Cardiac Disease The Leading Cause Of Death.

Some of the cholesterol we need is produced naturally (and can be affected by your family (genetic) health history – Familial Hypercholesterolemia), while some of it comes from the food we eat. There are two types of cholesterol: “good” and “bad.” It’s important to understand the difference, and to know the levels of “good” and “bad” cholesterol in your blood. Too much of one type (Total Cholesterol, LDL, VLDL, Triglycerides, Lipo a) — or not enough of another (HDL Cholesterol) — can put you at risk for coronary heart disease, heart attack or stroke.

What Is Cholesterol?

Cholesterol is a soft, fat-like, waxy substance found in the bloodstream and in all your body's cells. It's normal to have cholesterol. Cholesterol is an important part of a healthy body because it's used for producing cell membranes and some hormones, and serves other needed bodily functions. But too much cholesterol in the blood is a major risk for coronary heart disease (which leads to heart attack) and for stroke. Hypercholesterolemia is the medical term for high levels of blood cholesterol.

What are the sources of Cholesterol?

Cholesterol comes from two sources: your body and food. Your liver and other cells in your body make about 75 percent of blood cholesterol. The other 25 percent comes from the foods you eat.

What does Total Cholesterol Mean?

Total Blood Cholesterol Levels Risk Due to Total Cholesterol
Less than 200 mg/dL Desirable (Lower Risk)
200 – 239 mg/dL Borderline High (Higher Risk)
240 mg/dL or Higher High Risk (> 2 times Normal Risk)


What is LDL Cholesterol?

LDL cholesterol is the “bad” cholesterol. When too much of it circulates in the blood, it can clog arteries, increasing the risk of heart attack and stroke. LDL cholesterol is produced naturally by the body, but many people inherit genes from their mother, father or even grandparents that cause them to make too much. Eating saturated fat, trans fats and dietary cholesterol also increases how much you have. If high blood cholesterol runs in your family, lifestyle modifications may not be enough to help lower your LDL blood cholesterol. 

LDL Cholesterol Levels Risk Due to LDL Cholesterol Levels
Less than 100 mg/dL Ideal for people with heart disease & Diabetes
100 – 129mg/dL Near or Higher than optimal
130 – 159 mg/dL Borderline High Risk
160 – 189 mg/dL High Risk Group
190 mg/dL and above Very High Risk Group


Lowering LDL cholesterol by 1 mg/dL decreases the risk of Heart Attacks by 1%. It is presently advised that in people who are diabetic and have had a heart attack the ideal levels of LDL cholesterol should be upto 80 mg/dL.
Lowering LDL cholesterol have been shown to significantly improve long term survival and significantly decrease the incidence of heart attacks. There is objective evidence of decrease in plaque (block) reduction on serial angiographic evaluations. This effective decrease in the modern day improvement by medications in non critical (< 80% Block) has lead to an increasing debate on – “is Angiography and Angioplasty being overused for Non Scientific Monitory benefits?”
The present recommendations by the European and Western world clearly – indicates angioplasty or bypass surgery only after – effective evaluation for functional significance of a lesion. 

What is HDL Cholesterol?

HDL stands for high-density lipoprotein. HDL is “good” cholesterol because it seems to lower your risk of heart attack and stroke. That means that — unlike other cholesterol levels — the higher your HDL, the better. You can raise your HDL by quitting smoking, losing excess weight and being more active. Increasing your HDL cholesterol by 1 mg/dL decreases the risk for heart attacks by 2%. Increasing HDL cholesterol is more difficult than decreasing LDL cholesterol. The average HDL cholesterol in the South Asian Indian population is 35 – 45 mg/dL compared to the European and Western populations average of 50 to above 60 mg/dL, this is another reason why Indian’s are at a greater risk for Diabetes and Heart Attacks.  

HDL Cholesterol Levels Risk Due to HDL Cholesterol Levels
Less than 40 mg/dL Low HDL (High Risk)
40 – 59 mg/dL Higher HDL the better (Lower Risk)
60 mg/dL or More Borderline High Risk


What Triglycerides Mean?

