Are you at high risk for heart disease?

Getting tested for cholesterol is a good idea if you are over 30, eat out often & have a high-stress job


Naman Maheshwari had always been a foodie. As a young techie living alone in Bangalore, eating out was his passion. His stomach could tolerate almost anything - spicy, oily, fatty, creamy and cheesy. And because he led an active life, putting on weight wasn’t a concern.


But as his workload in office increased, Maheshwari was left with little or no time to exercise. “I was working 15-16 hours a day and on most weekends. Where was the time to hit the gym?” he notes. Apart from adding some extra pounds, Maheshwari’s friends also noticed he wasn’t as energetic as before. But because there were no major health issues, he chose to ignore it.


An annual health checkup few years later (he was 36 at that time), threw up the first warning sign - his cholesterol levels were way off the charts. A lifestyle change was recommended, but this advice went largely unheeded. Ten months later, disaster struck!


Maheshwari had to be hospitalized with acute chest pain radiating down his right hand, profuse sweating and difficulty breathing. He had suffered a Heart Attack! “Timely intervention saved my life, but not everyone is as lucky. It was my wake-up call - I realized there was no option but to change my habits, for my well-being and that of my family,” recalls Maheshwari.


He is not alone. More than 75% of urban Indians have skewed cholesterol (or lipid) ratios – this statistic is scary because abnormal cholesterol levels can clog up arteries and lead to diseases that are either fatal or have severe medical complications.


Considered an old-age disease up until a few years ago, high cholesterol is now common in youngsters. The culprit is an unhealthy lifestyle and dietary habits. Says Dr. Anupama Kakade, Consultant, Internal Medicine, Apollo Clinic, Bangalore, “Sedentary lifestyles, increased stress, lack of physical activity, smoking and regular intake of junk or oily food are the reasons we are seeing so many young people with high cholesterol.”


Understanding Cholesterol


Cholesterol is a waxy substance found in the fat in your blood. Contrary to popular perception, cholesterol by itself isn't bad. In fact, cholesterol is essential for building healthy cells. However, excess cholesterol is unhealthy.


There are two types of cholesterols - good cholesterol (or HDL) and bad cholesterol (or LDL). LDL is considered as “bad cholesterol” because it contributes to plaque, a thick, hard deposit that can clog arteries and make them less flexible. HDL is considered as “good cholesterol” because it helps remove excess LDL from the arteries.


Triglycerides are another type of fat (or lipid) found in the blood. When you eat, the body converts calories it doesn't need to use right away into triglycerides. If you regularly eat more calories (particularly carbohydrates and fats) than you can burn, you may have high triglycerides.


Knowing Your Cholesterol


Total Cholesterol, HDL, HDL Ratio, LDL, VLDL and Triglycerides are the most common tests prescribed to assess heart risk. These may also be  done together as part of a Lipid Profile.


A total cholesterol level below 200 mg/dL is desirable; between 200-239 is borderline high; upwards of 240 is considered high-risk.


HDL should ideally be over 40 mg/dL for a man and over 60 mg/dL for a woman. 


LDL should be under 100 mg/dL. Triglycerides should be under 150 mg/dL. An elevated VLDL cholesterol level is more than 30 mg/dL.


Keeping your cholesterol in check is necessary because high cholesterol can cause atherosclerosis, a dangerous buildup of plaque on the walls of your arteries. This can, in turn, lead to complications such as angina, heart attack and stroke. Your heart may not get as much oxygen-rich blood as it needs, which increases the risk of a heart attack. Similarly, decreased blood flow to your brain can cause a stroke.


Dr. Pratik Soni, Consultant Cardiologist, Wockhardt Hospital, Mumbai, recommends regular cholesterol checks for those over 30 years. “There are no obvious signs and symptoms of high cholesterol, so it’s good to get tested. If your cholesterol is high, repeat the tests after three months. If your cholesterol is under control, do a follow-up test after 6 months (recommended for people at high risk).


Keeping Cholesterol in Check


Lifestyle changes are the first line of defense against high cholesterol. But if you've made these lifestyle changes and your cholesterol levels are still high, medication may be prescribed. Dr. Kakade notes, “I don’t prescribe statins (cholesterol lowering drugs) to my patients right away unless the case is extreme and it involves a family history of dyslipidemia coupled with diabetes and heart disease.”


Dr. Soni advises his patients to exercise daily, avoid junk food, cut back on red meat & dairy products, quit smoking and eat a balanced meal that includes a lots of vegetables. “You don’t even have to buy an expensive gym membership – just walk briskly for about 25-30 minutes daily,” he adds. 


Maheshwari, for example, says he now uses the stairs instead of taking an elevator and does on-the-spot marching for 100 counts if he cannot go for a walk. “I eat out much less frequently and avoid red meat, butter & cheese altogether. I already feel ten years younger,” he adds.


Some medical professionals have recently questioned the long-held belief that high cholesterol increases the risk of heart disease – citing other reasons such as high blood pressure, diabetes, obesity, family history, etc. as being more important. Even as the medical fraternity debates the merit of this argument and comes to a definite conclusion about the real trigger, it suffices to say that a healthy lifestyle is the key to a healthy heart!


- Rahul Lahkar, Saralhealth Bureau, Bangalore    


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