High cholesterol is often a silent health threat. Like other conditions that increase the risk of cardiovascular disease, such as high blood pressure, high cholesterol doesn’t typically present with noticeable symptoms. A significant portion of the population – around 40 percent of adults in the U.S., according to a study published in JAMA Cardiology – are unaware they even have it. This lack of awareness means many individuals go untreated for a condition that can ultimately lead to heart attack, stroke, peripheral artery disease, or other cardiovascular problems.
“Know your numbers,” advises Dr. Seth Martin, a preventive cardiologist at Johns Hopkins Medicine. “Very high levels of cholesterol can cause cholesterol buildup in the eyes and tendons that are detectable on a physical exam. However, most people don’t have those, and regular cholesterol blood tests are a reliable way to catch high cholesterol and intervene.”
Fortunately, a standard annual checkup typically includes blood tests that measure cholesterol levels. A lipid panel provides readings for several key components:
- HDL (high-density lipoprotein): Often referred to as “good” cholesterol, HDL helps remove excess cholesterol from the body by transporting it from the bloodstream to the liver for elimination. An optimal level is 60 milligrams per deciliter or higher.
- LDL (low-density lipoprotein): Considered “bad” cholesterol, LDL contributes to the buildup of plaque in the arteries. An optimal level is under 100 mg/dL.
- Triglycerides: The most common type of fat in the body. Optimal levels are under 150 mg/dL.
- Total: Represents the total amount of cholesterol in the blood, including both HDL and LDL, plus 20 percent of triglycerides.
While cholesterol numbers, particularly LDL, are important, they don’t provide a complete picture. As Dr. Martin explains, “We interpret and treat numbers in the context of a person’s cardiovascular risk. Treatment decisions are based on a comprehensive assessment, not just a single number.”
What is Cholesterol?
Cholesterol is a waxy, fat-like substance found in all cells of the body. The liver produces most of the cholesterol the body needs, while the rest comes from dietary sources like meat, eggs, and cheese. Despite its often-negative reputation, cholesterol isn’t inherently harmful. The body requires cholesterol to build cells, produce hormones – including estrogen, testosterone, and cortisol – synthesize vitamin D when the skin is exposed to sunlight, and aid in the digestion of fats.
The problem arises when there’s an excess of cholesterol in the blood. Specifically, high levels of LDL cholesterol can lead to plaque formation within the artery walls. This plaque buildup, known as atherosclerosis, causes the arteries to narrow and lose flexibility, increasing the risk of heart attack and stroke.
High cholesterol can be inherited, meaning it can be passed down through families. However, it’s often a result of lifestyle choices, such as insufficient exercise and a diet high in saturated fats. Making changes to lifestyle can help prevent and lower cholesterol.
High cholesterol is closely linked to other medical problems. It can both cause serious conditions like coronary artery disease and result from other diseases, particularly those that cause inflammation, such as lupus. People with high cholesterol also frequently develop high blood pressure.
The American Heart Association offers guidance on preventing and treating high cholesterol through lifestyle modifications and, when necessary, medication as recommended by a healthcare professional. If diagnosed with high cholesterol, overall health and other risk factors, like smoking or high blood pressure, will guide treatment decisions. Healthcare professionals may use the ASCVD Risk Calculator to assess an individual’s risk of a coronary event within the next 10 years.
It’s important to note that plaque buildup can occur silently for years, making early detection crucial. The only way to know your cholesterol levels is through a blood test, called a lipid panel. Knowing your numbers and working with a healthcare professional to manage them is a vital step in protecting your cardiovascular health.
