Most people focus on whether their cholesterol falls within the laboratory reference range. If the number is marked “normal”, it is easy to assume everything is fine.
However, according to Dr Jason See, Consultant Cardiologist at The Cardio Clinic Singapore, the numbers only tell part of the story.
LDL cholesterol, often called “bad” cholesterol, remains a major risk factor for heart disease. However, doctors do not apply the same cholesterol target to everyone. A healthy level for one person may still be too high for another.
For example, people with heart disease, previous stenting procedures, or multiple cardiovascular risk factors often need much lower LDL levels. In contrast, people with no known cardiovascular disease may have a different target. Experts increasingly support a “lower for longer” approach. Research suggests that achieving lower cholesterol levels earlier in life may reduce the lifetime risk of heart attacks and strokes.
Why Might a “Normal” Cholesterol Result Not Be Enough?
The conversation around cholesterol is also evolving beyond LDL alone.
Doctors are paying increasing attention to lipoprotein(a), or Lp(a). This inherited cholesterol particle can significantly increase cardiovascular risk. Unlike traditional cholesterol levels, diet and exercise have little effect on Lp(a). Genetics largely determine its level.
According to Dr See, elevated lipoprotein(a) affects approximately one in five people. Identifying it early can help doctors better assess cardiovascular risk and may also prompt screening among close family members, as the condition often runs in families.
One of the biggest challenges is that high cholesterol is typically a silent condition. Most people experience no symptoms at all, even when cholesterol levels are significantly elevated. In many cases, the first sign of a problem may be a serious cardiovascular event such as a heart attack or stroke.
That is why regular health screening remains important, particularly for individuals with a family history of heart disease, high cholesterol, or premature cardiovascular events.
💭 When was the last time you looked beyond the word “normal” on your cholesterol report?
