What is a person with high cholesterol like? The fact is that they may appear outwardly “healthy” and thin people may be at the same risk as anyone else.
While there are some subtle signs that I, as a doctor, know to look out for (more on this in a moment), generally the only way to know for sure is with a blood test.
And it’s really important that you know what your levels are.
Because, after cancer, the leading cause of poor health and death is atherosclerosis, or clogged arteries, and cholesterol is largely to blame.
Virtually any artery can be affected by cholesterol, writes Dr Martin Scurr
Over time, this buildup leads to heart disease and heart attacks or strokes, or even both.
Virtually any artery can be affected and if cholesterol blocks the small vessels that supply the penis, for example, it can cause erectile difficulties.
The problem with high cholesterol (i.e., a total cholesterol reading greater than 5 mmol/L and low-density lipoprotein or “bad” LDL greater than 3 mmol/L) is that it is a silent killer, with few or no symptoms until that the damage is resolved. under way. However, alarming new figures published last week show that 53 per cent of adults in the UK have high cholesterol levels – but many are unaware that their levels are higher than they should be – and this is dangerous.
We need some cholesterol. It’s a key raw material that the body uses to make certain hormones, for example, and although we absorb some cholesterol from the foods we eat (like eggs), the liver makes up to 80 percent from foods containing saturated fats. and those with high sugar content.
While there is an adequate level of cholesterol, high amounts are silently harmful as it gradually builds up within the walls of the arteries. Deposits can build up due to a number of factors, including high blood pressure, diabetes, aging, and family history.
Your sex also influences. Women are more likely to have high cholesterol, with the number affected increasing from 45 percent in 2019 to 56 percent in 2022. This compares with an increase in men from 40 percent to 49 percent during the same period .
The hormone estrogen is thought to be critical as a woman’s cholesterol levels change throughout the month and tend to increase after menopause. Men and women also metabolize and store fat differently.
But for both sexes, high cholesterol represents a significant health risk and greater emphasis should be placed on each of us to be aware of our cholesterol levels and make extra efforts to reduce it to a safe range.
Testing is usually carried out, if you are otherwise healthy, as part of the NHS Health Check, which is offered to people aged 40 to 74 every five years.
That’s the time to start looking at risk factors, including weight, since eating a good diet and maintaining a healthy weight are the most important lifestyle decisions anyone can make.
One warning sign I look for in my patients is the buildup of cholesterol deposits in the skin, known as xanthelasmas or xanthomas. They are yellowish waxy plaques of cholesterol, usually 10 to 12 mm in size. There may be one or two of these, or there could be many.
They start as small, yellow, seed-like nodules, but can grow (if cholesterol is high enough) to be several centimeters long.
They are usually seen on the delicate skin just under the lower eyelids, but they can also appear on the knees, hands and feet: wherever they are, they are a warning that cholesterol levels need to be controlled.
Another sign is an arcus senilis, a gray ring around the edge of the iris of the eyes, although it is not clear why they appear here.
The xanthomas regress within a few weeks or months of lowering cholesterol levels, but the arcus senilis will remain forever.
Some people are born with a predisposition to high cholesterol, a condition called familial hypercholesterolemia: they may look thin and fit, but they have very high levels of “bad” LDL cholesterol because their livers, for complicated reasons, are not able to clean it. LDL from your blood. They almost universally have a family history of previous generations dying prematurely.
If there is some time before your next NHS check-up, I think it is advisable to take one of those DIY tests you can buy on the High Street, or visit a major pharmacy that offers in-store cholesterol testing.
The advice used to be to take the test in the morning on an empty stomach, but today it is considered less important. I encourage all adults to start testing. It is best to know as soon as possible if levels are increasing so action can be taken.
While statins may be offered to some people with high cholesterol, this should not be seen as a way to avoid the lifestyle changes necessary to lower cholesterol, such as losing weight, exercising more, and improving your diet.
But unless you know your numbers, you won’t be able to act.
