Most of us have had at least one set of lab work at the doctor which would include a cholesterol test (more than once I hope 😊). You may hear your doctor read off your numbers or just say all together your numbers are “normal” or “abnormal”. These numbers can feel confusing and even a little scary, however, understanding them is one of the most important things we can do to protect our hearts, especially as South Asians who are at higher risk for heart disease.

Let’s break this down!

What Is Cholesterol, Anyway?

Cholesterol is a fatty type substance that your body needs to build things such as cells, hormones, and vitamin D. Your body actually makes its own cholesterol and you also get some from the food you eat (such as meat, eggs, and dairy).

But too much cholesterol, especially the wrong kind, can build up in your blood vessels and cause problems over time.

The Two Main Types of Cholesterol You Need to Know

1. LDL : “Bad” Cholesterol

• LDL stands for Low-Density Lipoprotein
• Its main objective is to carry cholesterol from the liver to the rest of your body
• If there’s too much LDL in your blood, it start can start to find places to build up -> mainly your arteries
• Over time, this buildup forms plaque, a sticky substance that narrows your arteries, and can eventually limit or even block blood flow to your heart and brain
• And folks, THIS is the starting point of heart attack and strokes

2. HDL : “Good” Cholesterol

• HDL stands for High-Density Lipoprotein
• It picks up the extra cholesterol from your blood and brings it back to the liver to be removed
• Higher HDL levels are generally protective against heart disease

⚠️ Why South Asians Need to Pay Special Attention

South Asians often have:

• Higher LDL levels
• Lower HDL cholesterol
• More small, dense LDL particles ->  which are more harmful
• Higher Lipoprotein a (Lp(a) -> more on significance of this later) levels -> carrier of LDL
• Genetic predisposition for insulin resistance and inflammation that make plaque buildup more likely

What does this mean? Your cholesterol levels may look quite normal by general standards but you may still be at higher risk!

How Plaque Buildup Happens

Imagine your arteries are like water pipes in the shower or your bathroom sink. LDL cholesterol is like hair and junk that slowly starts sticking to the inside of those pipes (Ladies, this may sound familiar :)). Over the years, that buildup hardens into plaque. This narrows the pipe, making it harder for blood to flow through

Eventually, a piece of plaque can rupture causing a clot to form and that’s when a heart attack or stroke can happen

What Can You Do About It?

You can do A LOT simply by making different choices with respect to your diet and exercise. Some of us may need additional help with medications as well.

Remember, when we’re well informed, we are empowered to make better choices for ourselves which can lead to less risk of developing significant heart disease.