Atherogenic index: what it is and how it measures the risk of atherosclerosis

Our body is a highly complex organism, made up of various systems that work together to allow our survival.

These systems interact with each other, often being interdependent, in such a way that the operation of some affects or even allows others to perform their function. This is what happens with the vascular system, which allows blood to be carried from the heart to the organs and vice versa, in such a way that it allows oxygen and nutrients to be carried to the body's cells.

However, the vascular system can suffer some alterations that can hinder the proper functioning of the body, such as atherosclerosis. This problem is linked to our body's cholesterol levels, and being able to know the risk of suffering from it can save our lives. One way to do this is to calculate the atherogenic index, about which we are going to talk throughout this article.

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What is the atherogenic index?

The atherogenic index is a mathematical formula formulated in order to be able to calculate a person's risk of suffering from atherosclerosis

from your blood cholesterol levels. Thus, and based on certain values ​​of this index that are taken as criteria for it, we can determine or predict the probability that the person's arteries will eventually clog if no change is made to their arteries levels.

The atherogenic index, also called the Castelli index based on the director of the study that originated the formula (William Castelli), expresses at a mathematical level the relationship or proportion between the levels of total cholesterol and the levels of high-density lipoproteins or HDL (also popularly known as good cholesterol), in milligrams. Specifically, the general formula is as follows: Atherogenic Index= Total Cholesterol/HDL Cholesterol.

However, despite the fact that this is the atherogenic index that is most often considered, it should actually be taken into account that there could be different atherogenic indices: There are different formulas that make it possible to obtain an index with which to assess the risk of atherosclerosis onset.. In addition to the ratio between total cholesterol and good cholesterol, we can calculate the ratio between bad cholesterol and good cholesterol (LDL/HDL) or the ratio between triglycerides and HDL cholesterol.

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Interpretation and reference values

The interpretation of the results of the atherogenic index (considering the first of the formulas mentioned) must take into account that the presence of high values ​​of HDL cholesterol will cause us to have a relatively low index, something that implies a lower risk of obstruction and heart problems.

On the contrary, proportionally lower levels of HDL cholesterol than the rest will cause or make the presence of heart problems more probable, assuming this that in total cholesterol there will be more prevalence of bad cholesterol and low-density lipoproteins. The resulting index will be low.

Regarding the values, we can find that as reference values ​​there is a minimal risk of atherosclerosis when we obtain an index of 3.5 or less. The risk becomes moderate when the values ​​are between 3.5 and 4.5, at which point it becomes necessary to start controlling cholesterol and it would be useful to carry out prevention strategies. Finally, those values ​​greater than 4.5 represent a maximum risk of atherosclerosis, that is, there is a very high risk of suffering from some type of coronary disease. It is necessary to establish measures to lower cholesterol and monitor said levels.

These levels should also take into account the sex of the person concerned: the high risk is in men in values ​​of 4.5-5 or more, while in women we can consider as high risk any value above 4.

Atherosclerosis and its risks

The atherogenic index serves as we have said to visualize through numerical values ​​the risk of suffering from atherosclerosis.

Atherosclerosis is a disease or vascular disorder characterized by the accumulation of cholesterol particles and lipids in the walls of the arteries. Vessel walls become coated, leaving less space for blood to flow and increasing the risk of blockage. Likewise, it is common for a hardening and loss of flexibility of the walls of the arteries to occur, which together with the increase in arterial pressure (because the tube through which the blood passes is narrower) can cause ruptures in the vessels and bleeding.

Atherosclerosis is a relatively common condition but if not controlled can be very dangerous and lead to death. It is a disease that can lead to bleeding, thrombosis or stroke, in addition to being able to generate severe heart problems. Brain, kidneys or liver can also be tremendously affected, since it can cause cell death. One of the biggest risks of this disease is that it doesn't really cause symptoms until it causes complications, so treatment can be late.

Fortunately this risk can be controlled by lowering bad cholesterol or raising good cholesterol, controlling diet, weight or exercise. Risk factors must also be controlled and taken into account: age, diabetes, smoking, hypertension, sedentary lifestyle or the presence of a history of Family members are risk factors to assess, being able to control some such as a sedentary lifestyle, hypertension, diabetes or tobacco consumption to reduce levels of cholesterol.

Bibliographic references:

• Herrera-Villalobos, J.E., Sil Jaimes, P.A.. Pinal González, F.M., Garduño Alanís, A.; Santamaria Benhumea, A.M. and Rueda Villalpando, J.P. (2012). Atherogenic index as a risk factor for preeclampsia syndrome. CorHealth; 4 (4): 261-265.
• Lopez, A.A.; Rivero, Y. I.; Vincent, T.; Gil, M.; Thomas, m. and Riutord, B. (2015). Atherogenic indices in workers from different labor sectors of the Spanish Mediterranean area. Clinic and Research in Arteriosclerosis, 27 (3): 118-128.
• Núñez, M.V.; Ferrer, M.; Meneau, T.X.; Cabalé, B.; Gomez, O. and Miguelez, R. (2007). Atherogenic risk factors in the population between 19 and 39 years of age from 2 family doctor's offices. Rev Cubana Invest Biomed, 26(2).