High Cholesterol FAQs

High cholesterol itself usually causes no symptoms, which is why regular blood testing is essential. Over time, elevated cholesterol levels can show up as warning signs of cardiovascular disease, including:

1. Chest pain or angina
2. Shortness of breath
3. Leg pain or cramping when walking due to poor circulation
4. High blood pressure
5. Fatigue or reduced exercise tolerance
6. Stroke-like symptoms such as sudden weakness or slurred speech
7. Palpitations or irregular heartbeat
8. Dizziness or fainting spells
9. Xanthomas, which are yellowish cholesterol deposits in the skin or around the eyes
10. Family history of premature heart disease

Foods high in saturated and trans fats contribute the most to plaque buildup. The biggest culprits include fried foods, processed meats, fast food, baked goods made with shortening, full-fat dairy products, butter, and packaged snacks. Reducing these helps protect arteries and improve cholesterol numbers.

Hormones play a big role. Before menopause, estrogen helps keep HDL (good cholesterol) higher. After menopause, HDL tends to decline, raising cardiovascular risk. Women who enter menopause early and don’t use hormone replacement therapy have a much higher risk of cardiovascular events within the next 10 years. Studies show women who start estrogen therapy early may maintain healthier lipid levels and reduce long-term cardiovascular risk.

Targets depend on your overall risk and health history. For many people, LDL under 100 mg/dL is reasonable, but if you have plaque or a higher risk, goals may shift to <70 or even closer to 50. For HDL, higher is protective, ideally above 50 in women and above 40 in men. We also track ApoB (<80 for prevention, <65 for very high risk) and triglycerides (<150, but lower is better in insulin resistance).

Cholesterol levels and plaque risk can often be improved and managed. Lifestyle changes, nutrition, exercise, weight management, and in many cases medication when appropriate can lower cholesterol and stabilize plaque. While existing plaque may not completely disappear, it can be stabilized or slowed, significantly lowering the risk of heart attack and stroke.