By R. Morgan Griffin
A lot of people don't take the risks of high cholesterol very seriously.
After all, one out of five people have high cholesterol. A staggering
50% of Americans have levels above the suggested limit. Could something
so common really be a serious health risk?
Unfortunately, yes. Cholesterol is a direct contributor to cardiovascular disease, which can lead to strokes and heart attacks.
"Despite all of the amazing medicines and treatments we have,
cardiovascular disease is still the number one cause of death and
illness in our society," says Laurence S. Sperling, MD, director of
preventive cardiology at the Emory University School of Medicine,
The World Health Organization estimates that almost 20% of all strokes
and over 50% of all heart attacks can be linked to high cholesterol.
But if you've been diagnosed with high cholesterol, don't despair. The
good news is that high cholesterol is one risk factor for strokes and
heart attacks that you can change. You just need to take action now,
before your high cholesterol results in more serious disease.
All About High-Risk Cholesterol Numbers
When it comes to high cholesterol risks, it's tough to keep the details
straight. We might have a vague idea of whether our cholesterol is
"good" or "bad," but we forget the actual numbers by the time we get to
the parking lot outside our doctor's office. So it may be worth
reviewing the basics.
Cholesterol is a fat-like substance circulating in your blood. Some of
your cholesterol comes from the foods you eat. But the bulk of it is
actually made in your own body, specifically in the liver. Cholesterol
does have some good uses. It helps produce new cells and some hormones.
But an excess of it in the bloodstream can lead to trouble.
There are two types of cholesterol: LDL cholesterol and HDL cholesterol.
So although we all talk about high cholesterol risks, the term is a little misleading. What we really mean is high levels of bad LDL cholesterol and triglycerides and a low level of good HDL cholesterol.
What about total cholesterol, which is the sum of your LDL and HDL?
While anything under 200 mg/dL is still considered the target, most
experts don't focus on the number. It doesn't mean all that much.
"Someone can have a total cholesterol of under 200 -- which is lower
than average for Americans -- but still have unhealthy levels of HDL or
LDL," says Sperling.
Realizing the Risks: How Harmful Is High Cholesterol?
Everyone has cholesterol in their blood. But if your levels of LDL are
too high, the excess can accumulate on the walls of your arteries. This
build-up of cholesterol and other substances -- called plaque -- can
narrow the artery like a clogged drain. It can also lead to
arteriosclerosis, or hardening of the arteries, which turns the normally
flexible tissue into more brittle.
Plaques can form anywhere. If they form in the carotid artery in the
neck, it's carotid artery disease. When they form in the coronary
arteries -- which supply the heart muscle with blood -- it's called
coronary artery disease. Like any organ, the heart needs a good supply
of blood to work. If it doesn't get that blood, you could get angina,
which causes a squeezing pain in the chest and other symptoms.
There are other high cholesterol risks. If these plaques break open,
they can form a clot. If a clot lodges in an artery and completely
chokes off the blood supply, the cells don't get the nutrients and
oxygen they need and die.
If a clot gets to the brain and blocks blood flow, it can cause a
stroke. If a clot lodges in the coronary arteries, it can cause a heart
Do We Underestimate High Cholesterol Risks?
The risks of high cholesterol are quite clear. "If you look at
populations of people," says Sperling, "the higher the cholesterol, the
higher the level of heart and blood vessel disease." It's that simple.
But experts say that people don't take high cholesterol risks seriously
enough. According to the CDC, in 2005 almost a quarter of American
adults said they hadn't had their cholesterol checked in the last five
One problem is that high cholesterol doesn't cause symptoms that make people pay attention.
"People naturally respond more to medical conditions that cause
symptoms," says Nathan D. Wong, PhD, fellow of the American College of
Cardiology and director of the Heart Disease Prevention Program at the
University of California, Irvine. Since you won't feel your rising
cholesterol levels, you won't go to the doctor about it.
By the same token, people may be less likely to stick to treatment for
high cholesterol than they would be for a painful condition.
"People on cholesterol-lowering medicine don't feel any better," says
Sperling. "It's not like taking a painkiller for an aching knee, where
you know it's working." As a result, people may be less likely to follow
their treatment plan over the long-term, Sperling says.
Also, high cholesterol risks are usually not immediate. The damage
accumulates over years and decades -- high cholesterol in your 20s and
30s can take its toll in your 50s and 60s. Because the effects take
time, many people don't feel real urgency in treating it. They feel they
can just deal with it later.
"Unfortunately, I think that many people are too casual about their high
cholesterol," says Adolph Hutter, MD, a cardiologist at Massachusetts
General Hospital and a professor of medicine at Harvard Medical School.
"They ignore it for years and it only gets their attention when they
actually develop vascular disease."
Taking Action to Lower High Cholesterol Risks
There are many good treatments for heart disease, arteriosclerosis, and
other serious conditions caused by high cholesterol. But it's a terrible
shame to let things get that far when making changes now could prevent
these life-threatening illnesses. Reducing your high cholesterol risks
is a crucial step.
So what should you do? First, go to the doctor. "It's very important for
all adults to get their cholesterol tested," says Wong. Every adult
over 20 should have a cholesterol test at least once every five years.
Also, keep track of your cholesterol levels yourself. Write down your
current numbers and, if they're high, what numbers you should be
If you do have high cholesterol, get serious. Talk with your doctor
about what your goals should be and how you should achieve them. Make
sure you understand what lifestyle changes you need to make. If you
already have heart disease or other risk factors like diabetes, you need
to be even more careful.
Whatever you do, don't ignore your high cholesterol risks. Don't put off treatment for another year.
"Having high cholesterol may not hurt you today or tomorrow," says
Sperling. "But if you don't do something about it, it can have a
terrible cost down the road."