What is cholesterol?
Cholesterol is a waxy substance your liver makes to protect nerves and to make cell tissue and certain hormones. Your body also gets cholesterol from the food you eat. This includes eggs, meats, and dairy. Too much bad cholesterol (LDL) can be bad for your health. There is “good” (HDL) cholesterol and “bad” (LDL) cholesterol.
What is the difference between “good” cholesterol and “bad” cholesterol?
Good cholesterol is known as high-density lipoprotein (HDL). It removes cholesterol from the bloodstream. Low-density lipoprotein (LDL) is the “bad” cholesterol.
If your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. But, if your total cholesterol level is high only because of a high HDL level, you’re probably not at higher risk.
Triglycerides are another type of fat in your blood. When you eat more calories than your body can use, it turns the extra calories into triglycerides.
Changing your lifestyle (diet and exercise) can improve your cholesterol levels, lower LDL and triglycerides, and raise HDL.
Your ideal cholesterol level will depend on your risk for heart disease.
- Total cholesterol level – less than 200 is best, but it depends on your HDL and LDL levels.
- LDL cholesterol levels – less than 130 is best, but this depends on your risk for heart disease.
- HDL cholesterol levels – 60 or higher reduces your risk for heart disease.
- Triglycerides – less than 150 milligrams per deciliter (mg/dl) is best.
Symptoms of high cholesterol
Often, there are no specific symptoms of high cholesterol. You could have high cholesterol and not know it.
If you have high cholesterol, your body may store the extra cholesterol in your arteries. These are blood vessels that carry blood from your heart to the rest of your body. A buildup of cholesterol in your arteries is known as plaque. Over time, plaque can become hard and make your arteries narrow. Large deposits of plaque can completely block an artery. Cholesterol plaques can also break apart, leading to formation of a blood clot that blocks the flow of blood.
A blocked artery to the heart can cause a heart attack. A blocked artery to your brain can cause a stroke.
Many people don’t discover that they have high cholesterol until they suffer one of these life-threatening events. Some people find out through routine check-ups that include blood tests.
What causes high cholesterol?
Your liver produces cholesterol, but you also get cholesterol from food. Eating too many foods that are high in fat can increase your cholesterol level.
Being overweight and inactive also causes high cholesterol. If you are overweight, you most likely have a higher level of triglycerides. If you never exercise and aren’t active in general, it can lower your HDL (good cholesterol).
You family history also affects your cholesterol level. Research has shown that high cholesterol tends to run in families. If you have an immediate family member who has it, you could have it, too.
Smoking also causes high cholesterol. It lowers your HDL (good cholesterol).
How is high cholesterol diagnosed?
You can’t tell if you have high cholesterol without having it checked. A simple blood test will reveal your cholesterol level.
Men 35 years of age and older and women 45 years of age and older should have their cholesterol checked. Men and women 20 years of age and older who have risk factors for heart disease should have their cholesterol checked. Teens may need to be checked if they are taking certain medicines or have a strong family history of high cholesterol. Ask your doctor how often you should have your cholesterol checked.
Risk factors for heart disease include:
- Cigarette smoking.
- High blood pressure.
- Older age.
- Having an immediate family member (parent or sibling) who has had heart disease.
- Being overweight or obese.
Can high cholesterol be prevented or avoided?
Making healthy food choices and exercising are two ways to reduce your risk of developing high cholesterol.
Eat fewer foods with saturated fats (such as red meat and most dairy products). Choose healthier fats. This includes lean meats, avocados, nuts, and low-fat dairy items. Avoid foods that contain trans fat (such as fried and packaged foods). Look for foods that are rich in omega-3 fatty acids. These foods include salmon, herring, walnuts, and almonds. Some egg brands contain omega-3.
Exercise can be simple. Go for a walk. Take a yoga class. Ride your bike to work. You could even participate in a team sport. Aim to get 30 minutes of activity every day.
High cholesterol treatment
If you have high cholesterol, you may need to make some lifestyle changes. If you smoke, quit. Exercise regularly. If you’re overweight, losing just five to 10 pounds can improve your cholesterol levels and your risk for heart disease. Make sure to eat plenty of fruits, vegetables, whole grains, and fish.
Depending on your risk factors, your doctor may prescribe medicine and lifestyle changes.
Learn More About Cholesterol Treatment
- Cholesterol-lowering Medicines
- Lifestyle Changes to Lower Your Cholesterol
- Plant Sterols and Stanols
Living with high cholesterol
If you have high cholesterol, you are twice as likely to develop heart disease. That is why it is important to have your cholesterol levels checked, especially if you have a family history of heart disease. Reducing your LDL “bad cholesterol” through good diet, exercise, and medicine can make a positive impact on your overall health.
Questions to ask your doctor
- Am I at risk for heart disease?
- How often should I get my cholesterol tested?
- What are my cholesterol levels? Are they high?
- What lifestyle changes do I need to make to help improve my cholesterol levels and heart health?
- Do I need cholesterol medicine?
- What are the side effects of the medicine?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.