Conditions / High Cholesterol
High Cholesterol
Overview
High cholesterol is a chronic condition characterized by an excess of lipids in the blood, which can accumulate in the arteries and lead to cardiovascular complications. This buildup, known as plaque, can restrict blood flow and significantly increase the risk of heart attack, stroke, and peripheral artery disease. Often asymptomatic, high cholesterol can go undetected for years without routine testing. Contributing factors include poor diet, sedentary lifestyle, genetic predisposition, and coexisting medical conditions. Despite its silent nature, high cholesterol is manageable with lifestyle modifications, medication, and regular monitoring.
Symptoms
High cholesterol typically does not cause noticeable symptoms on its own. Most people discover the condition through routine lipid panel blood tests. In advanced or untreated cases, however, complications may present with symptoms such as:
• Chest pain (angina)
• Heart attack or stroke
• Xanthomas: Fatty deposits under the skin, often on hands or around the eyes
• Peripheral artery disease (PAD): Causing leg pain, numbness, or skin ulcers
When to see a doctor
Consult a healthcare provider if you:
• Have never had your cholesterol tested, especially if you’re over 20 or have risk factors
• Have a family history of high cholesterol, heart disease, or stroke
• Show symptoms of cardiovascular disease (e.g., chest pain, shortness of breath)
• Notice unusual skin changes like xanthomas
Causes
High cholesterol arises from a combination of genetic and lifestyle factors, including:
• Unhealthy diet: High in saturated fats, trans fats, and cholesterol
• Lack of exercise: Leads to lower HDL (good) cholesterol and weight gain
• Smoking: Lowers HDL and damages arterial walls
• Genetic predisposition: Conditions like familial hypercholesterolemia
• Medical conditions: Diabetes, hypothyroidism, liver or kidney disease
• Aging: Cholesterol levels tend to rise with age
Risk Factors
Key risk factors for high cholesterol include:
• Diet high in saturated and trans fats
• Physical inactivity
• Obesity (BMI ≥ 30)
• Smoking and excessive alcohol use
• Family history and genetic disorders
• Underlying diseases: Diabetes, thyroid disorders
• Limited access to healthy food and healthcare
Complications
Potential complications include:
• Atherosclerosis: Hardening and narrowing of arteries
• Heart disease and myocardial infarction
• Stroke: Due to reduced blood flow to the brain
• PAD: Pain and circulation problems in limbs
• Hypertension and kidney damage
• Gallstones from altered fat metabolism
Mediacal Risk
Effective management combines medication, lifestyle changes, and routine monitoring. Common treatment strategies include:
• Statins: Lower LDL cholesterol but may cause liver enzyme elevation, muscle pain, or increase diabetes risk
• Bile acid sequestrants and fibrates: May cause gastrointestinal discomfort or gallstones
• PCSK9 inhibitors: Injectable drugs that can cause site reactions or flu-like symptoms
• Dietary improvements: Emphasizing fiber, fruits, vegetables, and lean proteins
• Physical activity: At least 150 minutes of moderate aerobic exercise weekly
Monitoring cholesterol levels through regular blood tests and working closely with a healthcare provider can help reduce the risk of cardiovascular disease and support long-term health.