Heart Health
A lipid profile has five or six lines, and most people read only the total. The number that predicts heart attacks best is usually further down the page.
The target depends on your overall risk rather than on a universal cut-off. A healthy 30-year-old with no risk factors is generally advised to keep LDL below 100 mg/dL. Someone with diabetes or several risk factors should aim below 70. A patient who has already had a heart attack, stent or stroke is usually treated to below 55.
This is why two people can have identical reports and receive different advice. Ask your doctor what your target is, not whether your report is 'normal'.
Fasting is no longer mandatory for a routine lipid profile. Fasting samples are still preferred when triglycerides are very high or when monitoring a specific triglyceride problem.
Dietary cholesterol — eggs, prawns — has much less effect on blood cholesterol than was believed for decades. What raises LDL meaningfully is saturated and trans fat: vanaspati and bakery shortening, deep-fried snacks, reused frying oil, excess ghee and butter, and processed meat.
What lowers it: soluble fibre from oats, barley, pulses, methi seeds and apples; nuts, particularly almonds and walnuts, in a small daily handful; fatty fish twice a week; and replacing saturated fat with mustard, groundnut, rice bran or olive oil rather than simply reducing all fat.
Statins reduce heart attack and stroke risk substantially in people at genuine risk, and the benefit is proportional to how much LDL falls. They are prescribed for a level of risk, not merely for a number on a report.
Muscle aches occur in a small minority and usually respond to a change of drug or dose; severe muscle injury is rare. They do slightly increase the chance of developing diabetes in predisposed people, but the cardiovascular benefit outweighs this in those who need them. Liver enzyme monitoring is done, though serious liver injury is very uncommon. Statins are generally taken long-term, because stopping returns LDL to its previous level within weeks.
This article is general health education written and reviewed by the Department of Cardiology at SIMS. It is not a substitute for an examination, a diagnosis or the advice of your own treating doctor, and it cannot account for your history, medicines or reports. If a symptom is sudden or severe — chest pain, stroke symptoms, breathing difficulty, serious injury, seizures or heavy bleeding — call 9281862028 or come straight to the emergency department instead of reading further.
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