High Cholesterol: Silent But Serious
High cholesterol simply means you have too much fat (lipids) in your blood. Over time, these fats can build up on your blood vessel walls, causing them to narrow and become blocked. You may have no symptoms at first, but over time it can lead to a heart attack or stroke.
You can improve your cholesterol levels by eating a heart-healthy diet, getting regular exercise, avoiding tobacco smoke, and losing weight (if you’re overweight). If lifestyle changes aren’t enough, your doctor may also prescribe medication.
Clinical research is growing our understanding of high cholesterol and how to treat it. Read on to learn more.
If you are living with high cholesterol, we would like to hear from you.
- Please tell us about your experience living with high cholesterol in our brief online survey.
- At the end of the survey, you can sign up to be considered for an upcoming clinical trial.
- We also invite you to join our Heart Health online patient community and connect with others about high cholesterol.
Thank you for sharing with us.
Good and Bad Cholesterol
What are lipids and what do they do?
Cholesterol is a medical term for a type of lipids (fats) in the blood. Your body needs some of these lipids to work properly, but having too much can put you at risk for serious health problems.
There are three main types of cholesterol:
- Low density lipoproteins (LDL) or “bad” cholesterol - you want less of this type of cholesterol because it can build up on the walls of your arteries and cause problems over time. Having too much LDL-C in your body is called high cholesterol (hypercholesterolemia), a very common problem for many people worldwide.
- High density lipoproteins (HDL) or “good” cholesterol - you want more of this type of cholesterol because it helps take out some of the “bad” cholesterol from your body. If you don’t have enough HDL-C, fats can build up in your blood vessels.
How is high cholesterol diagnosed?
Because high cholesterol usually has no signs or symptoms, it may be found during a routine blood test, or after a heart attack or stroke. To check your lipid levels, your doctor will do a blood test called a lipid panel.
High cholesterol can run in families. Therefore, it is important to tell your doctor if someone in your family has it.
High cholesterol is one of many risk factors for heart disease. Therefore, your doctor will also look at other risks contributing to your overall heart health, such as blood pressure, your age, your weight and body mass index (BMI), as well as lifestyle such as smoking, alcohol, diet, and how much you exercise.
What are the risks, symptoms and complications of high cholesterol?
High cholesterol usually has no signs or symptoms until a serious problem occurs. However, if it runs in your family, you may have yellowish fatty growths around the eyes or joints.
In addition to putting you at risk for heart disease, high cholesterol increases your risk of developing other conditions, depending on which blood vessels are narrowed or blocked.
- Coronary heart disease: A buildup of fatty substances (plaque) on the blood vessel (artery) walls leading into the heart. This condition, called atherosclerosis, causes arteries to become narrowed, which reduces blood flow to the heart. This can result in angina (chest pain), or a heart attack. Signs of heart disease include:
- Chest pain, chest tightness, chest pressure and chest discomfort (angina)
- Shortness of breath
- Pain, numbness, weakness or coldness in the legs or arms if the blood vessels in those parts of the body are narrowed
- Pain in the neck, jaw, throat, upper abdomen or back
- Heart attack: When the flow of oxygen-rich blood is blocked from reaching a section of the heart muscle. This can happen, for example, when an area of fatty plaque in the artery breaks open. Signs of a heart attack include:
- Chest pain and discomfort
- Feelings of indigestion, heartburn, or nausea
- Pain down the left arm or in the upper arms
- Discomfort in the jaw, neck or back
- Extreme fatigue
- Problems breathing
- Stroke: When a blood vessel that carries oxygen and nutrients to the brain becomes blocked or bursts. This reduces the flow of blood to the brain. Signs of stroke include:
- Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness or loss of balance
- Sudden severe headache with no known cause
- Peripheral artery disease: Diseases of the blood vessels outside the heart and brain. Fatty deposits build up along artery walls and affect blood flow, mainly in arteries leading to the legs and feet. The arteries of the kidney can also be affected.
- Type 2 diabetes: Even if blood sugar control is good, people with diabetes tend to have raised triglycerides (another type of lipid in the blood), lowered HDL (“good”) cholesterol, and sometimes raised LDL (“bad”) cholesterol. This increases the likelihood of developing atherosclerosis.
- High blood pressure: When the arteries become hardened and narrowed from fatty substances (atherosclerosis), the heart has to work much harder to pump blood through them. As a result, blood pressure raises.
How is high cholesterol treated?
Depending upon the causes, symptoms, risks and severity, treatments for high cholesterol may include lifestyle changes, medicines or a procedure called lipoprotein apheresis.
Lifestyle changes may include:
- Eating a heart-healthy diet that is low in fat, sugar and salt and includes fish with omega-3 fatty acids, whole grains, fruit and fiber
- Regular exercise
- Avoiding tobacco smoking
- Limiting alcohol
- Keeping a healthy weight
- Managing stress
If you are unable to lower your cholesterol and triglycerides with lifestyle changes alone, your doctor may prescribe a medicine.
Medicines used to manage high cholesterol, used in addition to the above lifestyle changes, may include:
- Statins to lower or manage cholesterol levels by preventing cholesterol from forming (also known as HMG CoA reductase inhibitors)
- PCSK9 inhibitors to lower LDL cholesterol by helping to remove and clear it from the blood
- Resins (also called bile acid sequestrants) which lower LDL cholesterol by working in the intestines to promote disposal of cholesterol, thereby reducing the amount of cholesterol circulating through the bloodstream
- Ezetimibe to block dietary cholesterol from being absorbed in the intestine (also called selective cholesterol absorption inhibitors)
- Fibrates (fibric acid derivatives) to lower triglycerides and increase HDL (good) cholesterol levels
- Lomitapide to block the release of VLDL cholesterol into the blood in patients with high cholesterol that runs in the family
- Mipomersen to decrease levels of non-HDL cholesterol in the blood in patients with high cholesterol that runs in the family
- Niacin (nicotinic acid) to decrease LDL (bad) cholesterol and triglycerides while raising HDL (good) cholesterol
Medical procedures may include:
- Lipoprotein apheresis - A procedure in which LDL cholesterol is removed from the blood by a filtering machine, with the remainder of the blood returned to the patient. This procedure is typically only used in some patients with high cholesterol that runs in the family.
Clinical Trials - Learn More
Clinical trials are helping medical researchers better understand high cholesterol and how to treat it. Finding these answers depends on people like you to take part.
Have you considered taking part in a clinical trial for people with high cholesterol?
Potential benefits of participating in a clinical trial include:
- Close care and monitoring by a study doctor and staff throughout the study
- No cost for study treatment, related tests and procedures
- Contribute to our understanding of the treatment options for high cholesterol
If you would like to be considered for an upcoming clinical trial in high cholesterol, take our survey.
Please take some time to answer a few questions and be considered for an upcoming clinical trial for people with high cholesterol. We also invite you to join our patient community.
Thank you for sharing with us.
If you would like to be notified about an upcoming clinical trial in high cholesterol, you may sign up at the end of our survey.