73844425e432.jpgYou will be forgiven for thinking that only the obese, cigarette-smoking and lazy couch potatoes are typically at risk of getting a heart-attack. On the contrary, fit and active people are also at risk ‘€“ all because they have slightly increased cholesterol levels. Fifty-six year-old, Dan Lupou, from Johannesburg is such a patient. Having practiced karate for about 25 years, he is very fit.   He goes to   gym and swims about 2 – 3 kilometres a week.   Yet, two weeks ago, he had a heart-attack while playing soccer.

‘€œI had a sharp pain in my chest. It was very cold outside and I thought the whole chest pain came from the cold, but I realised it’€™s not that and I stopped ten minutes before end of the game. Next day I went to the doctor and the doctor did some blood tests and they realised that I had a heart-attack and that’€™s when they sent me to see a specialist’€, says Dan Lupou.

Lupou says this came as a shock to him as he did not think he would have a heart- related illness, as he is highly active and generally keeps a healthy life-style.

‘€œBasically, I’€™m a very active person’€¦ I’€™ve played sports all my life. I don’€™t smoke. I drink beer now and then’€, says Dan Lupou.

So, what caused Lupou’€™s heart-attack if he leads such a healthy life-style?   Dr.   Eric Klug, a cardiologist in private practise, is Lupou’€™s doctor.

‘€œWe think we know all the factors that cause heart disease. And when we look at populations, thousands of patients around the world – whether   it’€™s a developing country or a developed country – the   major risk factors   have always stood out’€¦ and that is smoking, diabetes , blood pressure, obesity   and inactivity.   But there are other factors’€¦ the genetics. Maybe a gene in him that he inherited from mother and dad. There might be an unknown factor to him in addition to his cholesterol’€, he says.

Cholesterol  is a fat (lipid) which is produced by the liver and is crucial for normal body functioning. According to Dr. Klug there are two types of cholesterol in our bodies – one a good type and another a bad one. Low Density Lipo-protein (LDL) is a bad form of cholesterol because it builds up in the arteries of the heart, brain and throughout the body, which can lead to blockages. This can eventually cause clogged arteries in the legs, a heart-attack or even a stroke. High Density Lipo-protein (HDL) is good because it helps to get rid of cholesterol from the body.  

‘€œCholesterol is a necessary requirement for the structure and ongoing functioning in our body.   However, the majority of raised cholesterol is lifestyle and the lifestyle relates to us ingesting too much animal fat and full cream dairy in our diets’€, says Dr. Eric Klug.  

In the case of Dan Lupou,  it was found that his bad cholesterol, the Low Density Lipo-protein (LDL) level, was a bit high, which is what triggered his heart-attack.

‘€œHis cholesterol would not be very severe. The total cholesterol was 5.4 and his bad cholesterol – and we call that LDL – was 3.6.   And we like it to be less than 2.8. His HDL, which is the healthy cholesterol, is 1.4. And for a male to have a HDL is pretty neutral.   It does not make him at risk. When people have an HDL less than 1, it increases the risk’€, says Dr Eric Klug.

Dr.   Klug says it is recommended that everyone from the age of 20 has their cholesterol checked and does a follow up test, at least, once every five years. This is something that Dan Lupuo has never done in his life before.

‘€œI didn’€™t go do a blood test to check the cholesterol levels… thinking I’€™m a very active person, thinking as a sports man, cholesterol shouldn’€™t be an issue’€,   says Dan Lupou.  

Dr. Klug advised people not to ignore symptoms they can’€™t explain, as not all heart- attacks are typically dramatic.  

‘€œIt’€™s not always this dramatic…   severe pain, lying on the floor, losing consciousness type of thing.   This man had his soccer match, went home and complained to his wife about the pain.  His wife intelligently gave him two Disprins and he went to bed and woke up the next day. He could have gone to bed and never woken up!   If it’€™s a new symptom, central chest pain, heaviness, tightness that you have never experienced before, that needs to be seen by a doctor’€ , concludes Dr Eric Klug.