Why is cholesterol a silent killer?
It seems so obvious that cholesterol is linked to cardiovascular disease that the question of the exact connection is rarely asked anymore.
As a general rule, cholesterol is often mentioned in the same breath as cardiovascular disease, stroke, arteriosclerosis, and other medical evils. The clogging of our arteries is a noiseless, slow and painless process, resulting from cholesterol besides other factors.
Read on to discover the link between cholesterol and cardiovascular disease and why cholesterol is a silent killer.
Table of Contents
- 1 Why is cholesterol a silent killer? Introduction
- 2 What are cardiovascular diseases?
- 3 Arterial calcification is the cause of many diseases
- 4 Diseases due to arteriosclerosis
- 5 What exactly is arteriosclerosis?
- 5.1 Twists and turns in arteries are weak spots
- 5.2 Formation of a fatty streak in the vascular wall of cells
- 5.3 The emergence of a bulge in the vessel wall (plaque)
- 5.4 Chemical versus mechanical stress on the vessel wall
- 5.5 Not all risk factors are modifiable
- 5.6 The difference between veins and arteries
- 6 When does arterial calcification occur?
- 7 Consequences of arteriosclerosis
- 8 Minor symptoms of arteriosclerosis (the silent killer)
- 9 Symptoms of narrowing of the blood vessels (stenosis)
- 10 Why is cholesterol a silent killer? Conclusion
Why is cholesterol a silent killer? Introduction
Exactly what mechanism is playing out here? How can such a body’s own substance as cholesterol have such tremendous effects on the proper functioning of our bodies?
Understanding this process is essential because it allows you to see what you can do yourself to make timely adjustments.
Below you will discover what the link is between cholesterol and cardiovascular disease.
We also pay due attention to the effects and symptoms of arteriosclerosis so that you are armed with enough knowledge to start living healthier!
What are cardiovascular diseases?
Cardiovascular disease is an umbrella term for a wide range of diverse conditions. Most people conveniently associate the term immediately with heart disease.
Although they can be equally threatening, the somewhat lesser-known vascular diseases are often overlooked.
The name cardiovascular disease refers to several well-known conditions such as:
- Aneurysms in which the blood vessel does not constrict but widens. A local bulge or hump forms in the artery where the vessel wall has become more stretched and brittle and can suddenly rupture.
- Peripheral vascular disease (this is narrowing of the leg arteries)
- Brain infarctions (also known as cerebral thrombosis, stroke, or CVA)
- Heart attack
- Heart failure (due to a weakened heart muscle)
- Sudden death (also called cardiac artery rupture)
The importance of cardiovascular disease to our quality of life can hardly be overstated yet despite all medical advances, it remains the leading killer in the Western world.
It is even more important to also look at premature deaths or lower quality of life due to disease and understand why cholesterol is a silent killer
Prevention of cardiovascular disease to boost the quality of life
The goal of cardiovascular disease prevention is not necessarily to prolong life but to increase the quality of life.
Cardiovascular disease is often responsible for premature deaths before the age of 65.
In addition, cardiovascular disease is also the leading cause of disability and causes more invalidity than traffic accidents and lung or back problems.
In practice, mainly cerebral thromboses or strokes claim the leading role here as the cause of severe disability.
And not only does this cause a great deal of medical and psychological suffering, but also economical issues.
Arterial calcification is the cause of many diseases
The bulk of all cardiovascular disease shares one common culprit: arteriosclerosis.
Arteriosclerosis is a mechanism by which arteries gradually clog, and it is at the root of numerous diseases.
The phenomenon of arteriosclerosis is also responsible for the majority of all strokes, heart attacks, and sudden deaths.
In addition, arteriosclerosis is also at the root of many vascular problems in other parts of the body, such as the kidneys, legs, etc.
Similarly, a problem such as heart failure cannot be separated from arteriosclerosis, even though it plays a more indirect role here.
Indeed, most cases of heart failure occur because some part of the heart was previously damaged and weakened by a heart attack as an infarction leaves marks on the heart muscle.
