Tuesday, Dec 26, 2023

IIT Kanpur prof dies of sudden cardiac arrest at 53: Why do we need to detect cholesterol early enough?

Cholesterol, BP and obesity form the three-pillared risk for heart health, says Dr Kumar Kenchappa, Consultant, Interventional Cardiologist, Manipal Hospital, Bengaluru

Prof Sameer Khandekar suffered a cardiac arrest while speaking at an alumni meetProf Sameer Khandekar suffered a cardiac arrest while speaking at an alumni meet. (Express Photo)

The news of a 53-year-old IIT professor dying of a sudden cardiac arrest while delivering a speech from a dais drowned an important fact. That he had been suffering from high cholesterol levels for five years. Though one doesn’t know the kind of medication he was on and for how long, it does highlight why Indians not only need an aggressive cholesterol management but need to detect it early enough.

In fact, recent research, published in the journal PLOS One, says having high blood pressure and/or high cholesterol before age 55 can increase the risk of heart disease, even in people who improve those conditions as they get older.

How does cholesterol trigger sudden cardiac arrest & stroke?

Sudden cardiac arrest may occur if the heart arteries become clogged with cholesterol, which in turn reduces blood flow to the heart. A heart attack can trigger ventricular fibrillation or a series of rapid irregular heartbeats that stops the heart and triggers a sudden cardiac arrest. Also, a heart attack can leave scar tissue, which in turn changes the heartbeat.


Why some have a high cholesterol tendency?

Much of the stubborn cholesterol buildup among Indians is genetically pre-determined. Which means they do not have enough enzymes to metabolise cholesterol. The liver takes away low density lipoprotein (LDL) or bad cholesterol from the blood through receptors that attach themselves to the floating sticky mass. The higher the LDL receptors, the lesser their volume circulating in the blood. But in certain genetic disorders, such receptors are less and even absent. This condition is called familial hypercholesterolemia that leads to cholesterol accumulating in the bloodstream. Sometimes familial cholesterol even shows up in teens.

So how do you find out if you are prone to high cholesterol that may start damaging the heart earlier?

I recommend that you get a first cholesterol check done between the ages of 20 and 25. If the readings are normal, then evaluate your levels after every five years. If not, get tested once every year and immediately take correctives to bring them down. First, we try lifestyle corrections, particularly addressing obesity, through diet changes and upping physical activity.

Festive offer

Also, the threat from cholesterol has to be correlated to both blood sugar and blood pressure as elevated levels of each increase the risk of heart attacks and strokes. A fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL is considered prediabetes, and 126 mg/dL or higher indicates diabetes. The HbA1c test, on the other hand, indicates the average blood sugar levels over the last three months and should be less than four per cent. Unregulated blood pressure can have adverse effects on the functioning of your arteries and blood vessels.

In Indians, obesity is a major risk factor and on an average those with high cholesterol are overweight by over 10 kg. That’s because we do not exercise seriously. Besides, yoga can only ensure your well-being. You need moderately intense physical exercise to drop the flab.


Looking for a safe LDL level?

Doctors may prescribe statins if the LDL levels are very high. A normal LDL level is considered to be below 100 mg/dL and a normal triglyceride level is below 150 mg/dL. But high blood sugar levels and blood pressure mean that you need to keep your LDL levels below 70 mg/dL, preferably below 50 mg/dL. The goals get stricter with these risk factors and should you have a family history of heart attacks under 55, the doctor will straightway prescribe statins. This medication stops cholesterol production in the liver and is safe to start early in cases with compound risk factors.

Do not stop statins

The side effects like muscle spasm are negligible compared to the benefits of statins. So do not stop them on a whim and fancy as your cholesterol levels bounce back to where you started from within six to eight months. Remember, as we age, co-morbid conditions develop, causing complications. And statins do much more than mopping up LDL, they control inflammation in the arteries and reduce the risk of existing plaque rupturing, which can trigger a heart attack.

First published on: 26-12-2023 at 11:10 IST
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