News of untimely, unexpected deaths due to cardiac arrests is becoming more common. You might have seen viral videos on social media of people collapsing due to heart attacks while working at their desks or despite appearing fine just moments before.
It’s terrifying, I know. But what can we do, right?
Wrong — we can do something. When was the last time you had your lipid profile test? If you don’t remember, it’s time to get it done.
Keeping track of your lipid levels is one of the first and crucial steps that you can take to prevent heart attacks and strokes — even if you think you are a healthy adult.
Last week, the Cardiological Society of India (CSI) released India’s first guidelines on dyslipidemia, based on local data. Dyslipidemia is the term used to describe abnormal lipid levels in the bloodstream.
These new guidelines recommend that you start checking your lipid levels annually once you turn 18. Set a yearly reminder, perhaps on your birthday or anniversary, to ensure you get the test done.
Dyslipidemia is a ‘silent killer’. High cholesterol and high triglycerides often show no symptoms, but plaque will keep building up in your arteries, potentially leading to a sudden stroke.
A study published in June 2023 in The Lancet Diabetes & Endocrinology, supported by the Indian Council of Medical Research (ICMR), revealed that the national prevalence of dyslipidemia in India is an alarming 81.2%. This means a vast number of us are vulnerable to heart attacks. Therefore, we cannot afford to ignore the simplest way to monitor our heart health: the lipid profile test.
In fact, you can now have your lipid profile tested without fasting, shifting from traditional fasting measurements. The move, CSI expects, would make it more convenient for people to get their tests done at any time of the day without waiting for 12-hour fasting.
Most Important Parameter in Your Lipid Test
One of the most important parameters in your report is LDL-Cholesterol — also known as bad cholesterol — which contributes to plaque build-up in arteries. Once this level starts showing an uptick, you need to get very serious about your heart health.
And if your triglycerides are high, the parameter of ‘non-HDL cholesterol’ should be the focus. Non-HDL includes all types of bad cholesterol and it is the difference between good cholesterol (or HDL) and total cholesterol.
The new guidelines now include Lipoprotein (a) as an important parameter in lipid testing. Previously, the key parameters were LDL cholesterol, non-HDL cholesterol, HDL cholesterol, and triglycerides. However, testing for Lipoprotein (a) levels is now recommended.
Elevated levels of Lipoprotein (a) indicate an increased risk for heart disease and stroke. These particles, composed of proteins and fats (lipids), transport cholesterol through your bloodstream to your cells.
How to Read New Lipid Profiles?
New guidelines are different and bring customisation for four sets of people – low risk, moderate risk, high risk and very high risk.
Now, with your report, you will see a table segregating the reading based on your condition. While it’s important to consult your healthcare provider once you get your report, the first step is to understand that in which category you lie.
‘Low risk’ means an individual who has no known risk of having heart disease – this means you don’t smoke, consume tobacco, or have any medical history including high blood pressure, diabetes, previous history of high lipids or a family history of heart attack or heart disease.
‘Moderate risk’ means the one who either smokes, consumes tobacco, has hypertension, diabetes, dyslipidemia or a family history of young heart attack. Those who fall in ‘high risk’ are people with diabetes with one or more risk factors, hypertension with one or more risk factors or chronic kidney disease or people with a family history of heart disease.
The ‘very high risk’ category includes people with clinical evidence of blockages in arteries, diabetes for more than 20 years or diabetes with complications, and a family history of blockages in arteries.
Now, once you know which category you fall in, match your report with the reference ranges given in the table.
For instance: a patient with a history of heart disease should not be relieved by seeing his bad cholesterol (LDL) levels at 100 in the report (as per the present guidelines inserted in his lipid test report shows his results in the normal range). For his medical history, he should have levels less than 55, which the new format will clarify.
What You Should Not Do If Your Report is Out of Sync?
If the report is out of sync, you should follow medical advice, which may involve lifestyle modifications and medication if necessary. The authors of the latest guidelines believe that at least 50% of heart attacks can be prevented if Indians start adhering to these guidelines and unfollow the unscientific and ill-conceived WhatsApp forwards.
Yes, several doctors, including cardiologists, are extremely disappointed with their patients altering or quitting the medical treatment due to ‘advice’ on social media or WhatsApp forwards. “Patients stop or alter the medicines based on some random videos or messages they receive on social media platforms,” Dr Tanmay Yermal Jain, consultant cardiologist at Manipal Hospital, Pune told News18. “We face serious challenges as patients come to us with half-knowledge or in critical conditions.”
“I commonly come across people with high cholesterol levels who stop their treatment and don’t come for regular follow-ups. People must understand that these levels need to be treated as per their requirements.”
Senior interventional cardiologist, Dr Debdatta Majumdar explained that Indians are genetically susceptible to getting heart diseases, at least 10 years younger than their Western counterparts.
Majumdar, who works at NH RN Tagore Hospital in Kolkata, pointed out that the age of getting heart diseases among Indians is going down. “We are catching heart diseases at least 10-20 years early now. And the reason is a mix of increasing awareness, better diagnosis and advent of the disease.”
He warned that “our genetics are unhealthy” – with respect to the vulnerability of catching heart disease and hence, 50% of heart disease will be out of our control. “We can only control the remaining 50% by modifying our lifestyle and diet.”
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