Those spores cause impaired pump function, possibly resulting in heart failure. With few symptoms, this is why cholesterol is a silent killer.
Diseases due to arteriosclerosis
Arteriosclerosis can occur in all arteries of our body. Still, a few places are affected more often and give rise to several typical syndromes. Some examples are as follows:
Arterial calcification at the level of the crown arteries of the heart is responsible for heart attacks.
Narrowing of the coronary arteries must be addressed by classical bridging surgery (the bypass) or balloon dilatation (Dotter treatment) and stenting.
Heart attacks are also very often at the root of so-called sudden deaths.
A myocardial infarction in which a large part of the heart muscle is damaged is a major cause of heart failure.
An aneurysm or dilatation of the artery is often, but certainly not always, the result of arteriosclerosis.
Peripheral vascular disease
In the leg arteries, arterial calcification gives rise to peripheral vascular disease.
In practice, such strictures are treated by bypass surgery and stent implantation.
Arterial calcification in the carotid and/or cerebral arteries causes strokes.
Narrowing in this area is treated with balloon dilatation (Dotter treatment) and stents or with surgery (carotid artery resection).
What exactly is arteriosclerosis?
The clogging of our arteries is a noiseless, slow and painless process. You don’t actually notice anything about it.
Arterial calcification manifests itself in the inner lining of the arteries in the so-called vessel wall.
Twists and turns in arteries are weak spots
Arteries have a lot of twists and turns, where the blood naturally starts to swirl a bit.
You can compare this to a violently raging river at the point where it splits.
In those places, the cells that make up the inner lining of the vessel wall no longer align as a nicely contiguous harmonious whole. Under the pressure of that swirling blood, the cells start to act a little more chaotically.
This makes the vessel wall more permeable and vulnerable in those places so that cholesterol has the opportunity to penetrate into the vessel wall, settle and accumulate there.
Formation of a fatty streak in the vascular wall of cells
Over time, a fatty streak can form in the vessel wall, a kind of fatty layer in the vessel wall, not just on it, but part of the wall itself.
If that fatty streak continues to grow, it creates a plaque that is a bulge in the vessel wall.
The emergence of a bulge in the vessel wall (plaque)
Composed of cholesterol and inflammatory cells that play a crucial role, the body considers such an overloaded and slightly damaged spot in the vessel wall as a wound that it is trying to heal.
However, unlike a normal wound, here, the overload persists. With each heartbeat, there is the pounding force of the blood flow and thus no chance of healing nicely. After all, that place never gets flat rest.
It is similar to an abrasion on a joint that heals much slower and much less nicely due to frequent movement and rubbing of clothing, such as your knee.
Chemical versus mechanical stress on the vessel wall
Cholesterol is certainly not the only culprit in the development of plaques or arteriosclerosis.
Cholesterol is just one of many so-called risk factors that stress the vascular wall.
Diabetes, smoking, cholesterol, and obesity primarily cause chemical irritation and strain on the vascular wall.
On the other hand, high blood pressure results primarily in mechanical stress on the vascular wall.
Not all risk factors are modifiable
Some of the above risk factors are not modifiable, such as your gender, age, and hereditary predisposition.
In contrast, other risk factors are modifiable, such as:
- Unhealthy food
- High cholesterol
- Not enough sport and exercise
- High blood pressure
Tip: Luckily, we do indeed have some level of influence over our cholesterol levels through our diet. Check our other article to find out What to Eat to Lower Cholesterol? 3 Nutraceuticals (Functional Foods) in the Spotlight
The difference between veins and arteries
It is important to distinguish between arteries and veins.
Arteries are the blood vessels that carry blood from the heart to the tissues:
- Arteries are exposed to a high pressure that we know as blood pressure.
- The radial artery that you can feel beating on the thumb side of your wrist is an example of this.
- Arteries are the blood vessels exposed to arterial calcification.
Veins are the blood vessels that carry blood back to the heart:
- Veins are exposed to much lower pressures and are the blood vessels you can see on the back of your hand, for example, or that are pricked in during a blood draw.
- You can already flatten these by applying a little pressure.
