cholesterol flare ups

Overview

A cholesterol 'flare-up' is not a medical term. It usually refers to a time when your cholesterol level becomes higher than normal, or when the effects of high cholesterol start to cause symptoms, such as chest pain. Cholesterol itself is a waxy substance made by your liver and found in some foods. Your body needs it to build healthy cells, but too much can build up inside your arteries and increase your risk for heart disease.

Yes. High cholesterol is very common. Health agencies suggest that many adults have levels that are above the recommended target.

It can affect people of all ages, but it becomes more common as you get older. You are also more at risk if someone in your family has high cholesterol, if you are overweight, or if you have conditions like diabetes or high blood pressure.

Symptoms

Common symptoms

• Most people notice nothing at all.
• Some people with very high cholesterol may develop yellowish skin deposits or rings around the cornea.
• If a cholesterol flare-up is linked to narrowed arteries, you may feel chest pain or shortness of breath.

Symptoms in children

• Children usually have no symptoms. Very high inherited cholesterol may cause fatty bumps on the skin or around tendons.

Symptoms in older adults

• Older adults may experience symptoms of reduced blood flow, such as leg pain when walking, which is called claudication, but cholesterol itself stays silent.

Causes

Main causes

• Eating foods high in saturated fats gives your body more cholesterol than it can use.
• Your liver sometimes naturally makes too much cholesterol.
• Inherited genes can cause very high cholesterol.
• Conditions like an underactive thyroid or diabetes can raise cholesterol levels.

Risk factors

• A diet high in saturated and trans fats.
• Being inactive or having a low level of physical activity.
• Smoking or breathing in second-hand smoke.
• Having high blood pressure, diabetes, or being overweight.
• A family history of early heart disease or high cholesterol.

When to see a doctor

See a doctor urgently if:

• If you have chest pain or other heart attack warning signs, call your local emergency number immediately. For other new symptoms, see a doctor the same day.

Book a routine appointment if:

• See your doctor for a routine cholesterol check if you are over 40 and haven't had one recently, or if you have a family history of high cholesterol or heart disease.

Diagnosis

Doctors diagnose high cholesterol with a simple blood test called a lipid panel.

Tests that may be done

• A fasting blood test to check LDL (bad), HDL (good) and total cholesterol.
• A blood pressure check.
• A short conversation about your health history and risk factors.

What to expect at your appointment

A health professional will take a small blood sample. You may be asked not to eat for 9 to 12 hours before the test. Your doctor will explain your numbers and what they mean.

Treatment

Treatment focuses on lowering your cholesterol level to reduce your risk of heart attack and stroke. You and your doctor will agree on a plan based on your personal risk.

Self-care at home

• Eat plenty of fruits, vegetables, whole grains, and beans.
• Switch to healthy fats like olive oil, nuts, and seeds, instead of butter and processed meats.
• Be active at least 150 minutes a week.
• Maintain a healthy weight.
• If you smoke, seek support to quit.

Medical treatments

For people at higher risk, doctors may prescribe cholesterol-lowering medications to help reduce the amount of cholesterol your body makes. These are taken long-term and are chosen based on your specific numbers and overall health. Always take any prescribed medicine exactly as directed.

When is surgery considered?

Surgery is not used to treat cholesterol itself. However, if a cholesterol buildup causes a blocked artery, a procedure such as angioplasty or stent placement may be needed to restore blood flow. This is decided by heart specialists after tests.

Living with this condition

Living with high cholesterol means keeping close track of your numbers and following your plan. It is a long-term condition, but you can stay in control with regular check-ups and healthy habits.

Lifestyle tips

• Take your medicines as prescribed, if you have been given any.
• Weigh yourself regularly and aim for a waist size within a healthy range.
• Limit alcohol to no more than recommended guidelines.
• Learn to manage stress with activities like walking, breathing exercises, or talking to a friend.

Diet and exercise

Choose a heart-friendly diet that includes vegetables, fruits, whole grains, lean proteins, and unsalted nuts. Limit processed foods, sugary drinks, and foods high in saturated fats. Aim for moderate exercise most days of the week, such as brisk walking, cycling, swimming, or gardening.

Mental health and emotional wellbeing

Being told you have high cholesterol can feel frightening or stressful. It is normal to feel worried. Remember that you can take action to improve your health, and talking to your healthcare team or a trusted person can help you manage these feelings.

Prevention

You can reduce many of the risk factors for high cholesterol with healthy habits, even if you have a family history. Some types, such as familial hypercholesterolemia, cannot be prevented, but they can be treated effectively.

Vaccines

Vaccines do not prevent cholesterol problems. However, staying up to date with recommended vaccines, such as flu and COVID-19 vaccines, is important to protect your heart.

Screening programmes

Screening for high cholesterol usually starts at age 20. If your first test is normal and your risk is low, you may not need another test for some time. Adults with risk factors or a family history should be screened more often.

Complications

If left untreated

• Plaque build-up in your arteries, called atherosclerosis.
• Heart attack or angina (chest pain due to low oxygen to the heart).
• Stroke or mini-stroke.
• Poor blood circulation in your legs, which can cause pain and slow healing.

Long-term outlook

High cholesterol is not something to ignore, but it is also not something to fear. With regular check-ups, a healthy lifestyle, and medicines when needed, most people can successfully manage their cholesterol and greatly reduce the risk of heart attacks and strokes.

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