Prognosis for Hypercholesterolaemia

Generally speaking high cholesterol levels do not cause any acute complications. Vascular complications associated with a high cholesterol level can develop over time and are due to a total or almost total lack of arterial blood supply to areas of the heart (heart attack), brain (stroke) or legs.

Exceptionally, in specific patients with very serious genetic alterations, their cholesterol level is so high (above 700–800 mg/dL) that it can provoke an acute blockage of the microcirculation in different organs (retina, pancreas, etc.). This is more common in people with very high triglyceride levels (above 1,000 mg/dL).

When hypercholesterolaemia is poorly controlled over a long period it leads to hardening of the arteries and the formation of atheromatous plaques, which is also known as atherosclerosis. Atheromatous plaques grow inside the wall of arteries, although they are separated from the blood by one of the artery’s layers, as if they were swallows’ nests. They contain cholesterol and other materials and represent a point of constant inflammation, so the body’s defence system either tries to destroy them or remove the cholesterol from them.

If these plaques are large, there are a lot of them or if they erode the layer of the artery wall and come into contact with the blood, then it can lead to acute (blood clots) or chronic symptoms of atherosclerosis. There are several chronic symptoms, but they are not always linked to atherosclerosis because of a lack of knowledge of this disease. The best known are angina and chronic lower limb ischaemia, which is pain in the legs brought on by walking that forces the individual to stop and rest after just a few dozen metres. Other problems are some types of dementia, kidney failure and erection problems.