Normal cholesterol report may still hide heart risk, doctors say
Doctors say a normal total cholesterol reading can still mask heart risk if a person's personal LDL-C target is not checked
Most people check their cholesterol report only to see whether it says "normal" or "abnormal". But experts say looking at total cholesterol alone is not enough for heart health. Every person's target for LDL-C, or low-density lipoprotein cholesterol, can be different, based on age, family history, diabetes, high blood pressure and other risk factors.
The case of 34-year-old Vikram Desai from Mumbai illustrates this well. His cholesterol level was within the standard limit in his annual health checkup. Since he exercised regularly and stayed fit, he assumed his health was fine.
But after speaking to a doctor, he learnt that the general limit given in a lab report is different from a person's own personal LDL-C target. If there is a family history, diabetes or another risk factor linked to heart disease, the LDL-C target can be stricter.
LDL-C is often called "bad cholesterol". When its level rises, a layer of fat called plaque starts building up in blood vessels, a condition called atherosclerosis. This can block blood vessels and affect blood flow to the heart, brain and other parts of the body, raising the risk of heart attack, stroke and peripheral artery disease.
It is also worth noting that being young, exercising regularly or keeping weight under control does not guarantee that a person's LDL-C has not risen. Experts therefore advise against skipping regular checkups.
According to the Cardiology Society of India (CSI), lipid profile testing should begin from the age of 18 so that heart health can be tracked in time.
Dr Nimit Shah, consultant interventional cardiologist at Saifee Hospital in Mumbai, said the LDL-C target is not the same for everyone. The personal target is decided based on age, family history, diabetes, high blood pressure and other risk factors.
The next time a health checkup is done, it can help to discuss LDL-C with the doctor rather than just looking at the report's numbers. Patients can ask their doctor what their current LDL-C level is, what their correct personal target should be, whether their level is within that target, and what the options are if it is not.
A balanced diet, regular exercise, weight control and stress management can help heart health. But in some people, lifestyle changes alone do not bring LDL-C down to the required level. In such cases, lipid-lowering medicines may be necessary on a doctor's advice. Patients should not start or stop medication on their own without consulting a doctor. Regular checkups, knowing one's personal LDL-C target, and treatment under a doctor's guidance are considered key steps in taking care of heart health.