- Veins rarely show arteriosclerosis (only arteries show arteriosclerosis).
When does arterial calcification occur?
Arterial calcification is a long-term process that takes place mainly under the radar and at a slow pace.
Arterial calcification is part of the aging process
Actually, arteriosclerosis starts shortly after birth. Even in young people, signs of arteriosclerosis may already be present.
For example, in the Korean War, autopsies were performed on young American front-line soldiers. The coronary arteries were also closely scrutinized at that time.
These autopsies showed that three-quarters of those fallen young front-line soldiers were found to have traces of incipient arteriosclerosis. This was a sample of 200 boys with an average age of 22.
Thus, arteriosclerosis is simply part of the aging process. With age, arteriosclerosis also increases, but it is wrong to consider age as the leading cause.
Our arteries, of course, just age with us, but that aging rate is not the same for everyone.
Elastic buffer function of arteries causes wear and tear
Our arteries are already aging with each heartbeat. They must continuously buffer the rush of blood from the heart and convert it into a steady flow at the level of our organs.
This is the arteries’ essential function, and this elastic buffering function is already a monumental task.
Our arteries are stretched by up to 10% of their diameter with each heartbeat (an average of 60 times per minute).
So in someone 10 years old, this means that their arteries were stretched more than 300 million times.
And so, the arterial system of someone aged 50 has already endured more than 1.5 billion stretches over their life span.
To put this in perspective, let’s compare these figures to plastic materials. The best plastics can sustain such an elongation of 10% at 60 times per minute for only about 10 years.
Understand why is cholesterol a silent killer?
The additional useless strain on the arterial system
Unfortunately, the base rate of aging due to mechanical strain can increase as additional, useless extra stress is added.
- Diabetes, smoking, and high cholesterol that create a chemical irritation and strain that makes the arteries less resilient.
- High blood pressure, in particular, increases the strength of the mechanical load.
- In turn, a healthy lifestyle, sufficient exercise and sports, a healthy diet, and correct and sensible stress management have a protective effect.
Tip: Get to know how a heart-healthy diet can reduce the risk of cardiovascular disease: Heart-Healthy Foods to Reduce Your Risk of Cardiovascular Disease, Diabetes and Tumors
The condition of the arteries of a 60-year-old who has been overweight for 25 years, has had high blood pressure for 15 years, or has a lifetime of excessively high cholesterol is usually markedly worse than that of another 60-year-old who has none or far less of these things.
The rate of aging of our arteries is not the same for everyone, so we are partly in control. The longer the exposure to the various risk factors, the worse.
Thus, arteriosclerosis can be thought of as an accelerated aging of the arteries.
Women versus men
Women are slightly better protected against arteriosclerosis than men. In females, arteriosclerosis, on average, does not cause problems until a slightly older age, due to the hormonal protection of women until menopause.
But in the end, the ladies quickly catch up with the men after menopause to end up being affected by cardiovascular disease at least as often.
Consequences of arteriosclerosis
We speak of arteriosclerosis if a plaque develops, a bulge in the vessel wall. And in this case, there are 3 possible scenarios:
No problems: Scenario 1
This scenario is common, where nothing at all happens most of the time.
It is not like the accumulation of limescale in a water pipe.
Instead, the process of arteriosclerosis should be seen as a dynamic and active event. Calcifications can remain stable for years or suddenly grow slower or faster and become unstable.
In most cases, people have many smaller calcifications that they don’t notice, which may never even be a medical problem.
Narrowing of blood vessels: Scenario 2
If such a plaque does continue to grow, it can begin to obstruct part of the bloodstream.
The bulge in the vessel wall then narrows the passageway, making blood flow a little more difficult.
Even at that point, people often just have no symptoms. Usually, symptoms do not appear until the blood vessel is more than 70% clogged.
Thrombosis: Scenario 3
A clot can suddenly form at the site of a calcification, unfortunately often without any signs. Such a clot is called a thrombus, hence the name thrombosis.
This clot on the calcification then suddenly closes the blood vessel, depriving the organ for which this artery was responsible for nutrition and oxygen.
