High cholesterol – the four signs of the silent condition

High cholesterol: Nutritionist reveals top prevention tips

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High cholesterol is something we’ve all heard of but aren’t too scared of because there are no obvious symptoms. You wouldn’t know for sure that your cholesterol is high unless you have a cholesterol blood test, but there are four signs that signal possible elevated levels. Express.co.uk chatted to Dr Deborah Lee from Dr Fox Online Pharmacy to find out how to tell if your cholesterol is too high.

High cholesterol is mainly caused by eating fatty foods and being overweight, so most of the time you can prevent your cholesterol levels from rising.

When you have too much cholesterol in your blood, it is deposited onto the walls of your arteries, where it builds up and causes narrow vessels.

Narrow blood vessels starve your arteries of enough oxygen, and if this happens in your coronary arteries this can cause angina or a heart attack.

If these fatty plaques are laid down in the arteries in the brain, this can result in a stroke.

If it happens to the arteries supplying your leg muscles, you can get pain in the calf when walking (claudication) and if the artery furs up completely, the leg can die resulting in gangrene.

If the main artery in the body, the aorta is involved, this can result in stretching of the aortic wall and the development of an aortic aneurysm, which can rupture suddenly and is most often fatal.

Raised cholesterol levels do not cause symptoms – that is, until your arteries are so furred up you end up with angina, a heart attack, or a stroke.

Obviously, it’s much better to have your cholesterol levels checked long before you get to this stage.

For this reason, the British Heart Foundation (BHF) recommends all adults have a cholesterol check at any age, even if they feel completely well.

If the test was abnormal, you should have the test more regularly than this.

Testing is crucial for people over 40 years old, but it’s just as important for young adults because.

Dr Lee explained: “One in 250 of the UK population will familial hypercholesterolaemia (FH) – a genetic condition that results in high cholesterol levels (usually raised LDL cholesterol).

“This needs to be diagnosed at a young age and treated appropriately to stop you from developing heart disease at a young age

“If you have close relatives who have had heart disease at a young age, this should alert you to having a medical check-up and a cholesterol test.

“Close family history is an important risk factor for heart disease.”

Ask your GP or pharmacist to do a cholesterol test for you, or make an appointment for your free NHS health check offered to all UK adults between the ages of 40 to 74 years.

There are very few clinical signs of raised cholesterol and raised cholesterol is most commonly diagnosed when a person is admitted to hospital, for example, with a heart attack, or from asymptomatic testing.

However, Dr Lee said there are four key signs to look out for:

Arcus senilis

Arcus senilis is a grey or white arc visible above and below the outer part of the cornea — the clear, domelike covering over the front of the eye.

It is very common in older adults, but not in people under 45.

Dr Lee said: “If arcus senilis occurs in a person under 40, it may signify raised cholesterol.”

In people with familial hyperlipidemia, this arc or ring typically occurs before age 45 and is associated with an increased risk of heart disease, the Mayo Clinic added.


Xanthelasma are yellowish-white lumps of fatty material accumulated under the skin on the inner parts of your upper and lower eyelids.

They normally pop up around the eyes and nose and are usually symmetrical.

Dr Lee said: Xanthelasma are harmless but may occur in association with raised cholesterol levels.

“Tendon xanthomas can occur on the knuckles, the knees, the Achilles tendon or tendons of the feet.”

Dupuytren’s contracture

Dupuytren’s contracture is a type of deformity of the hand that could signal high cholesterol.

Dr Lee said: “With this condition, there is tightening of the tendons that supply the fourth and fifth fingers, in the palm of the hands, such that you find it hard to fully straighten the fourth and fifth finger. Eventually, the fingers are completely bent.

“In research studies, Dupuytren’s contracture occurs more often in those with raised cholesterol levels.

“It is also associated with smoking, alcohol and diabetes.”

Absent pulses

When the doctor examines you, they may find absent pulses in your limbs and this is sometimes indicative of high cholesterol.

Dr Lee said: “If they listen over the blocked artery with a stethoscope, the doctor may hear abnormal sounds called bruits.

“Heart murmurs, such as aortic stenosis, may also be present.”

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