According to the Ministry of Health’s National Population Health Survey 2020, 39.1% of Singapore residents aged 18 to 74 had high blood cholesterol from 2019 to 2020. Making things worse, high cholesterol is a silent killer as many people regrettably do not check regularly and miss the warning signs until they have serious medical complications like heart disease, stroke and peripheral artery disease.
Recognising high cholesterol is vital for early detection, intervention, and effective management. In this article, we will dive into the symptoms of high cholesterol, and the vital importance of regular screening to help you gain a better understanding of this common chronic disease.
What is high cholesterol? Should I be worried if my cholesterol is high?
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High cholesterol (also known as hyperlipidaemia) is a condition in which you have excessive levels of cholesterol (fats) in your blood.
To further understand what cholesterol is, cholesterol is a waxy substance produced by the liver and is acquired through eating certain foods. Not all types of cholesterol are bad. There are 2 types of cholesterol: HDL, otherwise known as “good” cholesterol and LDL, otherwise known as “bad” cholesterol.
A high level of HDL (good) cholesterol levels is great because they reduce your risk of suffering from heart attacks, strokes and other health problems.
On the other hand, excessive LDL (bad) cholesterol in the blood is worrisome because it may increase your chance of heart attacks, strokes and other serious health problems. It can slowly deposit within the artery walls (a condition called atherosclerosis), forming blockages that clog up your blood vessels. These blockages can restrict blood flow to vital organs like the brain and the heart. As a result, insufficient oxygen supply can cause your vital organs to suffer.
One of the key challenges with high cholesterol is its silent nature. Thus, many people with hyperlipidaemia do not even know they have it. This is because it often does not give rise to any symptoms.
Symptoms of high cholesterol
High cholesterol does not cause any specific symptoms. Rather, it usually leads to the development of other health conditions, for example atherosclerosis (hardening and narrowing of the arteries), which can result in symptoms. In rare cases, people with very high cholesterol levels may experience certain external signs such as development of Xanthomas, Xanthelasmas and Arcus Senilis.
1. Symptoms/ serious complications of high cholesterol:
Angina: High cholesterol elevates your risk of having heart disease. One of the symptoms of heart disease is angina, which is defined by chest pain or discomfort that may radiate to the arm, shoulder, jaw, or back. Angina happens when the heart muscle receives insufficient oxygen-rich blood from narrowed or blocked arteries.
Peripheral Artery Disease (PAD): PAD is a condition caused by the blockage of arteries that supply blood to the limbs, particularly the legs. Warning signs include leg pain, cramping, numbness, or weakness.
Transient Ischemic Attack (TIA) or Stroke: High cholesterol is a risk factor for the development of blood clots, which can restrict the blood supply to the brain, resulting in a transient ischemic attack (TIA) or stroke. Red flags to watch out for include sudden weakness or numbness on a single side of the body, speech problems, serious headaches, and imbalance.
Xanthomas: These are fatty deposits that develop under the skin. They look like small, yellowish bumps or nodules and typically affect the elbows, knees, tendons, or eyes. When the yellow growths are on the eyelids, they are called Xanthelasmas.
Xanthelasmas: A common form of Xanthomas, Xanthelasmas are yellowish patches or plaques that form on the eyelids. They are usually painless but can be aesthetically bothersome.
3. Arcus Senilis (a.k.a Corneal Arcus):
Arcus Senilis: It is a white or grey ring that forms around the eye’s cornea (the clear front part of the eye). Although this condition is more common among older people, it can affect younger individuals with high cholesterol too.
Seeking medical evaluation and treatment
Although having one or more of the symptoms above could hint towards a case of high cholesterol, the only proper way to diagnose cholesterol level is by getting a blood test done. High cholesterol is often asymptomatic, which is why we recommend regular cholesterol screenings.
In general, healthy young adults should have their cholesterol checked every few years. But for those who reach middle-age and with one or more risk factors, like family history of high cholesterol, sedentary lifestyle, smoking, lack of exercise or with underlying medical conditions, a more regular and detailed cholesterol check is warranted.
During your health screening, your cardiologist will do a cholesterol blood test to assess your blood cholesterol level when you are in a fasted state. If you are diagnosed with high cholesterol, your doctor will advise you on a heart-healthy lifestyle and if necessary medications so that you can optimise your health fully.
Visit Capital Heart Centre
Helmed by an award-winning Senior Consultant Interventional Cardiologist, Capital Heart Centre provides a wide range of detailed heart-health screening packages which evaluate your cholesterol profile, diabetes profile, cardiac risk profile and more. The heart screening tests are crucial for detecting heart disease early and monitoring your cholesterol levels. If you are unsure which tests are required, Dr Loh will be able to recommend a suitable heart screening package for you.
High cholesterol is prevalent among adults in Singapore. Unfortunately, there is a worrying trend that people with high cholesterol remain undiagnosed until they suffer from complications such as heart disease, stroke and peripheral artery disease. We hope that by reading this article, you can understand the critical importance of regular blood cholesterol screening, and be aware of some of the symptoms of high cholesterol. If you would like to schedule a blood cholesterol screening, please consult your cardiologist.
- Ministry of Health Singapore. National Population Health Survey 2020 Survey Report. [PDF]. Retrieved from https://www.moh.gov.sg/docs/librariesprovider5/default-document-library/nphs-2020-survey-report.pdf
- SCS Physicians. (2019, December 9). High Cholesterol: The Other Silent Killer. Retrieved from https://www.scsp.net/articles/high-cholesterol-the-other-silent-killer/.
- Healthline. (n.d.). Xanthoma: Types, Causes, and Treatment. Retrieved from https://www.healthline.com/health/xanthoma.
- Mayo Clinic. (n.d.). Arcus Senilis: Is It a Sign of High Cholesterol? Retrieved from https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/expert-answers/arcus-senilis/faq-20058306.
- Centers for Disease Control and Prevention. (2021, May 27). Cholesterol Screening.
Retrieved from https://www.cdc.gov/cholesterol/cholesterol_screening.