Vikram Desai, a 34-year-old professional working in a multinational software company, has always balanced his career with a passion for fitness. But during a routine check-up, he was stunned to learn that his cholesterol levels were significantly higher than normal. He says, “I had no idea my cholesterol levels were so high. I regularly exercise and eat healthy. But during a regular check-up, I discovered my cholesterol levels were well above the normal range. As there were no symptoms, I wouldn’t have known if I hadn’t done the check-up. I had a false assumption that my health is perfectly fine.”
This story isn’t rare. According to recent data, 31% of people in India have elevated cholesterol levels,[1] with high cholesterol being one of the leading causes of mortality worldwide[2]. Cholesterol is responsible for producing hormones, vitamin D, and bile acids that aid digestion. It’s not inherently harmful, in fact, it’s essential for life. However, Low-density lipoprotein cholesterol (LDLC), commonly referred to as “bad cholesterol,” when it rises beyond optimal levels, becomes deadly.
LDLC is a ‘silent killer’ that doesn’t knock or announce its arrival. Excess LDLC starts building plaque in the arteries, eventually creating blockages and causing a heart attack. It not only affects cardiovascular function but can affect the entire body. Because of its silent nature, it’s crucial to be proactive with screenings and treatment. One should know their target LDLC levels, which are unique for every individual. Consistently reaching the target and maintaining the levels is essential.
Dr. PLN Kapardhi, Cath Lab Director, Senior Consultant, Cardiologist, Care Hospital Banjara Hills, Hyderabad, says, “The narrowing of arteries causes blood pressure to rise, organs start feeling strained, and there is an imbalance in hormones- all this can progress asymptomatically for years. The notion that high cholesterol only affects individuals over 50 is outdated. It’s now recommended that routine lipid profile screenings start as early as age 18, to enable early detection and get timely management for any abnormalities. Once you know the target levels, it’s important to seek treatment from a professional and adhere to the prescribed medicines. In severe cases, advanced treatments such as inclisiran can be prescribed.”
Most people wouldn’t associate cholesterol with cognitive function. Yet, elevated LDL cholesterol can reduce blood flow to the brain, slowly starving it of oxygen. Over time, this increases the risk of vascular dementia, memory loss and in some cases, sudden neurological events like stroke.[3]
Cholesterol is a building block for hormone production. But in certain instances, hormonal imbalances impact LDLC. For instance, after menopause, when estrogen levels drop sharply, LDLC levels rise in women.[4] Similarly, in hypothyroidism, where the thyroid is underactive, LDLC levels tend to spike.[5]
High LDLC can also cause peripheral artery disease (PAD), which narrows or blocks arteries in the legs and arms. As the arteries become stiffer, the heart must work harder, raising blood pressure and pushing the body closer to severe hypertension.[6] LDLC also leads to gastrointestinal issues. Excess cholesterol in bile can gradually solidify into crystals, which may accumulate in the gallbladder and lead to the formation of [7][8]
Cholesterol metabolism in the body is influenced not just by what we eat or how much we move, but also by factors like stress, sleep quality, and overall metabolic health. While regular physical activity helps raise HDL – good cholesterol, and supports heart function, it’s only one piece of the puzzle.
A more holistic approach, including stress-reducing practices like mindfulness, yoga, and maintaining a consistent sleep schedule, can further support healthy cholesterol levels. However, these lifestyle changes, while powerful, are not substitutes for medication. For individuals with consistently elevated LDL cholesterol or those at high risk of cardiovascular disease, medication remains a vital part of effective treatment.