The relationship between cholesterol levels and atherosclerosis is very important: LDL is called the bad cholesterol and HDL is called the good cholesterol. LDL works to transport cholesterol from the liver to the blood vessels and maintain the construction of the blood vessels. If there is not enough of this, the blood vessels become fragile with less cholesterol in them, causing them to break easily and bleed. In times when people did not get enough cholesterol, brain hemorrhages were more common, largely due to high blood pressure, but also probably due to low cholesterol intake. Conversely, HDLs are responsible for transporting cholesterol from the blood vessels to the liver. In today’s society, people tend to take in too much cholesterol, which causes cholesterol to accumulate in blood vessels and promotes atherosclerosis. For this reason, LDL, which carries cholesterol from the liver to blood vessels, is called the “bad” type, while HDL, which draws cholesterol from blood vessels, is called the “good” type.
In the Edo or Meiji periods, HDL, which pulls cholesterol out of blood vessels, might be called bad, and LDL, which carries cholesterol from the liver, might be called good, because the intake of cholesterol was low.
I feel that it is more important to explain to patients exactly what their functions are than to name them “good” and “bad. I am concerned about the monolithic nature of the names. I think it is important to explain from the patient’s point of view.
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