High cholesterol is a major risk factor for heart disease, heart attack, and stroke. However, it can be difficult to tell if you have high cholesterol or if you are nearing dangerous levels, so knowing the signs your cholesterol is too high may allow you to stop the problem in its tracks.
“Cholesterol is a fatty substance that travels through your bloodstream,” explains Tracy Paeschke, M.D., a preventive cardiologist at Heart Health Prevention and Wellness. “Your body needs cholesterol to build healthy cells and produce hormones, but too much cholesterol can lead to plaque buildup in your arteries, increasing your risk of heart disease and stroke.” There are two types of cholesterol, per the American Heart Association (AHA): Low-density lipoprotein, or LDL, which is considered the “bad” kind, and high-density lipoprotein, or HDL, which is the “good” kind. “High LDL cholesterol can lead to atherosclerosis, or plaque, while low HDL levels reduce your body’s ability to clear cholesterol,” Dr. Paeschke says. Both issues can increase your risk of cardiovascular problems.
Meet the experts: Tracy Paeschke, M.D., a preventive cardiologist at Heart Health Prevention and Wellness; Kevin Shah, M.D., a cardiologist and program director of Heart Failure Outreach at MemorialCare Heart & Vascular Institute at Long Beach Medical Center in Long Beach, CA.
Read on to discover the signs that you might need to seek action to combat high cholesterol.
How to tell if your cholesterol is too high
Experts say that the only way to know for sure that your cholesterol is too high is to get a blood test to check your levels. “There isn’t a reliable physical sign, unfortunately,” says Kevin Shah, M.D., a cardiologist and program director of Heart Failure Outreach at MemorialCare Heart & Vascular Institute at Long Beach Medical Center in Long Beach, CA. “High cholesterol is typically silent, which is what makes it dangerous. Most people don’t have symptoms until plaque buildup leads to a cardiovascular event.”
The fact that high cholesterol is so difficult to detect is one of the reasons that the American College of Cardiology and the AHA released new guidelines this year on the management of high cholesterol, adds Dr. Paeschke. She notes that among other recommendations, the new guidelines suggest a lipid panel for children between ages 9 and 11 and a lipid panel for adults every five years beginning at age 19. They also suggest that all adults have their lipoprotein (a) levels measured at least once. High Lp(a), which is mostly determined by genetics, is associated with a 140% higher risk of heart attack or stroke over a lifetime, per the AHA.
While early high cholesterol does not cause any physical symptoms, if you’ve had it for a long time without treatment, physical signs may start to appear, says Dr. Shah. “Symptoms like chest discomfort, shortness of breath, or reduced exercise tolerance should prompt evaluation,” he says. “But these are usually signs of more advanced disease, not early high cholesterol itself.”
Likewise, Dr. Paeschke says that there are some genetic disorders that can cause very high cholesterol that do have some unique physical symptoms. According to the National Library of Medicine (NLM), these include familial hypercholesterolemia, familial combined hyperlipidemia, familial hypertriglyceridemia, and familial dysbetalipoproteinemia, which can cause symptoms like yellow fatty deposits on the skin or eyelids, a white, blue, or gray ring around the iris of your eye, chest pain, calf cramps while walking, sores on the toes that don’t heal, and sudden stroke-like symptoms. Per the NLM, most people with these disorders respond well to treatments such as diet changes, exercise, and medication.
The bottom line
Unless you have advanced cardiovascular disease or an inherited disorder, it’s nearly impossible to tell if your cholesterol is too high without a blood test. “A blood test is the only way to know for sure, which is why routine screening in people without symptoms is so important,” says Dr. Shah. In the meantime, making smart choices to improve your cholesterol and your heart health, such as choosing the best foods to eat for better cholesterol, maintaining a regular exercise routine, and not smoking, can go far towards keeping your cholesterol levels in a healthy range.
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