Think you’re heart-healthy? Your cholesterol may tell another story

Even in people who lead healthy lifestyles, regular health checks can reveal hidden cardiovascular risks such as high cholesterol, according to experts. While regular exercise, a balanced diet, and maintaining a healthy weight are important for heart health, they may not always be enough to lower LDL-C, or "bad cholesterol," to safe levels for everyone. LDL-C, produced primarily by the liver, can contribute to the buildup of fatty deposits in artery walls, raising the risk of heart attacks and strokes over time.

Certain factors, such as genetics and biological factors, can keep LDL-C levels high even in people who eat well and exercise regularly. In Malaysia, an estimated 7.6 million adults, or one in three, have high cholesterol, while around 40% have elevated LDL-C levels. Half of those with high cholesterol may not even be aware of it as the condition often shows no obvious symptoms.

High-risk individuals, including those with a history of heart attack or stroke, diabetes, high blood pressure, obesity, very high LDL-C, or multiple risk factors, may require structured cholesterol management. This often involves a combination of lifestyle measures and medication. While lifestyle changes remain important, medication may be necessary for higher-risk individuals who cannot achieve recommended LDL-C targets through diet and exercise alone.

Dr Lim Bee Chian, a cardiologist, emphasized that medication is often required alongside diet and exercise to meaningfully reduce cardiovascular risk for these individuals.

LDL-C targets vary based on a person's overall cardiovascular risk. Higher-risk individuals are typically advised to aim for lower levels, such as below 1.8 mmol/L. Consistency in cholesterol control is key, as the goal is not just to lower LDL-C once but to keep it consistently controlled over time. A three-pronged approach to cardiovascular protection includes diet, exercise, and medical treatment when prescribed.

Celeste Lau, a dietitian, advised that heart-healthy eating doesn't have to be complicated and that small, consistent changes can be more effective than drastic short-term diets. Nathalie Goh, a physiotherapist, highlighted that consistency in exercise is more important than intensity, and that regular, safe exercise can significantly improve long-term cardiac rehabilitation, overall quality of life, and functional capacity.