Everything You Need to Know About High Cholesterol

How we reviewed this article: · Healthline

Key takeaways

High cholesterol usually occurs without noticeable symptoms, making regular cholesterol screenings essential, especially for those over 20 or with risk factors.

Managing cholesterol involves lifestyle adjustments like diet changes (limiting cholesterol, saturated and trans fats, and processed foods) and regular exercise, which can be supplemented with medications like statins if needed.

High levels of LDL cholesterol can lead to plaque buildup in arteries, increasing the risk of serious complications such as heart attack and stroke. HDL cholesterol helps remove LDL, reducing these risks.

According to the

Centers for Disease Control and Prevention (CDC)

, nearly 86 million U.S. adults ages 20 or older have cholesterol levels higher than 200 milligrams per deciliter (mg/dL). A high total cholesterol is considered anything greater than 240 mg/dL.

But you may not know you have high cholesterol (also known as

hyperlipidemia

or dyslipidemia) until you get tested because this condition often doesn’t have symptoms.

Cholesterol is a type of

lipid

— a waxy, fat-like substance that your liver produces. It’s vital for the formation of:

cell membranes

certain hormones

vitamin D

Cholesterol doesn’t dissolve in water, so it can’t travel through your blood on its own. To help transport cholesterol, your liver produces lipoproteins.

You may hear these referred to as “bad” cholesterol (LDL) and “good” cholesterol (HDL).

LDL cholesterol is any cholesterol that low-density lipoproteins carry. If your blood contains too much LDL cholesterol, you may be diagnosed with high LDL cholesterol.

High cholesterol is often a “silent” condition and typically doesn’t have

symptoms

.

Many people don’t realize they have high cholesterol or receive treatment until they develop serious complications, such as heart attack and stroke. That’s why it’s important to get your

cholesterol levels checked

on a regular basis.

If you’re 20 years or older, ask your doctor if you should have routine cholesterol screening.

Having

obesity

may also increase your risk. Other lifestyle factors that can contribute to high cholesterol include inactivity and

smoking

.

Genetics

can also affect your chances of developing high cholesterol.

Other health conditions, such as

diabetes

and hypothyroidism, may increase your risk of developing high cholesterol and related complications.

People of all ages, sexes, and ethnicities can have high cholesterol. While these risk factors are out of your control, there are ways to reduce your risks.

Here’s the difference between the three types of cholesterol:

LDL ‘bad’ cholesterol

If your levels of LDL cholesterol are too high and left untreated,

plaque

can build up on the walls of your arteries, a condition known as

atherosclerosis

. This can:

narrow your arteries

limit blood flow to your tissues and organs

raise your risk of

blood clots

If a blood clot blocks an artery in your heart or brain, it can cause a heart attack or stroke.

High cholesterol can also create a bile imbalance, raising your risk of

gallstones

.

Complications of atherosclerosis

Atherosclerosis

can result in

life threatening complications, such as:

stroke

heart attack

angina

or chest pain

high blood pressure

peripheral vascular disease

chronic kidney disease

HDL ‘good’ cholesterol

HDL cholesterol

essentially works against LDL cholesterol by returning it to the liver for removal from the body, preventing cholesterol plaque from building up in the arteries. It lowers your risk of:

blood clots

heart disease

stroke

Triglycerides

Triglycerides

are another type of lipid. While your body uses cholesterol to build cells and certain hormones, it uses triglycerides for energy.

Your body converts calories it can’t use right away into triglycerides, which are stored in fat cells. It uses lipoproteins to circulate triglycerides through your bloodstream.

If you regularly eat more calories than your body can use, your triglyceride levels may become too high. This can raise your risk of health problems, including

heart disease

and stroke.

A doctor can use a

blood test

to measure your triglyceride and cholesterol levels.

The CDC recommends cholesterol level checks

every 4 to 6 years

. If you have a family history of high cholesterol or other risk factors for cardiovascular disease, your doctor may encourage more frequent cholesterol testing.

