disease, heart attacks and strokes.

“Cholesterol is most definitely a factor in heart disease,” Dr. Michael Budler, M.D. said.

Budler is an interventional radiologist in Grand Island, Nebraska. He treats patients with arterial plaque buildup using vascular stenting and angioplasty interventions. His experience as an interventional radiologist working with heart patients supports his position that cholesterol contributes to heart disease, and should be treated with medical interventions when necessary.

“High cholesterol levels contribute to the development of arterial plaque and ultimately makes the heart have to work harder,” Budler said.

High cholesterol is not the only contributor to heart disease. Most heart disease patients have a combination of risk factors that contribute to their condition. Lifestyle choices like smoking and inactivity are contributing factors. Diabetes, high blood pressure and chronic obstructive pulmonary disorder can also cause the development of heart disease in many patients. As a result, high cholesterol is not the only thing that should be treated when treating a patient for heart disease.

Most patients with the condition benefit from multiple approaches of treatment that include lifestyle changes, medications, and interventional radiology procedures like the angioplasty and vascular stenting procedures performed by Budler.

According to the Centers for Disease Control and Prevention, over 600,000 people in the United States die of heart disease each year. Heart disease is the leading cause of death of both men and women.



Live Science. “Are Cholesterol, Saturated Fat Less Important to Heart Disease?” 28 April 2017

Centers for Disease Control. Heart Disease Facts and Statistics. 4 August 2015