If my cholesterol is less than 200mg/dL, within the normal vary, should I be concerned about heart illness?

When 45-year-old Arjun Mishra* went to the emergency room with a heart assault and required a stent, he was disturbed. Just per week in the past, his full physique checkup studies confirmed that his complete cholesterol was less than 200 mg/dL. But the fact is that optimum cholesterol ranges don’t all the time assure heart well being, as the proportion of unhealthy cholesterol in the blood is nonetheless formation of plaques in the arteries.

“No cholesterol restrict is thought of protected. The commonest mistake folks make is to consider complete cholesterol as an indicator of well being. But the fact of the matter is that you must take a look at the particular person elements, particularly the variety of LDL (unhealthy cholesterol), the proportion of HDL (good cholesterol) and the HDL:LDL ratio. Indians have low HDL. They say 50 mg/dL is very best for neutralizing LDL, however in Indians the stage by no means exceeds 45 mg/dL. So we should solely deal with LDL ranges and maintain them low. In truth, in the final three a long time, the protected restrict for LDL has come down and for Indians who’re genetically susceptible to heart illness, LDL ranges are the solely concern,” says Dr. Balbir Singh, Chairman, Cardiology Sciences, Cardiology, Heart, Electrophysiology-Pacemaker, Max Hospital , Saket.

What is the most secure LDL quantity?

“Internationally, they like LDL beneath 70 mg/dL, however for Indians I would say beneath 50 mg/dL. Heart illness in Indians is compounded by further threat elements similar to household historical past, smoking, stress, hypertension and diabetes. “Many younger Indians are getting stents at an early age,” he says.

Another threat issue is triglycerides. “LDL ranges are related to co-morbidities, excessive triglycerides and physique weight for some folks. Triglycerides are a fats in the blood that, together with cholesterol, trigger plaque formation. Therefore, each triglycerides and LDL ranges should be stored pretty low,” says Dr. Singh.

In truth, the Johns Hopkins suggestions say that LDL can be too extra harmful in ladies than in males. “This is problematic as a result of ladies’s cholesterol ranges fluctuate barely after menopause and improve with age, placing them in danger for heart illness and stroke. “Knowing your cholesterol numbers and how one can management them is an enormous step towards staying wholesome,” he mentioned.

“LDL particles like cleaning soap scum on the pipes and like to stay to the partitions of your arteries. It sticks to the floor, creates an inflammatory response, and your physique begins to show it into plaque. Plaque in your blood vessels makes them more durable and narrower, proscribing blood move to essential organs like the mind and heart muscle, and inflicting hypertension. Furthermore, the clots can break off and trigger a heart assault or stroke. And guess what? This accumulation can start as early as your 20s,” says the Johns Hopkins tips.

Dr. Singh says India’s tips are totally different for this very cause. “Very low LDL ranges stop most cardiovascular occasions. In excessive circumstances, we should work towards a marker of less than 30 mg/dL. And we should begin early remedy with lipid-lowering medication along with optimistic way of life modifications for these in danger.”

What may be the preventive protocol?

“I have seen many sufferers who’ve normal cholesterol ranges however are at excessive threat for heart illness. This occurs for a lot of causes – they smoke, lead a anxious life, sedentary way of life, diabetes, hypertension, household historical past of heart illness. In sufferers who usually have low cholesterol, we take a look at all of those threat elements collectively after which decide whether or not additional testing is mandatory. This might embody a CT scan of the heart, a treadmill take a look at, and a carotid ultrasound. People suppose that as a result of their cholesterol is normal, they don’t seem to be in danger for heart illness. It’s improper. It’s a false impression that even people who find themselves match however heavy people who smoke and drinkers should get checked each six months. Those who’re overweight or don’t train recurrently are definitely in danger. Even if their cholesterol ranges are normal, they should stroll religiously for half-hour, which considerably reduces the threat of heart illness,” says Dr. Manish Bansal, Director, Heart Institute, Medanta Hospital, Gurgaon.

(*Name has been modified to guard identification)

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