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Artery Plaque Composition- Contradiction?

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My understanding is Artery plaque is comprised of either lipids (including cholesterol) or calcium deposits, or a combination of both.

Why do they tell us to eat a low fat diet and lower cholesterol, but then turn around and advertise a food as "great source of calcium"

Think about it. They tell us to lower one, but increase intake of the other. Doesn't make sense to me.

LOL, maybe it should be the other way around. Perhaps food labels should read "Lowers calcium" and "Great source for cholesterol"
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replied April 20th, 2011
Hello, and thank you for your medical question on e Health Forum.

The initial deposits that form the atherosclerotic plaque consists of the cholesterol.

This over time gets consolidated due to inclusion of platelets and blood cells to become a atherosclerotic thrombus.

Over time, as the plaque size, increases the tissue gets thickened and organised, calcium deposits occur.

Hence the main factor that causes plaque formation is high blood cholesterol and not calcium.

Hence it is advised to lower blood cholesterol.

I hope this helps.


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replied April 21st, 2011
Experienced User
Thank you for your answer. Interesting.

So then why do people with low cholesterol still develop artery plaque, and some people with high cholesterol have clear arteries?

What about the Greenland Inuits? They had high levels of total cholesterol (Mean 240) and very High levels of "bad" cholesterol ( mean 170) yet they had one of the lowest death rates from CAD of any population.

Granted the Inuits had high HDL (Mean 62) and they consumed a diet rich in marine oils, but they had high cholesterol by todays guidelines.

So how can we say high cholesterol is the main factor that causes plaque formation when world populations demonstrate otherwise?
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replied December 17th, 2012
"So then why do people with low cholesterol still develop artery plaque, and some people with high cholesterol have clear arteries?"

My reading about this lately is pointing to inflammation as a driving factor. With no chronic inflammation present the cholesterol can happily do it's important jobs. When there is inflammation then the cholesterol becomes stuck in the arterial walls forming plaques.
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replied July 23rd, 2013
Because total cholesterol, measured with LDL-C and HDL-C, has nothing to do with plaque formation. The only reliable predictor is lipoprotein particle count, measured with LDL-P or HDL-P.
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replied September 5th, 2013
There is also lipoprotein(a), aka lpa, which is a known and deadly form of cholesterol that is genetic, as far as they know, and which is one of the main culprits for creating plaque. Many doctors don't measure this cholesterol and it makes sense to get this specific form measured. If it is within normal level, you can at least reject that as a cause. I have very high lpa and am trying high doses of niacin -- the only medicine known to reduce lpa. Good luck.
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