GUJARAT, AHMEDABAD | 13th AUGUST 2025: The reason why LDL Cholesterol (LDLC) is often known as “bad cholesterol” isbecause it forms plaquesthat cause blockages in the arteries. This conditionis termed atherosclerosis, which can lead to various criticalheart-related problems such as heart attacks and strokes.
What’s more concerning about LDLC is its silent nature; it shows absolutely no symptoms, and in many cases, symptoms appear only when it’s too late. Globally,LDLCis responsible for one death every 33 seconds.[1]In India, the percentage of the population having LDLC is quite high at 31%.[2]
Cholesterol is an essential molecule for many body functions, and low densitylipoprotein or “LDL” transports cholesterol to cells. The problem arises when LDLC levels are high. Its counterpart,HDLC or “good cholesterol”,removes excess cholesterol from the bloodstream and transports it back to the liver. Though raising levels of HDL does not lower the risk of heart attack or stroke. Therefore,to avoid heart risks, the focus alwayshas to be on lowering LDLC.[3]
Dr. Milan Chag, Interventional and Heart Transplant Cardiologist, Lipidologist and Preventive Cardiologist, Marengo CIMS Hospital, Ahmedabad, “Almost 80% of people, when they visit me, are unaware of their LDLC levels. While some have heard of “bad cholesterol, many believe that high cholesterol only affects older individuals. Another common misconception I come across very often is that patients equate a good lifestyle with appropriate cholesterol levels. But sometimes even the young and seemingly healthy can have high LDLC. It’s important to get the levels checked, starting as early as possible. Age 18 is considered the age at which regular checkups are necessary but can do even at age around 10 if both parents have history of very high lipids or already have an established heart disease. The frequency of checkups depends on age, risk factors, and other comorbidities. Along with a healthy lifestyle, it’s important to seek therapy and commit to it. The therapies can be tailored as per the patients’ requirements. Studies show that cardiac events are reduced by 30-50% by taking statin group of drugs to achieve target LDL of < 70 mg/dL. When traditional medicine doesn’t show the desired result, advanced therapies in injectable form such as PCK9 inhibitors or inclisiran can be added; these are usually indicated in those who can not achieve target LDL goals or have side effects of the first line oral medication or those who have familial dyslipidemia. Like vaccines, Inclisiran has an advantage of just having two doses every year to keep LDL at the desired level.”
Even young individuals with a seemingly healthy lifestyle and someone who could be considered fit can have high LDLC levels. Take the case of 35-year-old Reshma.She was unaware of what ‘bad cholesterol’ was, until a routine health check revealed dangerously high LDLC levels despite her healthy weight and active lifestyle. Speaking about her shock, she said, ‘I thought cholesterol problems were only for older or overweight people.’ What followed was a deep dive into understanding how LDLC quietly damages arteries, putting even the seemingly healthy individuals at risk of heart disease, stroke, and various other conditions.
The LDLC targetsdiffer as per the risk factors. The healthcare provider is the best judge to decide the individual targets. Even lifestyleadvicevariesas per the patient’s needs. But it’s important to note that it’s not a replacement for therapy but a tool to improve overall health.
A study published in ‘Population Medicine’, reported that approximately 40%of patients discontinue medicines once they reach their target levels.[4]Only to experience a rebound in cholesterol over time. Therefore,it’svital to note that medicines are taken as per the dosage prescribed by the doctorand are a lifetime commitment.
For individuals who don’t respond adequately to standard therapy or are at extremely high cardiovascular risk, there are advanced therapy options available.These includePCSK9 inhibitors, siRNA-based therapies, andInclisiran, which offer more precise and effective ways to lower LDLC and manage long-term risk.