Triglycerides are the most common type of fat in your body. They’re also a major energy source. They come from food, and your body also makes them. As people get older, gain excess weight or both, their triglyceride and cholesterol levels tend to rise. Many people who have heart disease or diabetes have high fasting triglyceride levels. Some studies have shown that people with above-normal fasting triglyceride levels (150 mg/dL or higher) have a higher risk of heart disease and stroke.

Triglyceride Cholesterol Levels Risk Due to Triglyceride Cholesterol Levels
Less than 150 mg/dL Normal
150 – 199 mg/dL Borderline High
200 – 499 mg/dL High
500 mg/dL and above Very High


How often should you screen for Cholesterol?

Everyone age 20 and older should have a fasting "lipoprotein profile" – if normal it is advisable to repeat such a profile every 2 years till age 35 years and every year then on. This test is done by drawing 5ml of blood from one of your arm veins, after a 9- to 12-hour fast (without food), liquids or pills. It gives information about total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides.

How do I Monitor Cholesterol, Blood Pressure, Weight, Diabetes, Waist Girth and BMI ?

Height (Centimeters) ___ GOAL DATE DATE DATE DATE DATE
Blood Pressure (mm Hg)            
Total Cholesterol (mg/dL)            
LDL Cholesterol (mg/dL)            
HDL Cholesterol (mg/dL)            
Weight (Kilograms)            
Waist Circumference (Inch)            
Basal Metabolic Index (BMI)            

All these parameters should be discussed with your doctor and an ideal GOAL should be set before starting treatment.

How can I lower high Cholesterol through Life style modification?

Too much cholesterol in the blood can lead to heart disease and stroke — America’s No. 1and No. 3 killers. 53% of all deaths in India are due to Coronary Heart Disease. Even though there’s much you can do to lower your cholesterol levels and protect yourself, half of the adult population of the world still have levels that are too high (over 200 mg/dL).
You can reduce cholesterol in your blood by eating healthful foods, losing weight if you need to and exercising. Some people also need to take medicine because changing their diet isn’t enough. Your doctor and nurses will help you set up a plan for reducing your cholesterol — and keeping yourself healthy! Most heart and blood vessel disease is caused by a buildup of cholesterol, plaque and other fatty deposits in artery walls. The arteries that feed the heart can become so clogged that the blood flow is reduced, causing chest pain. If a blood clot forms and blocks the artery, a heart attack can occur. Similarly, if a blood clot blocks an artery leading to or in the brain, a stroke results.


Most heart disease and many strokes are caused by a buildup of fat, cholesterol and other substances called plaque in the inner walls of your arteries. The arteries can become clogged and narrow, and blood flow is reduced. If a blood clot forms and blocks blood flow to your heart, it causes a heart attack. If a blood clot blocks an artery leading to or in the brain, a stroke results.

Life style modifications do help a lot in cholesterol reduction.

  • Eat a healthy diet – Discuss with your doctor or nurse on what sort of diet should you take to have a healthy but not harmful diet. The misconception that you can never have tasty food is a myth and this will help you resolve that.

  • Regular exercise of moderate degree like walking 30 min a day on most days will help decrease diabetes, protect your heart and control cholesterol levels also. . 

  • Regular health checks – to see that your goals set at the start of the program or to reassess – if you need to me supplemented by medicines to have adequate control.

Medical management in cholesterol reduction.

  • If your doctor has decided that you need to take medicine to reduce high cholesterol, it’s because you’re at high risk for heart disease or stroke. Usually, the treatment combines diet and medicine.

  • Often you’ll be asked to take more than one. Always follow your doctor’s orders carefully, and let them know if you have any side effects. Never stop taking your medicine on your own!

  • Remembering to take your pills on time and periodically evaluating if the cholesterol levels are under control is the most important of all

  • There are different Groups of Cholesterol Medications

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