Don’t Ignore that Cholesterol | Heart Health Matters

Mrs A, a 48-year-old lady, walked to the OPD with sweating, uneasiness, and disturbed sleep the night before. She looked unwell, and hence, an immediate ECG was done, which revealed a myocardial infarction (heart attack). Emergency lifesaving medications were given, and she was shifted to the catheterisation lab, wherein her angiography revealed a complete occlusion of one major artery and significant blockages in other arteries, too. Immediate angioplasty and stenting to the culprit artery was done as a life-saving procedure. Further evaluation revealed very high cholesterol levels and a family history of premature cardiac death in both her parents at the ages of 50 and 55 years. She was suffering from familial hypercholesterolemia. Other conventional risk factors for coronary artery disease like hypertension, smoking, diabetes, obesity and a sedentary lifestyle were strikingly absent in her, and she denied any symptoms related to heart disease in the past.

We are increasingly seeing patients presenting with heart attacks and heart failure without premonitory symptoms.

Cholesterol | Understanding Your Body’s Vital Lipid

Cholesterol is a waxy substance found in the blood. The body needs cholesterol to build healthy cells, but high cholesterol levels can increase the risk of heart disease. With high cholesterol, fatty deposits develop in the blood vessels. Eventually, these deposits grow, making it difficult for enough blood to flow through the arteries. Sometimes, these deposits can break suddenly and form a clot that causes a heart attack or stroke. High cholesterol can be inherited, as in Mrs A’s case, but it's often the result of unhealthy lifestyle choices, which make it preventable and treatable. A healthy diet, regular exercise and sometimes medication can help reduce high cholesterol.

Symptoms Of High Cholesterol

High cholesterol has no symptoms, which is the biggest problem.
The first presentation of high cholesterol can be a heart attack, as in Mrs A’s case. A blood test is the only way to detect if you have it.

When To See A doctor?

Given the high incidence of childhood obesity, fast food culture, and sedentary lifestyle in children as well and also the very high incidence of heart disease in Indians that too at a young age, it would be worthwhile to screen first cholesterol between the ages of 9 and 11, and then repeat every five years after that. It is also recommended that cholesterol screenings occur every one to two years for men aged 45 to 65 and women aged 55 to 65. People over 65 should receive cholesterol tests annually.

More frequent measurements might be desirable if the test results aren't within desirable ranges. More frequent tests are also recommended in people with a family history of high cholesterol, heart disease or other risk factors, such as diabetes or high blood pressure.

Causes Of Cholesterol

Cholesterol is carried through the blood, attached to proteins. This combination of proteins and cholesterol is called lipoprotein. There are different types of cholesterol based on what the lipoprotein carries. They are

Low-density lipoprotein (LDL): LDL, the "bad" cholesterol, transports cholesterol particles throughout the body. LDL cholesterol builds up in the walls of the arteries, making them hard and narrow.
High-density lipoprotein (HDL): HDL, the "good" cholesterol, picks up excess cholesterol and returns it to the liver.
Triglyceride Levels: A lipid profile also typically measures triglycerides, a type of fat in the blood. Having a high triglyceride level also can increase the risk of heart disease. In comparison to Westerners, Indians have a higher tendency for high triglyceride levels due to dietary and genetic factors.
Modifiable Risk Factors: Modifiable risk factors such as inactivity, obesity and an unhealthy diet contribute to harmful cholesterol and triglyceride levels. Non-modifiable risk factors might play a role, too. The genetic makeup of an individual ( a non-modifiable factor) might make it more difficult for his body to remove LDL cholesterol from the blood or break it down in the liver.

Medical conditions that can cause unhealthy cholesterol levels include:

High Cholesterol Risk factors

Factors that can increase the risk of unhealthy cholesterol levels include:

Poor diet: Eating too much saturated fat or trans fats can result in unhealthy cholesterol levels. Saturated fats are found in fatty cuts of meat and full-fat dairy products. Trans fats are often found in packaged snacks or desserts.
Obesity: Having a body mass index (BMI) of 30 or greater increases the risk of high cholesterol.
Lack of exercise: Exercise helps boost body’s HDL, the "good," cholesterol.
Smoking: Cigarette smoking may lower the level of HDL, the "good," cholesterol.
Alcohol: Drinking too much alcohol can increase the total cholesterol level.
Age: Even young children can have unhealthy cholesterol, but it's much more common in people over 40. As one age, the liver becomes less able to remove LDL cholesterol.

Complications Due To High Cholesterol

High cholesterol can cause a dangerous accumulation of cholesterol and other deposits on the walls of the arteries (atherosclerosis). These deposits (plaques) can reduce blood flow through the arteries, which can cause complications such as chest pain, heart attack or stroke.

Prevention of High Cholesterol

The same heart-healthy lifestyle changes that can lower cholesterol can help prevent from having high cholesterol in the first place. To help prevent high cholesterol, one can:

Eat a low-salt diet that emphasises fruits, vegetables and whole grains
Limit the amount of animal fats and use good fats in moderation
Lose extra Kgs and maintain a healthy weight
Quit smoking
Exercise on most days of the week for at least 30 minutes
Avoid alcohol or drink in moderation, if at all
Manage stress.

Conclusion

Understanding and managing cholesterol is paramount for maintaining a healthy heart and well-being. By adopting a balanced diet, regular exercise routine, and periodic health check-ups, you empower yourself to take charge of your cardiovascular health. Remember, knowledge is key – educate yourself, stay proactive, and work closely with healthcare professionals to optimise your cholesterol levels. Dedication and awareness can pave the way for a lifetime of vitality and heart resilience.

Frequently Asked Questions

Q1. What role does cholesterol play in the body?
A1. Cholesterol is a type of lipid essential for building cell membranes, producing hormones like estrogen and testosterone, and aiding in the digestion of fats.

Q2.What are the different types of cholesterol, and how do they impact health?
A2. There are two main types: LDL (low-density lipoprotein) and HDL (high-density lipoprotein).
LDL is often referred to as "bad" cholesterol because it can build up in the arteries, increasing the risk of heart disease. However, HDL is considered "good" cholesterol as it helps remove LDL from the bloodstream, reducing the risk of heart disease.

Q3.What factors contribute to high cholesterol levels?
A3. Several factors can contribute to high cholesterol, including genetics, poor diet high in saturated and trans fats, lack of exercise, obesity, smoking, and certain medical conditions like diabetes and hypothyroidism.

Q4.How can I lower my cholesterol levels naturally?
A4. You can lower cholesterol levels naturally by adopting a healthy lifestyle, which includes eating a diet rich in fruits, vegetables, whole grains, and lean proteins, exercising regularly, maintaining a healthy weight, avoiding smoking, and limiting alcohol intake.

Q5.When should I check my cholesterol, and what are the recommended levels?
A5. It's recommended to have your cholesterol checked regularly, starting around age 20, and more frequently if you have risk factors for heart disease. Ideal cholesterol levels vary, but generally, total cholesterol should be less than 200 mg/dL, LDL less than 100 mg/dL, and HDL above 40 mg/dL for men and above 50 mg/dL for women.