LDLC: The Silent Killer You Can’t Ignore – Why Target Levels Matter for Heart Health

In India, non-adherence to medical treatment is a growing trend. As per a study published in Population Medicine, nearly 40% of older adults with high cholesterol in the country fail to adhere to their medication regimens. This non-adherence poses a concern, because of the role that low-density lipoprotein cholesterol (LDLC) plays in cardiovascular health. Without appropriate management, elevated LDLC can lead to the progression of atherosclerosis, a condition that heightens the risk of heart disease and stroke.

Patients frequently discontinue their treatment for a variety of reasons, including the absence of noticeable symptoms, a misplaced sense of security, or apprehensions about side effects. However, the management of LDLC necessitates a sustained, long-term approach. Even when patients feel asymptomatic, discontinuation of treatment can lead to a rebound in cholesterol levels, placing them at an increased risk of developing cardiovascular complications

A recent survey by Healthians revealed that 31% of Indians have high cholesterol, also pointing towards a surge in atherosclerotic cardiovascular disease (ASCVD) among individuals. In Hyderabad, 27.4% of the population is affected by elevated cholesterol levels, making it critical to address the issue.

Dr. PLN Kaparathi, Cath Lab Director, Senior Consultant & Cardiologist, Care Hospital Banjara Hills, Hyderabad said, “The management of LDLC, or “bad” cholesterol, is a lifelong undertaking, requiring sustained efforts and vigilance. I have encountered 32 % of patients who believed they were in the clear, only to experience heart attacks later. While it’s convenient to assume that all is well when one feels healthy, cholesterol management is not about immediate symptoms but the underlying health of the arteries. This is why regular follow-ups with your doctor and strict adherence to prescribed medicines is essential. Routine monitoring allows for early detection of any changes, while consistent medication provides ongoing protection. Long-term care is vital in protecting heart health, and doctors must work closely with patients to develop individualized treatment plans to ensure ongoing management of the condition.”

Another aspect of elevated LDLC is its asymptomatic nature, which makes it a “silent killer.” High LDLC levels can cause damage to the arteries, without showing any symptoms. As arteries gradually become clogged, individuals may not realize the severity of their condition until it’s late. The absence of symptoms can create a false sense of security, leading many to discontinue their cholesterol-lowering medications prematurely. Once medication is stopped or if it isn’t taken as prescribed by the healthcare provider, LDLC levels can rise again, posing an increased risk of heart attacks and strokes. Doctors play a key role in guiding patients through ongoing management, including regular LDLC monitoring and encouraging long-term adherence to treatment plans.

Myths regarding cholesterol-lowering medications also contribute to non-adherence. Some patients erroneously believe that pharmacotherapy is only necessary when symptoms are present, while others harbour concerns about the side effects of these medications. According to the Cardiological Society of India (CSI) guidelines, continuous management, including lifestyle changes and adherence to prescribed medications, is essential to keeping LDLC under control. While eating healthy and exercising regularly is important, those with high LDLC often need medication to stay within their target LDLC levels.

Managing LDLC is a long-term commitment to your heart health. Through consistent monitoring of target LDLC, medication adherence, and healthy lifestyle choices, individuals can mitigate health risks.