High cholesterol has no symptoms, only a disease can alert you to it. So test regularly, remove triggers

Some people complain of pain, cramps, fatigue and tingling in the lower limbs. This is called claudication and is again not a warning but a manifestation of cholesterol clogging up your peripheral vascular system. We must understand that cholesterol build-up is a slow process. And unfortunately, you experience conditions only when the damage has been done, like atherosclerosis or plaque formation in the heart, strokes and peripheral artery blockages. That’s why monitoring its levels is important and since most Indians do not have enough good cholesterol or high-density lipoprotein (HDL), this hardly going above the 40 mg/dL, there is a need to reduce our low density lipoprotein (LDL). With high-risk Indians, LDL should be between 70 and 100 mg/dL, for those with multiple risk factors even lower to 50 mg/dL. High triglyceride levels may result in hardening of the arteries, which increase risks of stroke, heart attack and heart disease, and become a threatening combination with high LDL and low HDL.

So what you need is to not look out for signs and symptoms but be conscious of your risk factors, adopt lifestyle corrections to modify them early and test annually to keep yourself within limits.

Watch your diet: Consuming saturated fat (mostly found in red meat and full fat dairy products), trans fats (found in packaged snacks and desserts) and processed food can result in unhealthy cholesterol levels. According to the American Heart Association guidelines, opt for “low-fat or fat-free dairy products, fruits, vegetables, whole grains, poultry, fish, nuts, and non-tropical vegetable oils. Healthier cooking oils include canola, corn, olive, peanut, safflower, soybean, sunflower, vegetable oil, and other specialty oils.” Go for more whole and plant foods.

Watch your weight: Having a body mass index (BMI) of 30 and higher means there is enough fat accumulation in the body, enough to put you at a risk of high cholesterol.

Take up exercise, now: If you didn’t already know, exercise not just keeps off the weight but helps build levels of HDL.

Quit smoking: Did you ever wonder why smoking is a major risk for heart disease? That’s because it lowers your levels of good cholesterol or HDL, which has a protective effect on the heart.

Stay away from alcohol: Research has already proven the link between overconsumption of alcohol and high blood pressure. Also, when you drink alcohol, it breaks down and gets converted into triglycerides and cholesterol in the liver. Not a happy news at all.

Follow age-related precaution: With advancing years, the liver metabolism changes and it loses its capacity to remove LDL cholesterol.

Remove stress: When stress hormones cortisol and adrenaline are in excess levels in the body, they elevate blood sugar levels for the body’s use as energy and do not touch the fat. The high blood glucose level in turn triggers the production of triglycerides.

Trust your statins: This is the best way to get your cholesterol levels down between four and six weeks from a dangerous threshold. Statins slow down the production of cholesterol in the liver and increase the liver’s ability to remove LDL. The drug Ezetimibe reduces absorption of cholesterol from the small intestine but statins are undoubtedly more effective. So what can those who have marked signs of statin intolerance do? A Cleveland Clinic-led clinical trial has showed that the use of Bempedoic acid (a cholesterol-lowering drug) in statin-intolerant patients – who have not yet had a cardiovascular event, but do have risk factors like diabetes – significantly reduced the chance of death from heart disease and other major adverse cardiovascular events such as heart attacks and strokes. But if an event has happened, you need to be on statins.