Controlling Bad Cholestrol
What are the markers that indicate it’s time to start medication to control bad cholesterol?
Start when you hit 100, say experts
If everyone at risk of heart disease used cholesterol – lowering statins to keep their bad
cholesterol level below 70 mg / dl as recommended by the newest US guidelines, India would become
the biggest consumer of the drug. Does everyone need medication to control bad cholesterol (low
density lipoprotein or LDL)? Not quite. Cardiologists in India recommend statins for people with LDL
over 100 and lifestyle modifications such as a high fibre-low fat diet and exercise for people with
LDL over 80mg / dl .”An upper limit of 100 mg / dl for bad cholesterol is fine if you are at low
risk of heart disease, but people who have had a heart attack and have other risk factors should
keep LDL under 80 mg / dl,” says Dr.S.C Manchanda, senior consultant cardiology at Ganga Ram
Hospital. Many studies have reiterated that a combination of a healthy diet and exercise can lower
bad and cholesterol. The dean Ornish zero-oil diet can lower LDL by 30 percent . Closer home an
AIIMS study reported that a low fat high fibre diet can bring down LDL by 20 percent. “Statins are
expensive and have to be taken life long , so they should be prescribed only if lifestyle
modifications don’t work”, says Dr. Manchanda, pointing out that statins can cause side effects such
as muscle pain and weakness. Most cardiologists, however, maintain the benefits far outweigh the
side effects. “ Statins are safe and studies show that over time, statin-users have a 25 percent
lower risk of developing diabetes and osteoporosis,” says Dr.K.K. Sethi, vice chairman, Delhi Heart
and Lung Institute. “Indians have unstable angina linked to the metabolic syndrome, a combination of
risk factors that include trunkal obesity, diabetes and high triglycerides Lowering bad cholesterol
using drugs brings benefits within a month,” says Dr.Upendra Kaul, director, interventional
cardiology, Batra Hospital.