High cholesterol

High cholesterol. We hear the term, often dismissed as "just a number" or a concern for "older folks." But here's a stark reality check: in a study conducted in Maputo, Mozambique, a significant 46.3% of the total population was found to have high total cholesterol. This isn't just a distant health issue; it's a silent, pervasive threat that demands our immediate attention, especially when considering the rising burden of cardiovascular diseases across Africa.
It’s time we truly understand what high cholesterol means for our health and, more importantly, what actionable steps we can take to safeguard our future.

Overview

Cholesterol is a waxy, fatty substance produced naturally by your liver, and it's absolutely vital for building healthy cells and producing hormones. It's not inherently "bad"! The issue arises when we have too much of certain types of cholesterol in our blood. This excess can lead to a dangerous buildup of plaque in your arteries, a process known as atherosclerosis.

Think of your arteries as high-speed highways for blood flow; when plaque accumulates, it’s like traffic lanes slowly becoming blocked, making it incredibly difficult for blood to pass through. This can severely restrict blood flow to vital organs, including your heart and brain, setting the stage for serious health complications.

Symptoms

Here’s the insidious truth about high cholesterol: it rarely presents with symptoms. Yes, you read that right! You can feel completely normal and still have dangerously high levels silently wreaking havoc on your arteries. This lack of overt symptoms is precisely why high cholesterol is often dubbed a "silent killer." By the time symptoms appear, they usually indicate a significant complication, such as a heart attack or stroke, which means the damage has already been done.

This reinforces the critical importance of regular screenings, even if you feel perfectly healthy.

When to see a doctor

Given its asymptomatic nature, knowing when to see a doctor for high cholesterol relies heavily on proactive screening. The American Heart Association recommends that adults generally get their cholesterol checked every 4 to 6 years. However, if you have certain risk factors, such as a family history of high cholesterol or early heart disease, high blood pressure, or diabetes, your doctor might recommend more frequent testing.

Children can also have high cholesterol, so screenings are recommended for them once between ages 9 and 11, and earlier if there's a family history or underlying health conditions like obesity. Don't wait for symptoms; be proactive about your health!

Causes

High cholesterol often stems from a combination of lifestyle choices and genetic predisposition. Our modern lifestyles, unfortunately, lend themselves to elevated levels. The most common culprits include:

  • Unhealthy Eating Habits: A diet rich in saturated fats (found in red meat, full-fat dairy, and many processed foods) and trans fats (often in packaged snacks and baked goods) significantly raises your "bad" LDL cholesterol.

  • Lack of Physical Activity: A sedentary lifestyle can lower your "good" HDL cholesterol and contribute to weight gain, both of which negatively impact your lipid profile.

  • Obesity: Carrying excess body fat, especially around your middle, is a major risk factor for high cholesterol.

  • Smoking: This damaging habit not only lowers HDL cholesterol but also directly harms your blood vessels, making them more susceptible to plaque buildup.

  • Excessive Alcohol Consumption: Drinking large amounts of alcohol can adversely affect your lipid profile, particularly raising triglycerides.

  • Genetics: Sometimes, high cholesterol runs in families. Conditions like familial hypercholesterolemia (FH) are inherited and can lead to very high cholesterol levels even in individuals with otherwise healthy lifestyles.

  • Underlying Health Conditions: Certain medical conditions, including chronic kidney or liver disease, diabetes, hypothyroidism (underactive thyroid), lupus, and sleep apnea, can contribute to elevated cholesterol.

  • Certain Medications: Some drugs used to treat conditions such as HIV, cancer, or after organ transplant, and others, can adversely affect cholesterol and triglyceride levels.

Risk factors

Several factors can increase your likelihood of developing high cholesterol:

  • Diet: As mentioned, a diet high in saturated and trans fats is a primary driver.

  • Weight: Being overweight or obese significantly raises your risk.

  • Inactivity: A lack of regular physical activity contributes to unfavorable cholesterol levels.

  • Smoking: This habit actively harms your arteries and lowers HDL.

  • Age: Cholesterol levels tend to rise with age LDL often increases and HDL may decline raising the chance of high cholesterol as people get older.

