High cholesterol is a sneaky condition. It builds up over time and causes no symptoms, yet it can lead to serious problems, like coronary artery disease, heart attack, or stroke. (Learn more about the difference between heart disease and heart attack here.)
Cholesterol is a waxy, fat-like substance found in all the cells in your body. It’s essential: Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. “We do need cholesterol to live a relatively normal healthy life, but when we have an excess amount of cholesterol, that’s when trouble can ensue,” says Rachel Bond, MD, a cardiologist at Lenox Hill Hospital.
When you have too much cholesterol in the blood, it can combine with other substances in the blood to form plaque that can build up slowly over time, hardening your arteries (formally called atherosclerosis). “When you have plaque in your arteries, think of it like a blockage in a drain in your house; the water doesn’t flow as well, and in the case of the body when blood isn’t flowing to an area, it causes problems,” says Paul Knoepflmacher, MD, a clinical instructor in medicine at Mount Sinai Hospital in New York City.
Plaque buildup can affect the entire body. If a clogged artery is blocking blood flow to the heart, it can cause angina or a heart attack; if it’s your brain, it can cause stroke; and if it’s your lower leg it could cause circulation and motility problems, says Dr. Knoepflmacher. “It can also affect your kidney function. [We] have arteries in our kidneys, and with time it can cause your kidneys to not function appropriately which can make your blood pressure raise,” says Dr. Bond.
High cholesterol can also trigger inflammation, because to the body, plaque is a foreign invader that it wants to fight. Inflammation is your body’s natural immune reaction to injury or infection, but when it persists day in and day out, it has a negative effect. Chronic inflammation is associated with an increased risk several conditions, like cancer, diabetes, heart disease, and Alzheimer's.
“The thing about high cholesterol is that, there [are] no symptoms, unless you happen to be unlucky enough to have a heart attack, or stroke, or some manifestation of cardiovascular disease. You could have cholesterol levels in the 200, 300, or 400 range and have really no symptoms,” says Dr. Knoepflmacher. (Learn more about what cholesterol numbers actually mean.) The only way you would know if you have high cholesterol is if you got a blood test.
Knowing your individual health markers—like your cholesterol and blood pressure numbers—is incredibly important for your overall health. Knowing if your cholesterol is too high is the first step lowering it—along with your risk of heart disease or having a heart attack. It allows you to make heart smart lifestyle changes or take cholesterol-lowering medication if you need it.
“Managing your cholesterol is a long-term investment in your health,” says Dr. Knoepflmacher. “You may not feel any different in the short term, but you’re giving yourself a better shot at a happy healthy heart, healthy blood vessels, and a longer life.”
Ready to test your heart smarts? Find out your cholesterol IQ with this quiz.