A considerable amount of attention has centred these days on 'cholesterol' -- from both the public and physicians. Sometimes health conscious people are too aware of this; and love to talk about abnormalities of blood fats (cholesterol) even in the social gatherings. It is true that high cholesterol levels are associated with an increased risk of heart disease. The two main fats in the blood are cholesterol and the triglycerides or TGL. They are eaten in the diet, but what is not widely appreciated is that cholesterol is also made naturally in almost every tissue of the body.

Cholesterol is a white waxy stuff which becomes high in the blood when there is an imbalance in the body regulatory system. A healthy body is normally capable of balancing the amount of cholesterol consumed. High cholesterol may be due to genetic defect in the ability of the body to extract cholesterol from the blood or an oversupply of dietary fat and cholesterol. Then again, cholesterol is important in bile formation, steroid hormone production, vitamin D synthesis and in cell membrane structure. So cholesterol is not always bad for everyone especially in early ages.

It is essential for most people to have the following basic investigations if illness related to chest or heart is suspect. These are -- a. pulse/blood pressure/checking neck veins etc; b. blood tests (fasting sugar, including lipid profile, urea and electrolyte); it is better to test the blood in empty stomach; c. chest X-ray; d. ecg, echo-cardiogram; and f. further investigations in some cases. Well, some may need more specialised tests afterwards.

There are many more people around us with much higher risk for heart disease than had been recognised. Heart disease in our country has increased due to generally unhealthy lifestyle (like stress/diet/obesity) and five other risk factors. Those are smoking, high blood pressure, high cholesterol levels, uncontrolled diabetes and family history. Yet again there is an intimate relationship between smoking and cholesterol. Smoking seems to promote the build-up of cholesterol, make the blood stickier and lowers level of substances in the blood which help defend arteries from clogging.

5 tips for those with high cholesterol-
1. Take reasonable physical exercise including walking; if possible swimming or some other sensible sporting activity.
2. Reduce the amount of beef, mutton and other animal fats. Trim down full cream milk and milk products and cut back on sugar (no 'mishtis' until the LDL comes down to '100') as much as possible. Also stop eating brain, liver and kidney. Reduce salt intake, both table and cooking. Take green, leafy vegetables and apples and oranges everyday. Garlic and onion are also not bad.
3. Relax. Stress and worry will ultimately affect the heart. Try to overcome this yourself as much as possible, as at the end of the day you will have to value your heart most.
4. Modifying the diet is a good way to lower cholesterol level; research studies suggest that it can lead to a reduction in cholesterol levels of 10-15 per cent. So many individuals need cholesterol lowering medicines. Consult your family doctor or a cardiologist regarding cholesterol lowering drugs (dose, duration / and about liver function tests). And,
5. One reading of high cholesterol is not enough to act on. Lipid profile test could be repeated.