High cholesterol is a health concern that often goes unnoticed due to its lack of symptoms, allowing it to silently increase the risk of heart disease and stroke.
Low-density lipoprotein cholesterol (LDLC), also known as 'bad cholesterol,' contributes to plaque buildup in the arteries and causes damage, making it a 'silent killer'.
Additionally, misconceptions about managing high LDLC levels impact treatment adherence and overall patient outcomes. Maintaining LDLC levels requires a lifelong commitment to sustain the target levels.
However, a growing trend shows people discontinuing medication due to the belief that once LDLC targets are met, continued treatment is no longer necessary. This is evident in the study published in Population Medicine, which found that nearly 40% of older adults with high cholesterol do not adhere to prescribed regimens.
This non-adherence can lead to the progression of atherosclerosis, often nullifying any progress achieved during the medication cycle.
In an interview with HT Lifestyle, Dr Viveka Kumar, vice chairman and chief of Cath Labs at Pan Max - Cardiac Sciences in Delhi, shared, "Managing LDLC is not about achieving a one-time target. It's a commitment to consistent, lifelong maintenance. High LDLC levels might not cause noticeable symptoms, but the damage within the arteries is constant.
"Over time, this silent accumulation of plaque in the arteries can lead to serious cardiovascular events like heart attacks and strokes, even in patients who feel completely healthy."
He revealed, "In my experience, I have noticed 40% of people who could have treated the condition, but due to misconceptions, they missed the opportunity.
Hence, patients must understand that LDLC management is a precise, evidence-based approach to reducing cardiovascular risk. Every patient has unique risk factors, so treatment plans must be personalised to fit those needs.
LDLC target level is often considered a fixed figure, whereas, in reality, it varies depending on individual risk factors, family history, and existing health conditions.
The recent Cardiological Society of India (CSI) guidelines emphasise the importance of personalised LDLC goals tailored to each patient's risk profile.
For instance, individuals with diabetes and hypertension may have a more stringent target LDLC level (e.g., <70 mg/dL) compared to those without significant comorbidities."
High cholesterol myths busted
There is a common misconception among people that when treating LDLC, lifestyle changes like dietary improvements and increased physical activity are sufficient to effectively manage LDLC goals, making medications seem unnecessary or redundant.
Dr Viveka Kumar highlighted, "Lifestyle modifications play an essential role in supporting cardiovascular health, but they often fall short of effectively controlling LDLC levels individually, especially in high-risk individuals. Clinical evidence underscores the importance of combining lifestyle adjustments with pharmacological therapies to achieve optimal LDLC reduction."
Another myth is that elevated LDLC is only relevant for older adults, further undermining early preventive care.
Dr Viveka Kumar said, "Elevated LDLC, along with its associated cardiovascular risks, can impact individuals of all ages, including young adults. According to the CSI guidelines, it is recommended that young adults undergo lipid profile assessments to identify and manage dyslipidemia early on, especially if they have a family history of cardiovascular disease or genetic predispositions.
"Early identification and management of elevated LDLC can help prevent the development of coronary artery disease (CAD) later in life, reducing the likelihood of heart disease in adulthood."
Shifting treatment paradigms also reflect evolving standards in LDLC management. Dr Viveka Kumar said, "Historically, cholesterol-reducing medicines were prescribed primarily for patients with LDLC levels above 130 mg/dL for those with diabetes or above 160 mg/dL for non-diabetics.
"This changed when new draft guidelines for the UK's National Health Service [NHS] suggested broader use of cholesterol-lowering drugs, recommending that they be prescribed even to individuals with less than a 10% risk of heart attack or stroke within the next decade but the older protocol regarding medicine use is still more widely followed."
He added, "Concerns regarding side effects from cholesterol-lowering medication, most commonly, muscle pain, are another obstacle to adherence. Although medications can cause side effects such as muscle pain, these adverse reactions are not universal.
"According to the CSI guidelines, many patients tolerate cholesterol-lowering medicines well, and those who experience side effects may benefit from dosage adjustments, alternative prescriptions, or supplementary therapies. Awareness of potential side effects allows clinicians to address patients' concerns while ensuring effective LDLC management."
Addressing common misconceptions and consulting your physician for the treatment regimen that best suits your diagnosis can support more effective treatment outcomes and a reduction in long-term cardiovascular risk.
Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
Hindustan Times
Bd-Pratidin English/ARK
