Z.I.A.D. Healthcare for the Underserved Inc. is a 501c3 Non Profit organization that came to be in 2002 when four individuals sat down and looked for ways to help provide access to the uninsured. Specifically they looked at those that fall through cracks, some 46,000,000 people in the United States. These are the people that work part time jobs (making them unqualified for governmental assistance), and receive no coverage from their employers, and cannot afford the premiums of health insurance.
Z.I.A.D. derives its name from the names of its founders Ray Zak, Iqbal Nasser MD, Ibraham Ahmed ND, Theodore Densley MD. Z.I.A.D. primarily works with private doctors to find a primary care home for the uninsured on a sliding scale program where they receive reduced office costs based on federal poverty guidelines.
If you are a primary care office and would like to participate in the program please call 313-815-8767.
HDL and LDL are cholesterol-carrying lipoproteins, not simply good and bad forms of cholesterol. Learn what the numbers mean and why broader cardiovascular risk matters.
A practical guide to understanding meta-analysis, pooled estimates, heterogeneity, study quality, publication bias, and certainty of evidence.
Learn how a prospective U.S. prescription drug moves from laboratory research through clinical trials, FDA review, approval, and continuing safety monitoring.
Resting metabolic rate reflects the energy your body uses while at rest. Learn what affects RMR, how it differs from BMR, and how to interpret a test or estimate.
A 50% lower risk can represent a large benefit or a tiny difference. Learn how relative risk, absolute risk, baseline risk, and NNT work together.
There is no universal plain-water quota. Learn how to use total-water benchmarks, thirst, activity, climate, diet, and health factors to guide hydration.
On August 9, 2022 Ray Zak the president of the board of ZIAD received a prestigious award from the Wayne County Health Authority for the work done by him in leadership of ZIAD Healthcare for the Underserved.
The plaque was awarded and titled “The Best Safety Net Award” with the following inscription:
“On The ninth day of August , 2022, in recognition for extraordinary commitment and service to community health care, we recognize Ray Zak.” The plaque was signed by Gail Warden and Chris Allen of the Wayne County Health Authority. Congratulations to Ray Zak on his devoted leadership of Z.I.A.D.
ZIAD Health Care for the Underserved participated in a health and community fair at Resurrection Lutheran Church Kelly Rd., Detroit, MI.. ZIAD provided the community with information on services that are available for the uninsured, and also provided Free Blood Pressure screening.The event was a cooperative program of three Lutheran churches in the Detroit area. Many residents turned out for the free information, screening, community togetherness, and some free hot dogs. Click here to see pictures from the event.
As always for information on health care call ZIAD at 313-815-8767
A Letter from the HeartDear Friends of ZIAD,
I have been blessed my entire life with the luxury of health insurance. My Father provided for me when I was a child, and I have been fortunate enough in my adult life to provide coverage for myself and my family. Recently, however, my son was stricken with a very rare blood disorder, and we were forced to live in a children’s hospital in Los Angeles for many weeks. I was able to see, first hand, how such a tragedy can financially ruin a family.
The bill for merely the first two weeks in the hospital came to just over $99,000 dollars. One bag of transfusable blood alone cost over $700 dollars. Our son faces a minimum of another 12 to 18 months of treatment. Without insurance, we would have been forced to declare bankruptcy, at the very least. There are thousands of families seeking care for loved ones with life-threatening and chronic afflictions every day. Sadly, the truth is there are many, many families that are turned away from facilities in this great country, only because they do not have enough medical insurance. Please help the gracious people of ZIAD provide care for the underinsured. If you have ever had a loved one need medical attention, you know the urgency of their mission.
Thank you, and may God bless your family with perfect health,
Paul Ganus
Nearly 46 million Americans, including more than 8 million children, are living without health insurance – forced to gamble every day that they won’t get sick or injured. That’s a risk no one should have to take. Uninsured Americans live sick and die younger than those with health insurance. Just one serious illness or injury can wipe out an uninsured family’s bank account, and the problem is getting worse.
To provide health care, health education, physical fitness and other programs to uninsured, under insured, poor, working poor families, and individuals. To provide access to health care in underserved areas, and to the frail elderly.
1) Expand the network of Private doctors offices, and services working with Z.I.A.D. Healthcare for the Underserved that provide primary healthcare as well as other services to underserved, poor, and working poor, and on a sliding scale basis to other geographical areas.
2) Expand services and assistance to the frail elderly.
3) To participate and collaborate with other organizations helping the uninsured or underinsured.
3) To participate and collaborate with Specialty, Pharmacy, Hospital, Dental and other programs to help the uninsured.
4) To identify, apply for and obtain grants that provide screening and outreach to identify disease early up.
Affiliates:
Donations: ZIAD Health Care for the Underserved Inc. is open to all donations public and private and has received Tax Exempt Status with the IRS (#75-3080830).
