New Delhi – A leading cardiologist from the All India Institute of Medical Sciences (AIIMS) is sharing expert advice on managing high cholesterol and reducing the risk of heart disease. Dr. Ambuj Roy, Professor in the Department of Cardiology at AIIMS, New Delhi, emphasizes that adopting healthy lifestyle changes and understanding new treatment options are crucial for a healthy heart. Heart attacks affect millions of people in India each year, but many cases are preventable, Dr. Roy stated.
Understanding Cholesterol and Its Dangers
High cholesterol, particularly elevated levels of low-density lipoprotein (LDL) or "bad" cholesterol, silently increases the risk of heart disease, heart attack, and stroke. LDL cholesterol contributes to plaque buildup inside arteries, a condition known as atherosclerosis. This narrowing of arteries can lead to serious cardiovascular events. Dr. Roy highlights that managing cholesterol is one of the most effective ways to lower these risks.[news+1]
For years, statins have been the primary treatment for controlling LDL cholesterol. These medications work by reducing the liver's production of cholesterol. However, not every patient responds well to statins. Some individuals continue to have high cholesterol despite treatment, while others experience side effects.[news+3]
New Treatment Options for High-Risk Patients
For high-risk patients who do not tolerate statins or whose cholesterol remains uncontrolled, a new oral medication called Lipfendra (enlicitide) offers an additional treatment option. The US Food and Drug Administration (FDA) recently approved this once-daily tablet. Lipfendra is a PCSK9 inhibitor. It works by blocking the PCSK9 protein, which typically destroys LDL receptors in the liver. By blocking this protein, the liver can remove more bad cholesterol from the bloodstream, leading to a significant reduction in LDL levels, potentially by 50 to 60 percent.[news+5]
Dr. Ambuj Roy explains that Lipfendra offers benefits beyond just lowering LDL cholesterol. The drug also reduces apolipoprotein B (ApoB), a protein associated with cholesterol particles that contribute to plaque buildup in arteries. ApoB is considered an important marker of cardiovascular risk, especially since research indicates that ApoB levels are often higher among Indians compared to many Western populations. Despite the promise of Lipfendra, cardiology experts stress that statins will remain the first-line treatment. Statins are affordable, widely available, and backed by decades of clinical evidence showing their effectiveness in reducing heart attacks and strokes. Lipfendra is likely to be considered for patients who cannot tolerate statins or whose cholesterol is not adequately controlled with optimal therapy.[news+6]
Essential Lifestyle Changes for Heart Health
While new medicines expand treatment options, Dr. Roy emphasizes that prevention remains the strongest defense against heart disease. Abalanced diet, regular physical activity, maintaining a healthy weight, avoiding tobacco, and managing stress are fundamental for long-term cardiovascular wellness.[news]
A balanced diet should be rich in fruits, vegetables, whole grains, and healthy fats. An AIIMS study found that a low-fat, high-fiber diet can reduce LDL cholesterol by 20 percent. Specific foods like oats, barley, flaxseeds, beans, lentils, apples, pears, and Brussels sprouts are good sources of soluble fiber, which helps lower LDL cholesterol. Choosing lean poultry, fish, beans, and soy proteins can also help. Limiting saturated fats found in red meat, butter, and cheese, as well as trans fats in packaged snacks, is crucial. Incorporating monounsaturated and polyunsaturated fats from avocados, olive oil, nuts, and seeds can help reduce LDL and raise HDL (good) cholesterol. Avoiding excess sugar and refined carbohydrates like white bread and pasta also helps prevent elevated triglycerides, which can negatively impact cholesterol levels.[news+10]
Regular physical activity is another cornerstone of heart health. Aim for at least 30 minutes of daily exercise. Brisk walking, running, cycling, or swimming can raise HDL cholesterol while lowering LDL and triglycerides. Even short bursts of activity, like taking the stairs or walking during a lunch break, contribute to a healthy heart. Strength training two to three times a week can also improve cholesterol profiles.[hiims+6]
Avoiding tobacco is critical. Smoking not only damages lungs but also accelerates atherosclerosis and increases the risk of heart attacks and graft blockades. Quitting tobacco can reduce heart disease risk by 50 percent within one year. Managing stress through practices like yoga and meditation also contributes significantly to overall cardiovascular wellness. Adequate sleep is also essential for maintaining healthy blood pressure and reducing stress hormones.[hiims+3]
Importance of Regular Screening and Monitoring
Regular cholesterol screening is essential for early detection and management. Adults between 18 and 29 years of age should have their cholesterol checked at least once. Individuals with diabetes, high blood pressure, obesity, or a family history of cardiovascular disease should undergo regular cholesterol screening based on medical advice.
New guidelines from major health organizations recommend even earlier screening. Children around age 10 should have their LDL levels checked, especially if there's a family history of high cholesterol. Adults should begin regular LDL testing at age 19, with repeat checks at least every five years, or more often if levels are high. The updated guidelines also suggest a one-time blood test for lipoprotein(a) or Lp(a) for all adults, as high levels can indicate higher cardiovascular risk.[news+3]
Optimal LDL levels should generally be under 100 mg/dL for most adults. However, for high-risk individuals, such as those who have had a heart attack or stroke and have additional risk factors like diabetes or hypertension, the target LDL is lower, aiming for 55 mg/dL or below. Triglycerides should be maintained below 150 mg/dL, and total cholesterol should be kept under 200 mg/dL.[uchicagomedicine+7]
Dr. Roy and other experts stress that medication alone cannot fully protect heart health. A comprehensive approach combining healthy lifestyle choices with appropriate medical treatments and regular check-ups is vital for preventing heart disease and ensuring long-term cardiovascular well-being.[therightdoctors]
