To understand why, we spoke with Dr Supratim Sen, Senior Consultant and Clinical Lead, Pediatric Cardiology, Narayana Health SRCC Children’s Hospital, Mumbai.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
Why is high cholesterol called a silent condition?
Dr Sen explains that high cholesterol is called a silent condition because it usually produces ‘no symptoms’, even when levels are significantly elevated.
“Cholesterol circulates in the blood and gradually accumulates in artery walls without causing pain, discomfort or fatigue. People may feel perfectly healthy while artery damage progresses over many years.”
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That being said, some people with high cholesterol may develop visible cholesterol deposits on their eyelids (xanthelasmas) and arms (xanthomas).
How does excess cholesterol damage the arteries?
Excess LDL, commonly called bad cholesterol, can enter artery walls and contribute to fatty deposits called plaques. Over time, these plaques gradually narrow the arteries and restrict blood flow.
“If a plaque ruptures, a blood clot may form, suddenly blocking blood supply to the heart or brain, causing a heart attack or stroke,” Dr Sen explains.
While this buildup happens gradually, its consequences can sometimes be sudden and life-threatening.
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Why do people discover high cholesterol only after a heart attack or stroke?
Since high cholesterol rarely causes noticeable symptoms, many people remain unaware of the condition for years unless they undergo medical tests.
“In some cases, the first indication is a heart attack or stroke caused by a sudden blockage of an already diseased artery,” Dr Sen notes.
That is why feeling healthy doesn’t necessarily mean your cholesterol levels are under control. Regular cholesterol testing is important, even for people who otherwise appear healthy.
Are there any early warning signs of cholesterol-related artery damage?
Unfortunately, most people do not experience early warning signs. “In most people, cholesterol-related artery disease progresses silently, without early warning signs.”
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Symptoms such as “chest pain during exertion, leg pain while walking or temporary weakness or dizziness due to reduced blood supply to the brain” usually appear only when blood flow is significantly reduced.
This means waiting for symptoms before getting tested may not be a good idea, particularly for people with additional risk factors.
Can young and physically active people also have high cholesterol?
Yes. High cholesterol isn’t limited to older adults or overweight people.
“Genetic conditions such as familial hypercholesterolemia and hyperlipidemia can cause very high cholesterol from childhood regardless of lifestyle or diet,” Dr Sen clarifies.
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He also points out that ‘childhood obesity’ and ‘metabolic syndrome’ due to sedentary lifestyles and unhealthy food habits during the teenage years can contribute to early-onset high cholesterol and diabetes in young adults.
Other risk factors include an unhealthy lifestyle, smoking, diabetes, thyroid disorders and a family history of early-onset heart disease.
When should you start getting your cholesterol checked?
Adults should ideally have their first lipid profile around age 20. If the results are normal and there are no additional risk factors, testing every four to five years is reasonable, Dr Sen advises.
Children should ideally be screened once between the ages of nine and 11 if there is a family history of high cholesterol or premature heart disease.
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Those with additional risk factors, especially obesity, diabetes and a family history of heart disease, need more frequent testing.
Can cholesterol-related artery damage be reversed?
The good news is that timely detection and treatment can make a significant difference. Lifestyle changes and cholesterol-lowering medicines, as the cardiologist explains, can slow plaque progression, stabilise existing plaques and sometimes produce partial regression.
“Preventing further cholesterol accumulation is particularly important because treatment is most effective when started early.”
Apart from lowering and controlling cholesterol levels with medication, a healthy and active lifestyle, a healthy diet, avoiding smoking and regular cardiac check-ups all play important roles in reducing the risk of sudden heart attacks and strokes.
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DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