Donations can be made to ZIAD Health Care via PayPal. Below are buttons that you can use to donate now. We appreciate your donations very much.
HDL vs LDL explained simply: both are lipoproteins that transport cholesterol through the blood. LDL-related particles can contribute to plaque formation in arteries, while HDL participates in moving cholesterol toward the liver. But the familiar “bad” and “good” labels leave out an important point: a favorable HDL-C value does not cancel elevated LDL-related risk. Your triglycerides, non-HDL cholesterol, medical history, blood pressure, diabetes status, smoking, kidney health, family history and other markers may all change the interpretation.
A lipid panel is best read as part of a cardiovascular-risk assessment, not as a report card with one winning and one losing number. Understanding what each result measures can help you ask better questions without trying to diagnose or treat yourself from a laboratory printout.
Not exactly. Cholesterol is a waxy substance the body uses in cell membranes and to make certain hormones and other compounds. Because cholesterol does not travel freely in the watery bloodstream, the body packages it with proteins and other lipids into transport particles called lipoproteins.
Low-density lipoprotein, or LDL, and high-density lipoprotein, or HDL, are two classes of those particles. The values shown on a standard laboratory report are usually LDL-C and HDL-C. The “C” means cholesterol: LDL-C estimates or measures the amount of cholesterol associated with LDL particles, while HDL-C describes cholesterol associated with HDL particles. These values do not directly count every particle or fully describe how those particles behave.
A useful analogy is to picture cholesterol as cargo and lipoproteins as vehicles. LDL-C and HDL-C tell you how much cholesterol cargo is associated with particular classes of vehicle. They are clinically useful measurements, but they are not complete maps of traffic throughout the bloodstream.
LDL earns its unfavorable nickname because LDL-related particles can enter the artery wall and contribute to the biological process that produces atherosclerotic plaque. Over time, plaque can narrow arteries or become involved in events such as heart attack and ischemic stroke.
That does not mean LDL has no normal biological purpose. The problem is cardiovascular exposure to atherogenic particles over time, particularly when the concentration is elevated or other risk factors are present. A single result also does not reveal how long someone has had that level. Two people with the same current LDL-C may have different lifetime exposure and different overall risk.
This is why clinicians do not interpret LDL-C in isolation. Existing atherosclerotic cardiovascular disease, age, blood pressure, diabetes, smoking, kidney disease and family history can change how concerning a result is and how aggressively risk should be addressed.
HDL participates in cholesterol transport, including pathways that move cholesterol toward the liver. That role helped produce the shorthand description of HDL as “good cholesterol.” At a population level, HDL-C has also been associated with cardiovascular risk, but an HDL-C value is not a standalone measurement of protection.
The distinction between a risk marker and a treatment target matters. A marker may correlate with better or worse outcomes without being the direct cause of those outcomes. Changing the marker with a drug therefore does not automatically reproduce the expected benefit.
Large niacin trials illustrate the problem. In AIM-HIGH, adding extended-release niacin to intensive statin therapy increased HDL-C but did not reduce the primary composite cardiovascular endpoint; the trial was stopped early for lack of efficacy. In HPS2-THRIVE, niacin combined with laropiprant increased HDL-C and lowered LDL-C but did not significantly reduce major vascular events, while serious adverse events increased.
These findings do not mean HDL biology is irrelevant. They show something narrower and more practical: pharmacologically raising the HDL-C number has not reliably produced better cardiovascular outcomes. A high HDL-C result should therefore not be treated as a shield against elevated LDL-C, smoking, hypertension, diabetes or other sources of risk.
No. HDL-C and LDL-C describe different parts of lipoprotein transport, and one does not mathematically or biologically erase the other. If LDL-C or non-HDL-C is elevated, a high HDL-C result does not make that finding disappear.
The same principle applies to overall cardiovascular health. A reassuring number cannot neutralize every other risk factor. Conversely, one abnormal value does not determine a person’s future on its own. Risk exists on a continuum and is shaped by multiple variables.
When comparing treatment benefits or reading health headlines, it also helps to understand the difference between relative risk and absolute risk. A meaningful decision depends not only on how much an intervention changes a relative percentage, but also on a person’s starting level of risk.
A standard lipid panel commonly reports total cholesterol, LDL-C, HDL-C and triglycerides. It may also show non-HDL-C, or you can calculate that value by subtracting HDL-C from total cholesterol.
| Measurement | What it broadly represents | Key limitation |
|---|---|---|
| Total cholesterol | Cholesterol carried across multiple lipoprotein classes | Does not show how that cholesterol is distributed |
| LDL-C | Cholesterol associated with LDL particles | Does not directly count the particles |
| HDL-C | Cholesterol associated with HDL particles | Should not be read as a standalone measure of protection |
| Triglycerides | A major form of circulating fat carried in lipoproteins | Levels can vary with metabolic and testing conditions |
| Non-HDL-C | Total cholesterol minus HDL-C | Combines several atherogenic lipoprotein classes rather than identifying each one |
Non-HDL-C includes cholesterol carried by LDL plus cholesterol in other potentially atherogenic lipoproteins, including very-low-density lipoprotein and remnant particles. It can therefore provide a broader view of cholesterol carried by particles associated with plaque formation.
