Lipids are fat or fat derived molecules that are part of various cells of our body, energy store house and plays an important function in cellular signalling. The commonly known form is cholesterol or transportation form of fat in human body, other major forms are triglyceride (forms 95% of dietary fat and important storage form) and phospholipids which are structural lipids.
The transport lipids or cholesterol as well as triglycerides are commonly increased in blood circulation in conditions like obesity, hypertension, diabetes and metabolic syndrome. A lipid screening is essential to measure the levels of cholesterol in the blood to help assess the cardiovascular risk of individuals.
Monitoring the levels of these lipids and keeping them normal is important for maintaining minimal cardiac risk. Lipid disorders (dyslipidaemia) often refer to abnormally high levels of cholesterol (hypercholesterolemia) and triglycerides (hypertriglyceridemia) in the blood.
There are different types of cholesterol: low-density lipoprotein (LDL or bad cholesterol) and high-density lipoprotein (HDL or good cholesterol) and VLDL (Very Low Density Lipid are also bad cholestrols). Having high cholesterol generally refers to high LDL levels.
While the human body produces the cholesterol required for proper functioning of our body (endogenous), the food we eat is the source for certain cholesterols (exogenous). The consumption of a diet rich in saturated fats and trans fats can result in a high level of cholesterol in the blood.
These high amounts of cholesterol can deposit as plaques on the inner walls of the blood vessels and can narrow or eventually block the blood vessels, leading to hardening of the arteries (atherosclerosis) thereby increasing the risk of numerous diseases, including heart disease and stroke.
The American Heart Association recommends that everyone over the age of 20 should get lipids analysed to know their cholesterol levels and take the necessary action as per medical practitioners’ advice. Healthcare providers prescribe a blood test that indicates the level of cholesterol that is carried in the bloodstream. Healthcare providers could also prescribe what is called a lipid profile that tests the following parameters:
- Total cholesterol
- LDL levels
- HDL levels
- VLDL levels and triglycerides
- Non-HDL cholesterol
- Ratio between cholesterol and HDL
- Ratio between LDL and HDL
Based on the lipid profile, a detailed risk assessment could be done through the ASCVD risk calculator available online: These calculators include the major risk factors to estimate a person’s chances of developing atherosclerotic cardiovascular disease (ASCVD). The risk factors include smoking, blood pressure, cholesterol levels, diabetes, and age (because atherosclerosis progresses with time, therefore age counts as a risk factor). Patients with higher levels of LDL cholesterol or with the presence of cardiovascular disease need immediate intervention with lifestyle modifications and drugs. Lifestyle is the first thing that needs modification in order to reduce the chances of heart attack and stroke.
Lifestyle modifications include regular exercise coupled with nutritious diet. A moderate intensity exercise on most days of the week is generally recommended which could include brisk walk for 30 minutes at least 5 days a week or swimming or yoga etc.
A cholesterol-lowering diet can bring down cholesterol by up to 30%. The food habits observed in the general population are usually variable, but the nutrient value could be maintained if the following options are considered:
When it comes to drugs, the most commonly prescribed class of drug is statin, which lowers the LDL cholesterol and prevents the risk of cardiovascular events. It is important to note that the dose of statin is individualized and is recommended only by a practicing physician.
It is worth bearing in mind that early screening and treatment of lipid disorders with statins can decrease the chance of developing symptomatic CVD or having a heart attack or stroke in the future. Regular screening together with lifestyle modifications can not only prevent the disabling effects of cardiovascular disease but can also enhance the quality of life.
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