  • Sex: Men generally have a higher risk of high cholesterol from a younger age compared to women. After menopause, women's risk tends to increase.

  • Ethnicity: Some ethnic groups (for example, people of South Asian descent) have higher cardiometabolic risk profiles. In sub-Saharan Africa, prevalence of high cholesterol is increasing in many populations due to urbanization, dietary changes, and reduced physical activity.

  • Family History: If close relatives have high cholesterol or early heart disease, your risk is elevated.

Complications

The true danger of untreated high cholesterol lies in its long-term complications, all stemming from the progressive hardening and narrowing of your arteries:

Development of atherosclerosis

Atherosclerosis is the core issue. It's a gradual process where cholesterol, fats, and other substances accumulate on the inner walls of your arteries, forming plaque. Over time, this plaque hardens and narrows the arteries, reducing blood flow. This critically impacts oxygen and nutrient delivery to your organs.

If these plaque deposits occur in the arteries supplying your heart, it can lead to:

  • Angina: Chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood.

  • Heart Attack: This happens when blood flow to a part of your heart is completely blocked, often by a blood clot forming on a ruptured plaque, leading to the death of heart muscle.

If the plaque affects arteries leading to your brain, it can result in:

  • Stroke: Occurs when blood flow to a part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients, causing brain cells to die.

Other serious complications can include peripheral artery disease (PAD), affecting blood flow to your limbs.

Prevention

The good news is that high cholesterol is largely preventable and manageable through strategic lifestyle choices! We have the power to influence our numbers:

  • Embrace a Heart-Healthy Diet: This is paramount! Focus on lean proteins, a rainbow of fruits and vegetables, and whole grains. Drastically limit saturated and trans fats, found in fatty meats, full-fat dairy, and many processed snacks. Instead, integrate healthy fats from sources like olive oil, avocado, nuts, and oily fish (salmon, mackerel) into your diet. Soluble fiber, found in oats, beans, fruits, and vegetables, can actively help lower LDL cholesterol.

  • Get Moving: Regular physical activity is incredibly effective. Aim for at least 30 minutes of moderate-intensity exercise on most days of the week. This boosts your "good" HDL cholesterol and helps with weight management. Even brisk walking makes a difference!

  • Maintain a Healthy Weight: Losing even a few extra pounds can significantly improve your cholesterol profile, reducing LDL and increasing HDL.

  • Quit Smoking: If you smoke, quitting is one of the most impactful steps you can take for your overall health, including your cholesterol levels. The benefits are almost immediate!

  • Moderate Alcohol Consumption: If you drink alcohol, do so in moderation. Excessive drinking can negatively affect your lipid profile.

  • Manage Stress: Chronic stress can impact your overall health, including contributing to unhealthy lifestyle habits that can affect cholesterol. Incorporate stress-reducing activities like meditation, yoga, or spending time in nature.

  • Prioritize Sleep: Adequate sleep (7-9 hours for most adults) plays a role in overall metabolic health, which can indirectly influence cholesterol levels.

FAQs

Can high cholesterol be cured ? High cholesterol itself isn't typically "cured" in the traditional sense, but it can be effectively managed and controlled, often to healthy levels, through lifestyle changes and, if necessary, medication. The goal is to keep your cholesterol levels within a healthy range to prevent complications.

Are there any natural remedies for high cholesterol? While lifestyle changes like diet and exercise are powerful "natural remedies," it's crucial to consult your doctor. Some supplements, like psyllium husk (a soluble fiber) or omega-3 fatty acids, can support cholesterol management, but they should be used under medical guidance and not as a replacement for prescribed treatments.

How often should I get my cholesterol checked? For most adults, a cholesterol check every 4 to 6 years is recommended. However, if you have risk factors such as a family history of heart disease, diabetes, or high blood pressure, or if you're already on cholesterol-lowering medication, your doctor may suggest more frequent screenings.

Is stress linked to high cholesterol ? While stress doesn't directly cause high cholesterol, chronic stress can lead to behaviors that do, such as unhealthy eating, lack of exercise, and smoking. Managing stress is important for overall cardiovascular health.

Published 7th August 2025

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