Triglycerides add another layer of context. Elevated triglycerides may accompany insulin resistance, type 2 diabetes and other metabolic conditions, although they can have multiple causes. If diabetes is part of the picture, understanding measurements such as A1C and the factors that affect it can help place lipid results within a broader metabolic discussion.
LDL-C measures cholesterol content, but cholesterol content and particle number do not always move in perfect agreement. Some people may have many particles carrying relatively little cholesterol in each one, while others may have fewer particles carrying more. This difference is one reason additional markers can sometimes improve interpretation.
Apolipoprotein B, usually shortened to apoB, is a structural protein found on major atherogenic lipoprotein particles. Because each of these particles generally carries one apoB molecule, an apoB measurement can serve as an estimate of their number.
ApoB is not presented as a universal replacement for the standard lipid panel. The 2026 ACC/AHA dyslipidemia guideline describes it as potentially useful in selected settings, including elevated triglycerides, type 2 diabetes, cardiovascular-kidney-metabolic syndrome, known atherosclerotic cardiovascular disease or a low achieved LDL-C level.
If LDL-C, non-HDL-C and apoB seem to point in different directions, the appropriate response is not to choose a favorite number. A clinician can interpret the discordance alongside triglycerides, treatment status and the rest of the person’s risk profile.
Lipoprotein(a), written as Lp(a), is a distinct lipoprotein with levels influenced substantially by genetics. It is not included in every routine lipid panel. The 2026 ACC/AHA guideline identifies measuring Lp(a) at least once as part of risk evaluation.
An Lp(a) result may be particularly relevant when cardiovascular disease appears earlier than expected in a family or when conventional measurements do not seem to explain the apparent risk. The result still needs clinical interpretation; it is one risk-enhancing marker rather than a diagnosis by itself.
The same LDL-C value can carry different implications in different people. Someone with established cardiovascular disease is not in the same situation as someone without known disease. Diabetes, smoking, high blood pressure, chronic kidney disease and a strong family history can also raise concern. Current cardiovascular guidance therefore combines lipid measurements with broader risk assessment.
Useful context may include:
Trends can also be more informative than an isolated test. A repeat result may help distinguish a persistent pattern from a temporary change, while older records can show whether exposure has existed for years. The timing and need for repeat testing depend on the clinical situation.
Instead of asking whether cholesterol is simply “good” or “bad,” use questions that uncover what the results mean in your situation:
Seek timely medical guidance for markedly abnormal results, known cardiovascular disease or a strong family history of early heart attack or stroke. Laboratory numbers should inform a clinical conversation rather than trigger unsupervised medication or supplement changes.
HDL and LDL are lipoprotein classes that carry cholesterol; they are not two fundamentally different kinds of cholesterol. LDL-C reports cholesterol associated with LDL particles, while HDL-C reports cholesterol associated with HDL particles. LDL-related particles can contribute to plaque, while HDL participates in cholesterol transport toward the liver.
No. A high HDL-C result does not cancel elevated LDL-C or non-HDL-C. Each result should be interpreted alongside other lipid measurements and the person’s overall cardiovascular-risk profile.
Non-HDL-C is total cholesterol minus HDL-C. It includes cholesterol carried by LDL and other atherogenic lipoproteins, such as VLDL and remnant particles.
ApoB is a protein found on major atherogenic lipoprotein particles. Measuring it can provide an estimate of particle number and may add information in selected situations, including elevated triglycerides or type 2 diabetes. It is not required as a replacement for a standard lipid panel in everyone.
The 2026 ACC/AHA dyslipidemia guideline identifies at-least-once Lp(a) measurement as part of risk evaluation. Whether, when and how to use the result should be discussed with a clinician, particularly when family or personal cardiovascular history raises concern.
No. A lipid panel describes important risk-related measurements, but it does not capture blood pressure, smoking, diabetes, kidney disease, family history, existing plaque or every relevant lipoprotein marker. A reassuring panel is useful information, not a guarantee of zero risk.
The “good HDL, bad LDL” shorthand is useful only as a starting point. LDL-C helps describe cholesterol carried in particles that can contribute to atherosclerosis. HDL-C describes cholesterol carried by HDL, but a high value is not a free pass and raising that number alone has not reliably improved outcomes in major drug trials.
Read the whole lipid panel, then place it within the whole-person risk picture. If a result is elevated, unusual or difficult to reconcile with other numbers, ask what non-HDL-C, triglycerides, medical history and selected markers such as apoB or Lp(a) add to the interpretation. The best next step is not chasing the most reassuring number; it is understanding which risk factors are meaningful and modifiable in your situation.