Ajit (name changed) was 50-years-old when a check-up revealed high cholesterol values. His total cholesterol was 280 mg/dl and LDL value of 165 mg/dl. When he visited his doctor, he was put on medication quickly considering his lifestyle and comorbidities – he was obese and had high blood pressure and diabetes. He was prescribed medicines to control his cholesterol, blood pressure and sugar.
“Usually, we don’t prescribe medicine for cholesterol in the first instance. We usually advise dietary modifications and regular exercise with a follow up lipid profile after two months of lifestyle modification. Here, the patient had diabetes, hypertension, history of smoking, and high cholesterol. His risk profile suggested a 12.8% 10-year risk of heart disease and a 30-year risk of 46%. So he was immediately started on medications. He was also instructed to adopt lifestyle and dietary changes, as he was overweight. The aim was to control the risk factors and reduce his chances of developing heart disease,” said Dr Sandeep R, senior interventional cardiologist, Aster Medcity, Kochi.
Ajit stopped smoking, followed his physician’s instructions and reduced his LDL to 70 mg/dL with statins and his BMI to 24. His HDL level increased to 40 mg/dl with weight loss, and his blood pressure dropped to around 130 mmHg by cutting down on smoking and with lifestyle changes within three months.
“Multiple studies have shown that by bringing down cholesterol by one mmol/l (millimole per liter), which is 39 mg/dl, we can actually reduce the chance of heart disease and heart disease-related complications by 20-25%. Regular exercise and changes like weight reduction, smoking cessation, and salt restriction helped this patient to reduce cholesterol levels and the risk of future heart disease and stroke,” Dr Sandeep pointed out.
Cholesterol is essential for normal body functions, including building cells, helping digestion, nerve function and hormone production. However, excess levels can be harmful and become a major risk factor for heart disease.
“Cholesterol is a component the body needs for functioning. However, when the levels of fats (lipids) in your blood are abnormal, it leads to complications. Earlier, the condition dyslipidaemia was not seen in many people. However, now the number of people diagnosed with high levels of cholesterol is on the rise,” said Dr Anu C Kochukunju, consultant physician at the General Hospital, Ernakulam.
The major reason, according to her, is the shift in lifestyle habits, diet patterns, and reduced body movement. “When you consume more calories, it leads to fat deposits,” she emphasises.
According to the study – ‘Prevalence of coronary artery disease and its risk factors in Kerala, South India: A community-based cross-sectional study’ – coronary artery disease is highly prevalent in both urban and rural Kerala. Among the major risk factors, the study found that 52% had high total cholesterol and 39% had low HDL cholesterol. It also highlighted the prevalence of obesity (59%), abdominal obesity (57%), hypertension (28%), diabetes (15%), smoking and physical inactivity, particularly in the urban population. This trend is very alarming and considered to be a major contributor to the rise in coronary artery disease in Kerala .
“If the cholesterol levels are persistently high, it will get deposited in the blood vessels, leading to obstruction and can eventually cause heart attack, stroke and peripheral vascular disease. Thus, primary prevention plays a significant role and trying to keep LDL under 100 mg/dl through dietary changes, exercise and lifestyle modifications is very important step in preventing heart disease,” said Dr Sandeep
High cholesterol is largely asymptomatic, which often leads patients to delay diagnosis and discontinue treatment prematurely. “People above 40, especially young people with hypertension and diabetes, should undergo regular checkups. Most of the time, cholesterol levels are tested only when there are complications. One important step is to reduce the consumption of food items that lead to high cholesterol. Sedentary lifestyle and changes in food habits add to the risk. The lifestyle and food habits of adolescents and youngsters should be given priority to catch them young,” added Dr Anu.