Silent until it’s not: Why regular cholesterol checks matter

Eighty-six million U.S. adults age 20 and older have either borderline high or high cholesterol, according to the CDC.

However, many go about their lives without any indication that something serious is happening inside their bodies.

That’s because high cholesterol is a silent condition. It typically causes no obvious symptoms until a blocked or ruptured vessel triggers a heart attack or stroke, or leads to a serious medical condition like kidney disease or dementia.

Over time, LDL (“bad”) cholesterol builds up into plaque in the artery walls, resulting in atherosclerosis—when the blood vessels become hard and narrow. This process is slow, usually with either no early warning signs, or signs that might not seem overly concerning.

“Sometimes, for years and years, people are building up plaque because of high cholesterol and don’t feel anything at all,” says Robert Singer, MD, a cardiologist at Trinity Health Mid-Atlantic’s Cardiology Holme. “And then one day, all of the sudden, they can’t walk as far as they could in the past. They get short of breath. They get chest discomfort or other symptoms that the heart is not contracting as well as it should be.”

To lower the risk of cholesterol-related conditions, it’s essential to have your cholesterol levels checked regularly.

Through a blood test and/or coronary calcium score, which measures calcified plaque buildup in the heart’s arteries using a quick, non-invasive CT scan, your provider can review your cholesterol levels and their potential impact on your cardiovascular system.

Healthy levels include:

• Total cholesterol: Below 200 mg/dL
• LDL cholesterol: Below 100 mg/dL
• HDL cholesterol: Between 60 and 80 mg/dL
• Triglycerides: Below 150 mg/dL

“As plaque gets older, it calcifies, so we can see in an asymptomatic person whether they have atherosclerotic cardiac disease or coronary artery disease,” says Dr. Singer. “With that score, we can help guide them. For example, if someone’s cholesterol is high but they have no plaque, they can repeat the study in a few years. But if they have severe calcification of their coronary arteries, we’ll recommend intense therapy, likely in the form of medications and lifestyle changes.”

While everyday habits such as eating too much saturated fats and sugars, inactivity and smoking negatively impact cholesterol, so do genetics in some cases. If there’s a family history of high cholesterol, Dr. Singer recommends that children get a lipid panel, which can test for Lipoprotein(a), or Lp(a)—a type of cholesterol-carrying particle in the blood that is largely inherited. It closely mimics LDL cholesterol and can increase risk of heart disease and stroke.

During National Cholesterol Education Month, it’s important to remember that cholesterol can be managed. But being proactive is the key to management and emergency prevention.

“Know your numbers. Talk to your doctor about your risk factors for cardiovascular disease, including family history,” says Dr. Singer. “And even before you speak to the doctor, it’s time to get active. Get your steps in every day. Get into a routine. Thirty minutes a day, five days a week is a great place to start, and it will help prevent other problems as well.”

For more information on cardiovascular wellness at Trinity Health Mid-Atlantic or to make an appointment, visit Heart and Vascular Care.