Lipid profile is a blood test that we all routinely do. When you show it to the GP (general practitioner / family doctor), the GP will recommend you improve your diet. You will improve your diet precisely for 1- 2 days or maybe 1-2 weeks. Then, it is forgotten. If you are over 40 (or is it 30), the doctor may prescribe Statins. I went to a specialist at Karuna Hospital, Borivali West. She recommended statins. I told her I do not wish to take it. (Had read many reports about its ill effects.) She was good enough to say...OK, follow these lifestyle changes.  Needless to add, I could not follow the lifestyle changes. My lipid profile has remained "bad" for the last 30 years!

 

Probably, you are in the same boat and hence reading this blog. Hope it helps you in doing something concrete. Hope it helps you in understanding lipids. Thousands of doctors are coming up with these tests and recommendations. Sadly, we are not putting it into practice. Then we end up with a heart attack, angioplasty, stents, etc. Paying Rs.2 lakhs remains the only option. Changing lifestyle, going to the gym, walking, exercise, meditation, yoga could have saved you the Rs.2 lakhs and, er, the heart ache for you and your family. 

Dyslipidemia is when your blood lipid levels are too high or low.  Lipids are fatty substances like triglycerides and cholesterol.  Lipids = fats (oils). High levels increase the chance of clogged arteries (atherosclerosis), heart attack,  and stoke.

 

Lipid Association of India came up with an Expert Consensus Statement on Management of Dyslipidemia in Indians 2020.

I came to know about this statement thanks to Dr Prabhakar Dorairaj @prabhud19

 He is one of the authors of the LAI guidelines.

 

JAPI (Journal of The Association of Physicians of India) published an abstract.  Here are my notes and observations on the abstract. Hope you will find it useful and help you to better understand your poor lipid profile and how to take care of it. 

 

CVD (cardiovascular disease) is a global phenomena, some term it as an epidemic.  Heart disease is the leading cause of death in India.  A young Kannada star recently died due to a sudden heart attack.  50% of CVD deaths are in the younger age group (less than 50 years). The expert statement says:  CAD (coronary artery disease) is increasing most rapidly among those younger than 40 years of age. 

Reason: smoking, sedentary lifestyle (as they say Sitting is the new smoking!), obesity, hypertension and diabetes. 

Statement says: 79% of Indians have at least one lipid abnormality.  Low HDL in 72.3%. High triglycerides in 29.5%. High LDL in 11.8% of the subjects.

During School we used to get RED UNDERLINIES   in our report cards. Some of us now get them in our Lipid Profiles.  Go check your report  (oye...not your school report card...your lipid profile!) How many red lines have you got?

 

You will need to make lifestyle changes to get rid of the red lines. To get your lipid profile right.  If your doctor or cardiologist recommends statins, then you need to take statins to keep your lipids in check. Statins lower the level of LDL ("bad cholesterol".

The Expert Statement is meant for doctors and not for the lay public. It provides a guide to doctors about the important blood tests to be done and the numbers which are normal. 

Some of the important parameters and recommendations are:
Lp(a) - Lipoprotein (a) -- recommends universal screening

Lp(b) - Lipoprotein (b) -- recommends universal screening

C-reactive protein (CRP) - role in inflammation

LDL 

HDL - co-primary target, as important as LDL.

Triglycerides

 

WHAT YOU NEED TO DO

1. Get a Lipid Profile done once a year at least. Learn about your lipids.
2. Try to improve these numbers as best as possible, within 6-12 months.
3. Show them to GP, cardiologist and get help. Take statins if recommended.
4. LIFESTYLE changes -- eat as per recommendations, exercise as per recommendations. 

DO REMEMBER: This is not medical advice. Always consult a doctor/cardiologist and follow their directions.

 

If you have a question regarding your lipids, feel free to ask me on Twitter at @KamathGurudutt. Will be happy to respond there or if it requires more space, will answer in this blog.

Somalaram Venkatesh @serioustaurean

Chief of Cardiology. Aster-RV Hospital, Bangalore #Cardiologist by day & Blogger/Bibliophile by night. LowCarb advocate, National High School/PGIMER alumnus

Dr Venkatesh writes a blog:  Mind Over Medicine

Most of his recent posts have been book reviews.

 

He is planning to write a blog soon on Statins after compiling some evidence.  Will share the link here when I read it. 

According to him: There's a strong case for starting statins right away when LDL is above 160.