Are You At Risk For High LDL Cholesterol? These Factors You Shouldn’t Ignore

Last Updated:September 24, 2025, 15:25 IST

Cardiovascular diseases (CVDs) already accounted for 32% of global fatalities in 2019 and are expected to rise to 23.6 million per year by 2030.

Studies show that only 25-30% of people stick to lifestyle changes or medications to control their cholesterol

People often wonder if they need a cholesterol test, while others assume it is not something that concerns them. LDLC, which is known as bad cholesterol, is one of the major risk factors of heart disease. But how does one know if they need a test, and who really needs it?

ICMR data shows that high cholesterol is widespread in both urban and rural populations, affecting 25–30% in urban areas and 15–20% in rural areas. Cardiovascular diseases (CVDs) already accounted for 32% of global fatalities in 2019 and are expected to rise to 23.6 million per year by 2030. A 2023 analysis published in The Lancet highlighted how lipid disorders are becoming more prevalent than hypertension or diabetes.

In India, LDLC is one of the most important components contributing to CVDs, as 6 in 10 individuals have high LDLC. Dr. Ashwani Mehta, Senior Consultant Cardiologist, Sir Gangaram Hospital, Delhi, explains “LDLC often progresses silently, building up plaque in the arteries and creating blockages leading to reduced blood flow to vital organs such as the heart and brain, with symptoms showing only when complications arise. While sometimes common signs of the early stage of LDLC might include angina, also known as chest pain, shortness of breath, fatigue, dizziness, and palpitations. Yet, it is equally important to note that many people remain completely asymptomatic until a severe or even fatal event occurs.”

The old assumptions, such as “I’m young,” “I’m thin,” “I feel fine,” no longer hold true. Research published in the British Medical Journal shows that many individuals develop adverse lipid profiles even at a normal body weight and BMI. Lean doesn’t always mean low risk. LDLC can be elevated in the absence of obesity. Refined-carbohydrate diets and a combination of factors, such as genetics, insulin resistance, and inflammation, can accelerate arterial damage with no symptoms.

One striking example comes from a family who shared their experience: “During a routine check-up for our 24-year-old son, we were shocked to learn that he had high LDL cholesterol, which had already begun causing blockages. The doctor asked if there was a family history of high cholesterol, and we said no. However, he advised my husband and me to get tested as well. To our surprise, both of us were found to have elevated LDL cholesterol levels, and so did our elder son, who is 27. What unsettled us the most was that none of us ever had any symptoms that could indicate something was wrong.” In this case, a silent pattern was uncovered not through symptoms, but through a simple blood test.

So, who really needs a cholesterol test? The answer is—almost everyone. At the very least, every adult benefits from having one baseline lipid profile done, ideally beginning at age 18, to establish their starting point. Once knowing the target level, which is unique for every individual, based on age, family history, and other comorbidities, regular health check-ups and proactive cholesterol screenings are crucial for early detection and intervention on a timely basis. The test itself is simple. A standard lipid panel measures LDLC, HDLC, total cholesterol, and triglycerides. The test no longer needs the requirement of fasting.

However, diagnosis is only the first step. It’s important to adhere to the therapy and continue medication even when the LDL targets are met. Although many people start adopting healthy diet, moving more, taking prescribed statins or other therapies, many drift. Studies show that only 25-30% of people stick to lifestyle changes or medications to control their cholesterol. It’s understandable; cholesterol is invisible, and success feels like nothing is happening. But in cardiovascular disease prevention, the absence of incident is the objective.

Success is built on realistic habits, such as choosing pulses, vegetables, fruit, and whole grains more often, and dialing down consumption of trans fats and ultra-processed snacks that sneak into busy days. Walking most days and sitting a little less. Sleeping consistently and managing stress with tools that fit your culture and schedule, such as breathwork, yoga, or meditation.

Everyone should take active steps to safeguard their heart health and reduce the risk of future cardiovascular disease. Adhering to the medicines is crucial, and just lifestyle modifications can’t control LDLC. When patients are unable to meet the LDLC targets, the dosage can be adjusted, or more advanced therapies such as PCSK9 inhibitors and Inclisiran can be prescribed.

Dr. Rahul Sharma, Additional Director Cardiology, CK Birla Hospital, Jaipur says, “The concept of personalized medicine is transforming cholesterol care from a population-based approach to an individual-based one. Instead of saying ‘one treatment for all,’ we now ask: what does this specific patient need? Elevated LDL cholesterol is the most significant modifiable risk factor for coronary artery disease, which remains the leading cause of death in India. While age and genetics cannot be changed, LDLC can be effectively reduced with appropriate interventions. Actors such as family history, baseline LDL level, comorbidities like diabetes or kidney disease, and even psychosocial aspects like stress and adherence play a role in shaping the plan. Personalized medicine allows us to set realistic LDL goals and select the most appropriate therapy. Personalized medicine is making LDL management more precise, effective, and sustainable for every patient.”

LDLC can be managed, especially when diagnosed early. A lipid test is not a verdict; it’s a map. It shows you where you are and how far you need to go.

About the Author

Swati Chaturvedi

Swati Chaturvedi, a seasoned media and journalism aficionado with over 10 years of expertise, is not just a storyteller; she’s a weaver of wit and wisdom in the digital landscape. As a key figure in News18 Engl…Read More

Swati Chaturvedi, a seasoned media and journalism aficionado with over 10 years of expertise, is not just a storyteller; she’s a weaver of wit and wisdom in the digital landscape. As a key figure in News18 Engl… Read More

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Author: News18