High cholesterol

Cholesterol is often viewed as something primarily important for the heart. However, what is bad for your heart is usually also bad for your brain. Prolonged elevated cholesterol increases the risk of problems in the blood vessels, which not only lead to your heart but also to your brain. Therefore, high cholesterol is a clear risk factor within the LIBRA score.

This is not about a one-time spike, but about years of elevated levels that can slowly cause damage.

What do we mean by high cholesterol?

Cholesterol is a fat-like substance in the blood. The body needs it, but too much can cause problems. Different components are usually considered:

• LDL cholesterol, often called the bad cholesterol
• HDL cholesterol, often called the protective cholesterol
• triglycerides, another form of fat in the blood

An unfavorable cholesterol profile usually means that the LDL is too high, the HDL is low, or the triglycerides are elevated. What is considered too high depends on your overall risk and any other conditions.

Why is high cholesterol bad for your brain?

Arteriosclerosis in the blood vessels An excess of LDL cholesterol can accumulate in the vessel wall. This leads to narrowing and stiffening of the blood vessels. This process occurs throughout the body, including in the arteries and small branches that supply blood to the brain.

Reduced blood flow to the brain When blood vessels become narrower and stiffer, blood flow can be less effectively adjusted to what the brain needs. Especially during exertion or stress, this can lead to temporary or prolonged shortages of oxygen and nutrients.

Increased risk of strokes and silent damage High cholesterol increases the risk of strokes. In addition, small, silent infarcts occur more frequently, which do not cause clear symptoms but can accumulate over time and impair cognitive function.

Association with other risk factors High cholesterol often occurs together with high blood pressure, diabetes, and overweight. This combination increases the risk of cognitive decline more significantly than a single factor alone.

Common Misunderstandings

“My cholesterol is hereditary, so I can’t do anything about it” Heredity plays a role, but lifestyle and treatment can still make a big difference. Even with a hereditary predisposition, lowering cholesterol is often possible and beneficial.

“Only total cholesterol counts” The total number is less important than the distribution. Particularly elevated LDL cholesterol is important for the risk of vascular and brain damage.

“I feel good, so it probably isn’t that bad” High cholesterol usually does not cause symptoms. Damage develops slowly and unnoticed, often only visible after many years.

“Cholesterol-lowering drugs are bad for your memory” Large studies show that well-managed cholesterol-lowering medications reduce the risk of heart and vascular diseases without affecting memory. For many people, the benefits outweigh the disadvantages.

What can you do yourself?

Pay attention to saturated and unsaturated fats Reducing saturated fat from butter, full-fat dairy, and fatty meats helps lower LDL. Unsaturated fats from olive oil, nuts, and fish have a beneficial effect.

Eat high fiber foods Fiber from vegetables, fruits, whole grain products, and legumes helps remove cholesterol through the intestines.

Exercise regularly Exercise can raise HDL and lower triglycerides. This contributes to a healthier cholesterol profile.

Watch weight and waist circumference Belly fat is strongly linked to an unfavorable fat profile. Even small improvements in weight can have an effect.

Medication and guidance

For some people, lifestyle alone is not enough, for example:

• existing cardiovascular diseases
• significantly elevated values
• a combination of multiple risk factors

In those cases, medication may be necessary. It is important to evaluate the overall risk with your general practitioner, rather than focusing on a single number.

When should I be extra alert?

Extra attention is advisable if:

• cardiovascular diseases are common in your family
• you have previously had a heart attack or stroke
• you combine multiple risk factors

Regular check-ups help to adjust in a timely manner.

In short

High cholesterol damages the blood vessels that supply your brain with blood over the long term. By paying attention to diet, exercise, and medication if necessary, you can protect the blood flow to your brain and reduce the risk of cognitive decline.