What happens if your cholesterol levels are uncontrolled? Cardiologists reveal risks and management tips

If your cholesterol levels are high for long time, you may be at risk of heart attacks and stroke. Know what are the measures that help to manage LDL levels.

World Heart Day 2025: September 29 is observed as World Heart Day, aimed to spread awareness about different heart conditions and the risk factors that are responsible. Awareness and prompt intervention are essential because, as per the World Heart Federation, up to 80 per cent of premature cardiovascular (CVD) deaths are preventable.

Heart health depends on your cholesterol levels too. (PC: Freepik)

On this day, let's take a look at one of the contributors, cholesterol and how it may be putting your heart at serious danger. HT Lifestyle reached out to a cardiologist to ask what happens if your bad cholesterol levels are left unmanaged.

What happens to your heart if your cholesterol is regularly high?

If your cholesterol is regularly high and untreated, it can severely damage your cardiovascular system. Dr Nagendra Boopathy S, Professor of Cardiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, shared with us that cholesterol is a major cause for plaque formation and rupture.

He added, “Persistently high LDL cholesterol is a causal driver of atherosclerosis as it promotes plaque formation, plaque rupture, and thereby raises the risk of heart attack, ischemic stroke, and peripheral artery disease.” So if you manage your cholesterol levels, then the risks of life-threatening risks also go down.

Other than cardiovascular risks, Dr Nagendra shared that other body organs like the brain, limbs, and kidneys also get affected. If you have any existing comorbidities, cholesterol may worsen those as well.

Indians have a distinct pattern

Dr Nagendra Boopathy S pointed at a pattern Indians show, a combination of cholesterol and fat levels, which raises the risk of early heart disease even if LDL levels are not extremely high.

He explained, “Many Indians show the ‘atherogenic dyslipidaemia’ pattern (raised triglycerides, low HDL and high small dense LDL), which increases early coronary disease risk even at modest LDL elevations; this means screening and treatment thresholds must consider the whole lipid profile and local epidemiology.”

How can you control your cholesterol?

Instead of refined flours and grains, choose whole grains like millets to make your favourite Indian dishes, such as dosa. Small switches like this will help to keep your cholestrol in check. (Shutterstock)

So managing cholesterol is an absolute must. Dr Zakia Khan, Cardiologist, Fortis Hospital, Mumbai, told us that a healthy lifestyle is important in reducing LDL cholesterol. So exactly should you follow?

Dr Zakia Khan advised a combination of clean habits, such as a balanced diet, keeping weight in a healthy range and exercising regularly.

She explained, “A whole-diet pattern that emphasises vegetables, fruits, legumes, whole grains, millets, dals, nuts, and minimal refined carbohydrates reduces cardiovascular events and improves lipid markers. Weight loss of around 5–10% can lead to meaningful reductions in LDL cholesterol levels. For many Indian patients who may be metabolically challenged despite a normal BMI, which is under 25, modest weight loss often translates into outsized cardiovascular benefits. Exercise should be prescribed as medicine; it has to be realistic. ”

But this is not where your heart protection measures end. There's more to the story than simply diet and exercise. Being aware of the current LDL levels is equally vital. In fact, Dr Zakia highly recommended regular screening because ignoring cholesterol levels can lead to ‘irreversible consequences.’

She said, “ I always recommend that lifestyle moderations alone may not achieve target LDLs for high-risk patients; their targets have to be less than 70 mg/dL. Regular screenings are crucial because cholesterol-related issues happen silently over time. Sticking to prescribed treatments and medical advice ensures long-term protection.”

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.