Pharmacy Insights with Chulalongkorn University: High Levels of Bad Cholesterol Can Be Deadly

This week, let’s talk about high cholesterol, one of the most common chronic conditions. Many people may have been told during a health check that their cholesterol levels are high—yet this condition often shows no obvious symptoms. The type of cholesterol often referred to as the “bad cholesterol,” known by its English abbreviation LDL, directly affects blood vessels. If it accumulates excessively and is left untreated, it causes arteries to harden and narrow, leading to heart disease. High cholesterol in the blood usually presents no symptoms, but it can be detected through blood tests, typically during annual check-ups or when visiting a doctor for other conditions.

Sources of Cholesterol

Our bodies obtain cholesterol from two main sources: the food we eat and what the body produces naturally. Therefore, cholesterol reduction can be achieved through lifestyle changes such as diet control, exercise, and weight loss. However, if lifestyle adjustments alone are insufficient to bring cholesterol down to safe levels, doctors may prescribe medication to help.

High-Risk Patients

Patients with a history or risk of heart and vascular disease—such as coronary artery disease, stroke, arterial stiffness, or a family history of early heart disease—are at higher risk. Likewise, patients with other underlying conditions combined with high cholesterol, such as diabetes, hypertension, or obesity, are also candidates for cholesterol-lowering medication.

Cholesterol-Lowering Medications

One of the most widely used groups of cholesterol-lowering drugs is statins. These work by inhibiting the body’s production of cholesterol. Common types include Simvastatin, Atorvastatin, Rosuvastatin, and Pitavastatin. Another commonly used medication, sometimes in combination with statins, is Ezetimibe, which works by blocking cholesterol absorption in the intestines.

Precautions and Misconceptions

High cholesterol is a silent threat that increases the risk of heart disease, stroke, and even death. Therefore, controlling cholesterol levels is crucial. Some people avoid medication due to fear or misinformation from social media—such as the belief that cholesterol-lowering drugs damage the kidneys or cause kidney failure. This is a misconception. When used correctly, at the right dosage, and under the supervision of doctors and pharmacists, these medications are safe. In rare cases, statins may cause muscle-related side effects. If you experience muscle pain (especially in the legs) after starting statins, you should consult a doctor to adjust your medication or identify possible interactions with other drugs.

The Importance of Consistency

If cholesterol-lowering medication is required, patients must not stop taking it without medical advice. Those with heart disease or a history of stroke who discontinue medication on their own risk recurrence of the disease, potentially leading to disability, bedridden conditions, or even death.

Lifestyle Adjustments Alongside Medication

While medication is effective, lifestyle changes remain the cornerstone of treatment. Avoid saturated fats, such as fatty meats, poultry skin, butter, and lard. On the other hand, fresh fruits, vegetables rich in fiber, and whole grains such as brown rice, oats, and barley help lower cholesterol levels. All medication use should be under the guidance of doctors or pharmacists, and regular blood tests are necessary to monitor both side effects and drug effectiveness.