High cholesterol is considered one of a number of silent killers--diseases that put people at risk for premature death before their first symptoms occur. By the time symptoms do appear, the disease may have progressed to the point where expensive treatment is necessary. In the case of high cholesterol, there are few physical symptoms. A good place to determine if you have high cholesterol is by having an annual physical examination by your physician that includes a blood lipid profile.
Total Cholesterol
Since high levels of cholesterol rarely produce visible symptoms or cause physical pain, it's easy to have elevated cholesterol for years before it becomes a problem. One of the first symptoms of high cholesterol appears in blood lipid tests. Doctors frequently order blood lipid tests as part of their patients' annual physical examinations. One of the tests includes measurements of total cholesterol. Cholesterol is a wax-like substance that courses through the blood and adheres to the inside of arterial walls. Over time, enough cholesterol can accumulate to entirely occlude the inside diameter of the arteries, causing a heart attack. The American Heart Association recommends keeping total cholesterol levels below 200 mg/dl.
Low Density Lipoproteins
Low density lipoproteins (LDL) are another marker of high cholesterol and are often called the bad type of cholesterol. LDL accelerates the accumulation of cholesterol inside the arterial walls. If this accumulation occurs inside the coronary arteries, it can cause angina or a heart attack. If it accumulates inside the carotid arteries that supply blood to the brain, a stroke could result. Optimal levels for LDL cholesterol are less than 140 mg/dl.
High Density Lipoproteins
High density lipoproteins (HDL) are often referred to as the good type of cholesterol because they help carry away LDL and prevent the buildup of cholesterol on the inside of the arteries. They are the one type of cholesterol where higher numbers are better. The recommended levels for HDL cholesterol are 45 mg/dl and above for men and 55 mg/dl and above for women.
Heart Attacks, Strokes and PAD
When cholesterol levels exceed the recommended values, secondary symptoms like angina, heart attack, stroke or peripheral artery disease can occur. Angina is described as a tightness in the chest and is the result of a diminished blood supply to the heart. If the disease progresses to complete occlusion of blood to the heart, a heart attack results. The same situation occurring in the arteries supplying blood to the brain causes a stroke or TIAs--trans-ischemic attacks or mini-strokes. Peripheral artery disease occurs when the arteries supplying blood to the lower extremities become occluded, and circulation to the legs is compromised.
Other Symptoms
If cholesterol levels remain high over long periods of time, a number of physical symptoms can occur. These include enlargement of the liver and spleen, palpable fatty nodules on muscle tendons, yellow patches of excess cholesterol under the skin around the eyes and rings around the corneas of the eyes. All of these symptoms represent advanced hypercholesterolemia and should be treated by a physician.
