What Is High Cholesterol?

High cholesterol can harm your health. It's important to keep track of your cholesterol levels because you may not have any symptoms until a serious problem occurs—like a heart attack or a stroke.

This article explains the causes of high cholesterol. It also discusses how to treat and prevent it.

Overview

You need cholesterol to produce hormones, digest food, and make vitamin D.

Your body has two main types of cholesterol: LDL and HDL.

• Low-density lipoprotein (LDL) is sometimes called "bad cholesterol" because high LDL levels can contribute to cholesterol buildup in the arteries, which is a risk factor for heart disease and stroke.
• High-density lipoprotein or HDL is often known as "good cholesterol" because it works like a cleanup crew in the bloodstream. It ferries excess cholesterol from the tissues back to the liver, where it is broken down. Higher HDL levels are good for the heart.

Your body also has other types of cholesterol in small amounts.

Your healthcare professional can measure your total cholesterol level, as well as individual types.

High cholesterol is defined as a total cholesterol level above 240 milligrams per deciliter (mg/dL), The target level for a healthy adult is below 200 mg/dL. It's much more common to have high levels than it is to have very low levels.

Experts recommend that healthy adults with no known history of high cholesterol have their cholesterol levels checked at least once every five years. You may need to have it checked more often if you are older than 65 or have certain health conditions.

Diagnosis

A lipid profile test measures several types of cholesterol. The simplest is total cholesterol, which includes the combined levels of LDL, HDL, and other types such as very-low-density lipoprotein (VLDL).

The lipid profile also gives a detailed breakdown of cholesterol levels by lipid (fat) type: LDL, HDL, and triglycerides. Triglycerides are the main type of fat that circulates in your blood. High levels of triglycerides are linked to health problems like heart disease and diabetes.

According to current guidelines, target levels are:

• LDL: Levels below 100 mg/dL for most adults, though levels above 70 mg/dL may be too high for people with diabetes, a prior history of heart disease, or high risk of heart disease
• HDL: Levels above 40 mg/dL for males, levels above 50 mg/dL for females
• Triglycerides: Levels below 150 mg/dL

If you've already had a lipid test and you're not sure what the numbers mean, you can use our lipid test analyzer. Type your test results into the tool below. It can help you understand what your levels may mean for your health, so you can follow up with your healthcare professional if needed.

Causes

Your genes, your diet, and how much you exercise can all influence your cholesterol levels.

• Diet: High-fat, processed foods can raise your LDL levels. So can obesity. Excess body fat can increase the amount of cholesterol and triglycerides in the blood.
• Lack of exercise: Not getting enough physical activity can raise your LDL level. It can also cause your HDL level to be too low.
• Genetics: Sometimes the way your body naturally processes fat and cholesterol can cause your levels to be unhealthy.
  
• Age: Males over 45 years of age and females over 55 years of age often have high cholesterol levels because the body doesn't process cholesterol as well as you get older.
  

Before menopause, females have added protection from estrogen, an advantage that decreases after menopause, leading to the potential for higher cholesterol levels.

About 1 in every 200-500 people have a condition called familial hypercholesterolemia. This genetic condition can boost cholesterol levels to twice the normal level or even higher.

Treatment

Bringing your cholesterol level into a healthy range is important for heart health. According to the National Heart, Lung, and Blood Institute, high total cholesterol levels are especially dangerous for people who smoke or have a family history of heart disease.

High cholesterol can also make some health conditions worse, including:

• Obesity
• Diabetes
• High blood pressure

In most cases, changes in diet and increased exercise are the first steps for lowering high cholesterol levels. Health experts recommend at least 150 minutes of moderate-intensity exercise per week.

Other strategies include avoiding foods high in saturated fats and maintaining a healthy weight.

Diet

Roughly 80% of the cholesterol in your blood is produced by your liver and intestines. The rest comes from your diet. It's important to avoid fried foods, foods high in saturated fats, and refined carbohydrates if you have high cholesterol, such as:

• Fatty meats, particularly red meat
  
• Whole-fat dairy products
• Processed foods
• White bread
• White potatoes
• White rice
  
• Highly processed sugars or flours

Foods proven to reduce cholesterol, on the other hand, include:

• Fatty fish such as salmon
• Walnuts and other nuts
• Oatmeal
• Soluble fibers such as psyllium
• Foods fortified with plant sterols or stanols

Medications

If lifestyle changes don't lower your levels enough, your healthcare provider may prescribe a type of drug called statins. They help reduce LDL and triglyceride levels and increase HDL levels.

Statins are the most widely prescribed class of cholesterol-lowering drugs. They limit the liver's ability to make cholesterol.

These are examples of statin medications:

• Lipitor (atorvastatin)
• Zocor (simvastatin)
• Mevacor (lovastatin)
• Lescol (fluvastatin)
• Crestor (rosuvastatin)
• Pravachol (pravastatin)

In addition to statins, some people with high cholesterol are also prescribed other cholesterol-lowering medications such as PCSK9 inhibitors like Praluent (alirocumab), Repatha (evolocumab), and Leqvio (inclisiran); fibrates such as Antara (fenofibrate) and Lopid (gemfibrozil); or bile acid sequestrants like Welchol (colesevelam) and Colestid (colestipol).

Summary

Your body needs cholesterol to carry out important functions. But if your total or LDL cholesterol levels are too high, you're at risk of heart disease, stroke, and other health problems.

A blood test can tell you how high your levels are. Aim for an LDL level under 100 mg/dL and an HDL level 40 mg/dL or higher. Your triglyceride level should be under 150 mg/dL.

If your test shows that you need to bring these numbers down, try to get 150 minutes of exercise each week. You can also try cutting out high-fat, highly processed foods. Your healthcare provider may recommend medication if these steps aren't effective enough.