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Mind Your LDL Levels! Even Borderline Cholesterol Can Trigger Health Problems

If someone with borderline cholesterol doesn’t take appropriate action to lower their LDL level, there is a risk of their LDL level rising, resulting in high cholesterol. Here’s what you need to know about managing cholesterol levels.

Cholesterol is a waxy substance that is made in the liver and is very important for our body. It is fat (also known as a lipid) that travels in the blood and to the cells in the body. According to a Harvard study, about 20% of the cholesterol in the bloodstream comes from the food consumed whereas the rest 80% is produced in the body.

The cells require it to form cell membranes. About 25-30% of the lipids that form the membrane are cholesterol. Cell membranes from outside each cell. They protect and organize each cell, delimiting the cell from the environment around it.

Cholesterol plays a major role in reducing membrane permeability. The two vital roles of cholesterol in cell membranes are to act as a barrier and keep the constituents of the cell inside while keeping unnecessary substances outside, and to allow transport of essential nutrients outside the cell and waste substances outside the cell. Because cholesterol is insoluble in water, it prevents water-soluble molecules from diffusing across the membrane.

But that is not the only importance of cholesterol. It is the starting point and important substance information of the liver bile that is vital for digestion and it breaks down fats into fatty acids so that they can be absorbed in the small intestine.

The body also needs cholesterol to make important hormones such as estrogen and progesterone. The two main components of cholesterol are LDL – low-density lipoproteins or bad cholesterol and HDL – high-density lipoproteins or good cholesterol.

The recommended levels of cholesterol in an adult are 200 mg/dl and 175 in 19 years or younger. If the body contains high levels of LDL, one will be diagnosed with high cholesterol. Whereas if the total cholesterol is between 200 mg/dl and 239 mg/dl, one is said to have borderline cholesterol and LDL cholesterol has to be less than 130 normal subjects.

Causes of Borderline Cholesterol

If one with borderline cholesterol does not take the necessary steps to reduce the LDL in the body then they risk an increase of LDL causing high cholesterol. The causes of borderline and high cholesterol include lifestyle, certain health conditions, and family history.

Excess weight or obesity, unhealthy eating habits or a diet high in saturated fats, smoking and lack of exercise can cause a risk in LDL. Adult men seem to have higher LDL and lower HDL than women but the LDL in women increases after menopause. Additionally, Type 2 Diabetes also causes a rise in bad cholesterol and a decrease in good cholesterol.

Genetics also plays a role in this. As one ages, the body stops clearing cholesterol as effectively thus making old age also a cause for higher LDL.

Adverse Effects of Borderline Cholesterol

If there is too much LDL in the bloodstream, it can over time build up in blood vessels forming fatty deposits. These fatty deposits are called plaques. Cholesterol lodges in the walls of the artery. The body sends white blood cells to trap this cholesterol forming a layer over it.

This layer becomes oozy and causes inflammation. This is one of the factors of cardiovascular disease (CVD). Eventually, they block the blood flow through the artery causing a clot. Pressure on this clot can cause it to break.

Both of these things lead to heart attack or stroke. In 2016, approximately 62.5 million people died due to CVD in India. CVD contributed to about 28.1% of total deaths in India in 2016 according to the US National Institute of Health.

Symptoms of Borderline Cholesterol

Neither borderline cholesterol nor high cholesterol usually has any symptoms. It is a ‘silent’ condition and only shows up in an emergency event. The only sure way of knowing if you have Borderline Cholesterol is to conduct a blood test. According to the National Health, Lung and Blood Institute of the US (NHLBI), blood tests for cholesterol screening for adults should be conducted every 5 years; whereas it should be every two years for men aged 45-65 and women aged 55-65. It should be conducted annually for everyone above 65 years of age.

However, one can look out for symptoms of heart damage or heart attack that include chest pain or angina, nausea, shortness of breath, slurred speech, and numbness or coldness in extremities.


Multiple precautions can be taken in order to prevent the rise of LDL and borderline cholesterol.

Healthy Eating:- Avoid packaged foods. Maintain a low sodium diet and steer clear of high sugar items and saturated fats and trans fats. Choose low-fat dairy products. Increase the intake of omega 3 fats and fibre by consuming more fruits, vegetables, and whole grains. A high potassium diet is also beneficial.

Lost Extra Weight:- If you are obese or are overweight, it is essential to reduce weight and maintain a healthy weight in order to maintain a healthy level of cholesterol. To maintain a healthy weight, attain a BMI of 18-25.

Daily Exercise:- 40-45 minutes of physical activity is very important on a daily basis. Yoga, taking brisk walks, cycling, dancing, or going to the gym are all good options. Exercise will help increase the level of HDL in the body while helping get the bad cholesterol down.

Alcohol:- Reducing alcohol is also said to reduce blood pressure which helps in maintaining a healthy cholesterol level.

Reduce or Quit Smoking:- Smoking is said to reduce the elasticity of your arteries and aggravates plaque formation. It also contributes to an increase in LDL. Quitting smoking can decrease one’s LDL by almost 10%.

Medication: If cholesterol levels remain high despite lifestyle modification, drugs like statin are prescribed for patient benefits.

Taking care of your health is important. If one has been diagnosed with borderline cholesterol, it is essential to remember that it can still be managed. Borderline and high cholesterol can have very adverse and long-lasting effects on the body. Thus it is important to be proactive in taking care of your health. A healthier life is a happier life.

Dr. Siddhant Jain, Director, Cardiac Sciences & Chief Interventional Cardiologist Indore

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