Multiple factors can impact heart health, with elevated LDL cholesterol, often referred to as ‘bad cholesterol,’ being a significant concern. Unlike uncontrollable factors like family history or aging, LDL cholesterol (LDLC) levels can be actively managed. High levels of LDLC can cause arterial plaque formation, leading to blockages that restrict blood flow and potentially result in heart attacks or strokes. Therefore, it is crucial to lower and maintain LDLC at recommended levels. Since high LDL typically presents no obvious symptoms, regular lipid profile checks are essential. Proactive testing is the initial step in addressing high LDL cholesterol. According to the Cardiological Society of India (CSI) guidelines released in 2024, cholesterol screenings should start at age 18.
Early diagnosis of high LDLC facilitates easier treatment and better management. Following test results, it is important to consult a cardiologist for individualized advice. Healthcare providers will assess LDLC targets tailored to the patient’s risk profile, as these targets vary from person to person. The physician bases these targets on factors such as age, family history, lifestyle, and other health conditions. Expert guidance can customize cholesterol management plans to fit individual health needs and risks, taking into account personal preferences, cultural context, and lifestyle factors. Dr. PLN Kapardhi, a Senior Consultant Cardiologist at Care Hospital Banjara Hills in Hyderabad, emphasizes that education is crucial in treating high LDL cholesterol.
Patients must recognize that cholesterol is more than just a number; it is a critical factor in heart disease. For many with mild elevations, lifestyle modifications may suffice to achieve healthy LDL levels. However, most patients, especially those with diabetes, obesity, or previous heart issues, will require medical therapy in addition to lifestyle changes. Physicians will set specific targets, and ongoing testing and timely adjustments are vital, requiring patient engagement. Managing high LDL cholesterol is a long-term commitment that necessitates both discipline and medical support. Treatment strategies have evolved recently, influencing how LDLC is managed. Previously, cholesterol-lowering medications were recommended for patients with LDLC levels exceeding 130 mg/dL for diabetics or 160 mg/dL for non-diabetics.
Many are unaware of this shift, mistakenly believing that medication is only for high-risk individuals. The UK’s National Health Service (NHS) has proposed broader prescription guidelines for cholesterol-lowering drugs, suggesting they be given even to those with less than a 10 percent risk of heart attack or stroke in the next ten years. This change reflects a global trend towards early intervention. Heart health can be improved through dietary and lifestyle changes. A diet rich in fruits, vegetables, and whole grains supports overall cardiovascular health. Consuming balanced meals with diverse nutrients is beneficial. Even when eating fatty foods, moderation and food hygiene are key to cardiovascular wellness.
A healthcare provider can recommend the most suitable diet while considering various factors like overall health and cultural context. Maintaining a healthy weight is crucial, as excess body weight can raise LDL cholesterol levels significantly. Regular moderate-intensity exercise can lead to improved health outcomes and lower LDLC levels. Even sporadic workouts can yield positive results. Both physical activity and strength training are beneficial for raising HDL cholesterol, known as good cholesterol, which aids in removing LDL cholesterol from the body. However, it is essential to understand that exercise alone does not guarantee protection against high cholesterol. It is a misconception that peak physical fitness equates to perfect health; even elite athletes can have elevated LDL levels.
Sudden cardiac death (SCD) is the leading medical cause of unexpected death in athletes. Relying solely on vigorous exercise and a healthy diet may not suffice to prevent heart issues. Medications are also critical in managing LDLC levels alongside a healthy lifestyle. For patients who do not achieve satisfactory results with traditional medications, newer advanced therapies are emerging as safe and effective alternatives. Treatments such as PCSK9 inhibitors, siRNA-based therapies, and inclisiran have shown significant promise in helping individuals reach their LDLC targets when conventional methods fall short. Consultation with a healthcare provider can help identify the optimal combination of lifestyle changes and medications for maintaining heart health.
