Cholesterol, metabolic & endocrine care

High blood cholesterol
& lipid disorders

Cholesterol and triglycerides are types of fats found in our blood. Our body needs certain amounts of these fats for normal functioning, but abnormal levels can increase the risk of serious health problems. High blood cholesterol and other lipid abnormalities are collectively called dyslipidemia. A lipid profile usually measures total cholesterol, LDL cholesterol (commonly called bad cholesterol), HDL cholesterol (commonly called good cholesterol) and triglycerides. High LDL cholesterol can gradually lead to fatty deposits in blood vessels, increasing the risk of heart attacks and strokes. High triglycerides are also associated with metabolic and cardiovascular problems, and very high levels can sometimes cause acute pancreatitis, a potentially serious inflammation of the pancreas. Most people with abnormal cholesterol have no symptoms, making timely testing and appropriate treatment important.

Not everyone with high cholesterol has the same type of lipid disorder. Some people have predominantly high LDL cholesterol, while others have high triglycerides, low HDL cholesterol or a combination of these abnormalities. In India, a common pattern associated with abdominal obesity, insulin resistance and type 2 diabetes is elevated triglycerides with low HDL cholesterol, sometimes accompanied by increased numbers of harmful cholesterol particles. Importantly, cholesterol problems can occur even in people who are not overweight or who appear otherwise healthy. The risk depends not only on the cholesterol value but also on age, diabetes, blood pressure, smoking, kidney disease, family history and existing cardiovascular disease. Understanding the complete lipid profile and the individual’s risk is more useful than looking at total cholesterol alone.

High cholesterol is not always caused by eating fatty foods. Several hormonal, genetic and medical conditions can influence cholesterol and triglyceride levels. An underactive thyroid gland (hypothyroidism) can significantly increase LDL cholesterol and sometimes triglycerides. Poorly controlled diabetes, obesity, kidney disease, nephrotic syndrome, certain liver disorders and medicines such as steroids can also contribute to abnormal lipid levels. Some individuals have inherited conditions such as familial hypercholesterolemia, in which LDL cholesterol is markedly elevated from childhood or early adult life. These patients may have an increased risk of premature heart disease, and identifying the condition can also help detect affected family members. Familial hypertriglyceridemia and other inherited lipid disorders may require specialised evaluation and treatment.

Finding the cause and assessing future cardiovascular risk are essential for choosing the right treatment. Evaluation includes reviewing the lipid profile, medical history, family history, lifestyle, blood pressure, diabetes control and possible hormonal abnormalities. Selected patients may benefit from additional measurements such as non-HDL cholesterol, apolipoprotein B (ApoB) or lipoprotein(a), also called Lp(a), which is largely genetically determined. A one-time Lp(a) measurement in adulthood is recommended by current cardiovascular guidelines. Treatment is individualised and may include dietary changes, regular physical activity, weight management, improved diabetes control and medicines such as statins, ezetimibe or other cholesterol-lowering treatments when indicated. Patients with very high triglycerides may require additional measures to reduce the risk of pancreatitis. Cholesterol targets vary according to the individual’s cardiovascular risk rather than following one common target for everyone.

Early and effective management of lipid disorders can help prevent long-term complications. Many patients need ongoing treatment and periodic monitoring because abnormal cholesterol may return when treatment is stopped. Correcting an underlying hormonal disorder, particularly hypothyroidism, can improve lipid levels in selected patients, although some may still require cholesterol-lowering medicines. Dr. Rajesh Moganti (MD, DM Endocrinology) provides comprehensive evaluation and management of high cholesterol, high triglycerides, familial lipid disorders and lipid abnormalities associated with diabetes, obesity and hormonal conditions at our Rajahmundry and Tanuku centres. The focus is on identifying the underlying cause, reducing cardiovascular risk and developing a personalised long-term treatment plan.