ICD-10 · E78.5
High Cholesterol (Dyslipidaemia)
High cholesterol means unhealthy levels of fats in the blood, particularly raised LDL, which builds plaque inside arteries. Indians tend to have high triglycerides and low HDL even at normal weight, which raises heart risk at a younger age.
Symptoms
None in most people. It is detected on a blood test. Very high levels can rarely show as fatty deposits around the eyes or on tendons.
Causes & risk factors
Diet high in refined carbohydrates, fried foods, vanaspati and trans fats; physical inactivity; obesity; smoking; diabetes; hypothyroidism; kidney disease; and inherited familial hypercholesterolaemia.
Diagnosis
A fasting lipid profile measuring total cholesterol, LDL, HDL and triglycerides. Adults should be screened from age 25–30 in India, earlier with a family history of premature heart disease.
Treatment options
Statins such as atorvastatin or rosuvastatin are the mainstay and are dosed by overall cardiovascular risk, not the cholesterol number alone. Fenofibrate is added for very high triglycerides, and ezetimibe when statins alone are insufficient. Replacing refined carbohydrates and fried snacks, adding 30–45 minutes of daily activity, and losing 5–10% body weight can lower LDL by 10–15%.
When to see a doctor
Chest pain or breathlessness on exertion, muscle pain or dark urine while on a statin, or a family history of heart attack before 55 in men or 65 in women.