Cholesterol is a waxy, fat-like substance that circulates in the blood. It is made by the liver but also enters the body through some of the foods we eat, especially those high in saturated fat, such as red meat, butter, and processed foods. Cholesterol gets a bad rap because of its association with heart disease, but in fact, it is essential for good health. It helps build cell membranes and make hormones and vitamins. But too much of anything can be bad, including cholesterol.
Cholesterol becomes a problem when excess cholesterol builds up on artery walls (a condition called atherosclerosis), causing blockages that can lead to heart attacks and strokes. High cholesterol is a common but silent condition.
Cholesterol is transported through your blood via lipoproteins, particles that have cholesterol on the inside and protein on the outside.
There are three types of cholesterol:
- LDL (bad cholesterol): carries cholesterol from the liver to the rest of the body. If there is too much LDL, it will accumulate in the artery walls.
- HDL (good cholesterol): has the task of “collecting” excess cholesterol and bringing it back to the liver for processing, cleaning the blood vessels.
- VLDL: not cholesterol, but carries triglycerides – a type of fat that can increase the risk of heart disease if the level is too high.
When testing, the doctor will analyze all three of these indicators to give a comprehensive assessment, instead of just relying on the total cholesterol number.
As we age, changes in the body are no longer simply gray hair or painful joints. Inside the blood vessels, cholesterol accumulation can be taking place, which if not checked promptly, can lead to serious consequences. For the elderly, checking cholesterol is not only a recommended action but an important step to maintain cardiovascular health and prevent unexpected events.
Risks of high cholesterol levels in the elderly
High cholesterol in the elderly is not simply an index that exceeds the threshold in a blood test. It is a potential sign of a series of serious health problems that, if not properly checked and controlled, can lead to life-threatening events.
Here are some common risks that older people need to pay special attention to when their cholesterol is high:
1. Heart attack
One of the most direct and dangerous consequences of high cholesterol is blockage of the coronary arteries, the blood vessels that carry oxygen-rich blood to the heart. When LDL (bad cholesterol) accumulates in the arteries, they form plaques, causing the arteries to gradually narrow.
If a plaque ruptures, it can form a blood clot, completely blocking the flow of blood to the heart. The result is a heart attack, an event that occurs suddenly, causing severe chest pain and can be fatal if not treated promptly.
2. Stroke
Similar to the heart, the brain also needs a continuous blood flow to function normally. When high cholesterol causes the blood vessels to the brain to narrow or become blocked, a part of the brain will suddenly lack oxygen. This is the mechanism that leads to ischemic stroke.
Not only that, if the blood vessels are weakened due to long-term damage from plaque, they can rupture, causing a brain hemorrhage. Both types of strokes leave serious sequelae such as hemiplegia, language disorders, memory loss, and sometimes, no chance of recovery.
3. High blood pressure
Cholesterol accumulates along the walls of blood vessels, making the arteries stiffer and narrower. At this time, the heart must pump harder to push blood through the “pipes” that have lost their softness. Blood pressure therefore increases, leading to chronic high blood pressure.
High blood pressure and high cholesterol often go together, and when combined, they form a dangerous spiral that further damages blood vessels, increases the burden on the heart, and accelerates the risk of stroke.
4. Peripheral artery disease
High cholesterol not only affects the heart and brain, but also affects the blood vessels in the limbs, especially the legs. When the peripheral arteries are narrowed by plaque, blood cannot circulate effectively to the lower limbs.
Patients will feel pain or cramps in the calves when walking, numb legs, cold legs, and in severe cases, ulcers that are difficult to heal may appear. These are manifestations of peripheral artery disease but are often overlooked because they are confused with old-age joint pain.
5. Dementia
Long-term high cholesterol not only affects the physical but also threatens cognitive ability. Some studies show that people with high LDL or low HDL in middle age and old age are at higher risk of memory loss, lack of concentration, or developing Alzheimer’s disease than people with stable cholesterol levels.
The reason is because blood flow to the brain is slightly reduced but prolonged, causing nerve cells to lack nutrients. This condition can start quietly from forgetting the names of acquaintances, reduced ability to concentrate, but over time, become serious dementia.
When should seniors get their cholesterol checked?
Health experts recommend that:
- From age 20 and up: if there are no special risk factors, check every 4–6 years.
- From age 45–65: check every 1–2 years, because this is the stage when cholesterol tends to increase even without symptoms.
- From age 65 and up: check every year, because as you get older, cholesterol can increase faster due to changes in the body’s metabolism.
Even if you have always had normal cholesterol levels, that does not guarantee that you will maintain stable levels after age 65. Annual check-ups will help detect small but important changes in time, and that is the way for you to act early, before the condition becomes serious.