This can have catastrophic consequences, such as a heart attack, stroke, or sudden death.
Minor symptoms of arteriosclerosis (the silent killer)
There are rarely any complaints in the early stages of this body process.
In fact, the symptoms only surface at a reasonably late stage:
- For example, a narrowing often needs to be addressed with a Dotter treatment or bridging surgery.
- Or only at the time of the infarction or stroke.
So waiting until you experience symptoms before working on your health is not a great plan! Because the moment you start experiencing symptoms, it is often already too late!
Roughly the following can be stated:
- 33% of people with cardiovascular disease feel the first symptoms at the time of a stenosis (narrowing).
- 33% of people’s first complaint is infarction or stroke. Thus, they only notice arterial calcification when there is a real possibility that their quality of life will suffer.
- 33% of people die suddenly without any prior complaints due to arteriosclerosis
Symptoms of narrowing of the blood vessels (stenosis)
Arterial calcification can, over time, lead to the narrowing of the blood vessels, also known as stenosis.
Once about 70% of the vascular cross-section is obstructed by the plaque, an impeding effect on blood flow is noticeable.
This is when people can develop symptoms.
Location of symptoms
Where the symptoms arise depends on which artery has become narrowed:
- Does the stenosis show up in one of the leg arteries? Then you develop symptoms and pain in the legs.
- Does the stenosis show up in one of the crown arteries of the heart? Then you develop pain in the heart region.
When do the symptoms of stenosis appear?
Complaints occur when the organ downstream, i.e., behind the narrowed piece, demands more oxygen than can be passed by the narrowing. At that point, symptoms and complaints emerge.
This is very typically the case, for example, when making an effort where the heart needs more oxygen but cannot get it because a coronary artery is narrowed.
Part of the heart then becomes oxygen-deprived.
At rest, sufficient blood can still flow across the stenosis, and the part of the heart that depends on that stenosed coronary artery will not be in need of oxygen.
However, if you were to make an effort, your heart has to start working harder and needs more oxygen.
At a certain threshold of exertion, your heart will demand more oxygen than can be supplied by the narrowed artery.
And at that point, oxygen deprivation occurs in the part of the heart that depends on that narrowed artery.
This can cause typical symptoms during sports efforts such as:
- Shortness of breath
- Compressive pressure on the chest
- Oppressive feeling in the chest area
- In some cases, the burden may also radiate to the arms or neck
A typical alarm symptom is that complaints occur from a certain exertion threshold onwards and disappear as soon as you fall below this exertion threshold.
Indeed, the symptoms disappear as soon as the activity is discontinued or if you switch to a lower effort level.
The oxygen demand is then rebalanced with the amount of blood (and therefore oxygen) that gets past the stenosis.
Why is cholesterol a silent killer? Conclusion
Are you suddenly developing shortness of breath, a feeling of tension, or tightness in the chest on exertion?
And does that burden disappear again within minutes when you rest? If so, this is a clear alarm symptom, and it is best to contact your doctor immediately.
Similarly, suppose you notice, for example, that a well-known effort such as your daily walk to the park or the supermarket is suddenly much more difficult than it was a month ago.
In that case, it is better to raise the alarm and consult a doctor immediately.
Those who notice complaints are among the lucky ones in this case! Don’t forget that arteriosclerosis and thus cholesterol is a silent killer that claims many unsuspecting victims!
Indeed, only 33% of people who suffer from arteriosclerosis develop ready and apparent symptoms such as those described above.
They are among the lucky few because it is precisely because of these symptoms that one can often intervene in time.
A significant narrowing is then usually present, but no irreparable damage has yet been done to the organ itself and often this blood vessel can be reopened.
Therefore, it is imperative that this opportunity is not lost and that you contact your family doctor and/or cardiologist as soon as possible if you have these kinds of symptoms.
These are genuine alarm bells that should not be ignored.
In other words, that’s really the time to get some tests done, such as an exercise test. Definitely don’t put this off. Every day counts! Understand why cholesterol is a silent killer and prevent it.