In India, cholesterol often comes with a cloud of confusion and fear. It is either seen as the last villain of heart disease or is completely rejected until it is too late.

But experts have warned that failed to monitor and manage cholesterol, especially from “poor” types, from heart attacks to stroke and even memory loss, may lead to silent but serious health problems.

Cholesterol, in itself, is not harmful. In fact, this is necessary. It plays an important role in the production of hormones, vitamin D and bile acids that help in digestion. Without it, the body can’t just function properly.

This issue arises when low-density lipoprotein cholesterol (LDL-C) levels, usually called “bad cholesterol”, arises beyond which is healthy.

The optimal reading for LDL-C should be less than 100 mg/dl. However, people who are at high risk of high blood pressure or diabetes should be below the reading 70 mg/DL.

Additional LDL-C can quietly construct as a plaque in the arteries, narrow them and eventually cause obstruction that can trigger heart attacks or strokes. This buildup is quietly, without symptoms, makes regular cholesterol screening absolutely important.

A particularly unseen marker lipoprotein (A) or LP (A), which is inherited by a genetically of cholesterol that does not respond to diet or exercise. The level of high LP (A) can significantly increase the risk of heart diseases, stroke and inflammation.

Unlike LDL, this form is rarely measured in standard cholesterol tests. Experts suggested individuals, especially people with family history of heart disease, should ask for an LP (A) testing. Ideally, LP (A) levels must be below 30 mg/dL (or 75 NMOL/L) to live in a safe area.

Chairman of Cardiology at Max Super Specialty Hospital, Lucknow. Nakula Sinha said, “Fitness is not necessarily equal to good lipid health.

Dr. Sinha said, “People often stop treatment when they feel normal, they are unaware that their cholesterol levels can be quietly returning to risky levels.”

In such cases, doctors may recommend triple combination therapy or more advanced options such as PCSK9 inhibitors, SIRNA therapy, or integration, which help reduce cholesterol if standard drugs are not enough.

Many people do not realize that cholesterol issues are not limited to the heart.

High LDL-C can restrict blood flow to the brain, which increases the risk of dementia, cognitive decline and even sudden neurological events such as stroke.

Women, especially after menopause, are at high risk because the falling estrogen levels cause spikes in LDL-C. Similarly, thyroid disorders, especially hypothyroidism, can disrupt cholesterol metabolism, further increase LDL-C levels.

High cholesterol can also affect digestion, as the bile can form excess cholesterol crystals that carry up to gallstones.

While diet and exercise are important, they are not the whole story. Stress, poor sleep and metabolic health also play a major role on how cholesterol is processed in the body.

Practices such as yoga, mindfulness and regular sleep routine can support heart health, but they cannot replace medical treatment when cholesterol levels are dangerous.