Cholesterol has long been a cause of concern for cardiovascular health. While not all types of cholesterol are bad, low-density lipoprotein (LDL) cholesterol is commonly known as “bad cholesterol” because it contributes to the buildup of arterial plaques and increases the risk of a heart attack.
Taking to X on May 29, Dr Sudhir Kumar, MD, DM, a neurologist at Apollo Hospitals in Hyderabad, shared that many people on social media have recently been claiming that LDL cholesterol levels are not that important. He went on to explain if that is the case, and what we should actually be focusing on.
Markers to detect heart attack risk
According to Dr Kumar, high LDL cholesterol is a marker for heart attack risk, but it is far from the only one. “Instead of arguing endlessly about LDL numbers alone, let us look at four other markers strongly linked to heart attack and stroke risk,” he shared.
The four markers are as follows.
1. High ApoB: ApoB, or Apolipoprotein B, is the primary structural protein found on all potentially harmful cholesterol particles in blood.
2. High hs-CRP: Detects long-term, low-grade inflammation.
3. Insulin resistance
4. Abdominal obesity: Results in high waist circumference
“A person with vascular disease risk rarely has all four of these perfectly normal, while having persistently very high LDL cholesterol,” noted Dr Kumar.
Implications of testing high in each marker
The markers of cardiovascular health all signify different potential risk factors. Dr Kumar listed them as follows:
- ApoB reflects the number of cholesterol-containing particles that can enter the artery walls.
- hs-CRP reflects chronic vascular inflammation.
- Insulin resistance and abdominal obesity drive diabetes, fatty liver, hypertension, and accelerated atherosclerosis.
“Modern cardiology is focused on atherosclerotic risk biology, not cholesterol alone,” stated Dr Kumar. “In fact, statins (prescription medications to lower bad cholesterol) are recommended even in some people with normal LDL cholesterol if hs-CRP or ApoB is elevated, because reducing vascular inflammation and atherogenic particle burden lowers risk of heart attack and stroke.”
“Decades of evidence from genetics, imaging, pathology, and randomised trials still support one consistent conclusion: ApoB-containing lipoproteins, especially LDL particles, play a central role in atherosclerosis. Ignoring that reality may be dangerous,” he added.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
This report is based on user-generated content from social media. HT.com has not independently verified the claims and does not endorse them.
