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There are also several have clinical data that can be used to predict whether a person has a high risk of coronary heart disease NCEP 2002. Table 2 shows several types of clinical
measurements of coronary heart disease risk. Table 2. Clinical measures to assess the risk of coronary heart disease
Clinical Measures Desirable
Borderline Risk High Risk
Total blood cholesterol mgdL 200
200 – 239
≥ 240 LDL cholesterol mgdL
100 130
– 159 160
– 189 HDL cholesterol mgdL
≥ 60 59
– 40 40
Triglycerides, fasting mgdL 150
150 – 199
200 – 499
Body Mass Index BMI 18,5
– 24,9 25
– 29,9 ≥ 30
Blood pressure systolicdiastolic 120 80
120-13980-89 ≥ 140 ≥ 90
Source: National Cholesterol Education Program 2002
B. CHOLESTEROL
Cholesterol is a hydrophobic natural chemical compound and is the main type of sterols in animals especially mammals Parish et al. 2002 in Akoh Min 2002. Despite the opinion to be
harmful compounds to health, cholesterol is substantial as the precursor for steroid hormones biosynthesis such as progesterone, glucocorticoids, mineral corticoid, androgens, and estrogens.
Cholesterol also plays an important role to the biosynthesis of bile acids and vitamin D Harper et al. 1988; Clarenburg 2001. Moreover, Clarenburg 2001 revealed that cholesterol also regulates the
permeability of the membrane and maintain the integrity of the cells throughout the body to prevent excessive water evaporation through the skin.
Cholesterol is not an essential substance for the body because it can be made endogenously by the body DeBruyne, Pinna, Whitney 2008. Endogenous cholesterol formation occurs
primarily in the liver Harper et al. 1988; Cheung et al. 1993. After synthesized in the liver, cholesterol and the other fats are transported in the form of lipoproteins to be stored in the tissue.
Lipoprotein is a combination of the triglycerides and other lipids such as cholesterol and phospholipids with specific proteins Almatsier 2003. Briefly, there are two main types of
lipoproteins with different characteristics,
1. Beta lipoprotein-low density lipoprotein LDL
This type of lipoprotein carries fat and cholesterol in high amount from liver to the body cells and tissues. LDL is often referred as
“bad cholesterol”, despite the fact that it is actually a lipoprotein, because it holds high amount of cholesterol and could
easily slip into epithelium wall in blood vessel and oxidized Almatsier 2003. The oxidation of LDL cholesterol would have a chain reaction resulted in a buildup inside
the blood vessels and form plaques, leading to atherosclerosis and coronary heart disease.
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2. Beta lipoprotein-high density lipoprotein HDL
HDL is produced separately in the liver and in charge of bringing back excess cholesterol from body cell to liver in order to be excreted Almatsier 2003. As the
lower cholesterol content and cholesterol disposal function, HDL cholesterol is often called as the good cholesterol.
Although cholesterol is sufficient from endogenous biosynthesis, dietary cholesterol also contributes to the so-called exogenous cholesterol. Exogenous cholesterol is cholesterol obtained
from the gastrointestinal absorption of the food consumed. Increased consumption of dietary cholesterol by 200-750 mg will increase blood cholesterol levels as much as 5.4 - 5.8 mmolL
Bender 2000. Most of the cholesterol in the blood comes from the synthesis in the body which is about 1 gday and 0.3 gday from food Harper et al. 1988; Clarenburg 2001; Bachorik et al. 2001.
Total blood cholesterol can be measured through several ways; either a complete blood test performed by medical professional or by using cholesterol home test kit. The examples of cholesterol
home test kit can be seen in Figure 2. Although the test is not able to identify the levels of each of the components such as LDL or HDL cholesterol accurately and the variability of result may be higher
than complete blood test, the American Heart Association 2010 stated that the measurement is considerably useful to screen the risk of developing cardiovascular disease. However, to determine
the levels of each composition of blood cholesterol and triglyceride, it is preferable to do complete blood test performed by medical professional.
Figure 2. Example of commercially available cholesterol home test kit
http:www.priceinspector.co.uk
C. PLANT STEROLS
