Cholesterol: the good, the bad, the ugly

City cardiologists say those with a family history of heart disease should get regular cholesterol checks from age 12.

Kavin Tulsiani has got his 10-year-old son, Hriday’s cholesterol levels checked. The 39-year-old had discovered he had high cholesterol when he was 24. He had a heart attack when he was 32. And now, he does not want to take any chances with his son.

High cholesterol levels increase the risk of heart disease and stroke. “Both my parents had bypass surgeries when they were 55. The doctor had told me to be careful, but how careful can one be at that age? I made my mistakes; I smoked for a decade, ate loads of burgers when I was studying in the US, but I got my jolt and now I lead a very different lifestyle,” said Tulsiani, who lives in Prabhadevi. “They say cholesterol deposits begin as early as three years of age so I want my child to be careful.”

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Tulsiani has made healthy eating and exercise part of the family’s routine. His son is taught about good food habits and doesn’t gorge on pizzas and French fries as often as other children of his age do.

An HT-C fore survey (see box on top) revealed that cholesterol-related problems are among the common lifestyle-related complaints Mumbaiites have. It also showed more men had these complaints than women. It is well-established that cholesterol leads to heart disease. However, there is still confusion about what are the normal cholesterol levels and the various types of cholesterol.

Indians have the highest rates of coronary artery disease (CAD), even though nearly half of them are vegetarians. By 2015, it is estimated that India will have 62 million patients with CAD. Of these, 23 million will be less than 40 years old. In the past 30 years, the average age of a first heart attack increased by more than 10 years in the US, but decreased by more than 10 years in India. Indians are generally five to 10 years younger than people from other countries by the time they get their first heart attack.

“We don’t take enough steps, it’s as simple as that,” said Dr Anil Kumar, head of cardiology, Bombay Hospital. “A person must take an average of 10,000 steps every day, but we range between 1,500 and 2,000. If the administration fixes the footpaths in the city, it will be a great service to citizens.” Dr Kumar said our genetic predisposition being higher than the rest, lifestyle plays an important role in maintaining our cholesterol levels. Another important factor he said was people’s casual attitude to medication. “My consulting room is filled with people who start on statins (cholesterol-lowering medication) without proper advice. They should be the last resort as they all have side effects. Also, once you go on medication it is very difficult to go off it because it affects your health adversely,” added Dr Kumar.

Doctors advise that you should get your cholesterol levels checked as early as possible. However, getting tests is not enough, reports need to be examined by a doctor and preventive measures need to be taken. Prashant Bhat, a photographer, learnt this the hard way. Being overweight, he would check his cholesterol levels regularly since he was 35. When he did his test at 37, his triglyceride level was quite high. A quick Internet search showed that beer intake can cause this. “I didn’t show my reports to my family doctor and blamed it all on the beer. Then at 38, at 94 kg, I had a heart attack when I was in a meeting,” said the 40-year-old. After an angioplasty at Asian Heart Institute, Bhat lost 21 kg in seven months. “I could eat an entire bar of 250gm milk cake, now I feel guilty even if I eat a piece,” said Bhat.