Your doctor will use a test called a

lipid panel

to measure the levels of your:

total cholesterol (overall amount of cholesterol in your blood, including LDL and HDL cholesterol)

LDL cholesterol

HDL cholesterol

triglycerides

If your total or LDL cholesterol levels are too high, your doctor may diagnose you with high cholesterol. High cholesterol can be dangerous when your LDL levels are too high and your HDL levels are too low.

Optimal cholesterol levels charts

According to the

CDC

, the optimal cholesterol levels of most adults are:

Cholesterol levelCholesterol typeabout 150 mg/dLtotalabout 100 mg/dLLDLat least 40 mg/dL in men and 50 mg/dL in womenHDLless than 150 mg/dLtriglycerides

StatPearls

also provides optimal to high categories of LDL levels:

LDL cholesterol levelsCategorybelow 100 mg/dLoptimal100 to 129 mg/dL near/above optimal130 to 159 mg/dLborderline high160 to 189 mg/dLhighabove 190 mg/dLvery highThese measurements are general. Your doctor will consider other factors before deciding on a treatment plan.

If you have high cholesterol, your doctor may recommend lifestyle changes to help lower it.

Most doctors use generalized measurements to decide on treatment plans. They may categorize these measurements as:

desirable

borderline high

high cholesterol

Your doctor may also prescribe medications to help lower your cholesterol levels. Sometimes, they may refer you to a specialist for more care.

Diet

To help you achieve and maintain healthy cholesterol levels, your doctor may recommend changes to your diet. They may advise you to:

limit your intake of foods high in cholesterol,

saturated fats

, and

trans fats

choose lean sources of protein, such as chicken, fish, and legumes

eat a variety of

high fiber foods

, such as fruits, vegetables, and whole grains

opt for baked, broiled, steamed, grilled, and roasted foods

avoid sugary, prepackaged food options when possible

Foods that are high in cholesterol, saturated fats, or trans fats that your doctor may recommend avoiding include:

red meat, organ meats, egg yolks, and high fat dairy products

ultra-processed foods made with cocoa butter or

palm oil

deep-fried foods

certain baked goods, such as some cookies and muffins

Medications

A diagnosis of high cholesterol doesn’t mean you will be put on medication. If your doctor does prescribe

cholesterol medication

, different factors may influence what they recommend.

Your doctor might prescribe medications to help lower your cholesterol levels if lifestyle changes alone aren’t working.

Statins

are the most commonly prescribed medications for high cholesterol. They block your liver from producing more cholesterol.

Examples of statins include:

atorvastatin

(Lipitor)

pravastatin

(Lescol)

rosuvastatin

(Crestor)

simvastatin

(Zocor)

Other medications for high cholesterol can include:

niacin

bile acid resins or sequestrants, such as colesevalam (

Welchol

), colestipol (Colestid), or

cholestyramine

(Prevalite)

cholesterol absorption inhibitors, such as

ezetimibe

(Zetia)

PCSK9 inhibitors

, such as alirocumab (

Praluent

) and evolocumab (

Repatha

)

Some products contain a combination of drugs to help decrease your body’s absorption of cholesterol from foods and reduce your liver’s production of cholesterol. One example is a combination of ezetimibe and simvastatin (

Vytorin

).

Home remedies

You may be able to lower your cholesterol levels

without taking medications

. A nutritious diet, regular exercise, and avoiding smoking tobacco products may be enough for some people.

Some people claim that certain herbal and nutritional supplements may also help lower cholesterol levels. Claims have been made about:

garlic

hawthorn

astragalus

red yeast rice

plant sterol

and stanol supplements

blond

psyllium

, found in psyllium seed husk

ground

flaxseed

The level of evidence supporting these claims varies. The Food and Drug Administration (FDA) hasn’t approved any of these products for treating high cholesterol. More research is needed to learn if they can help treat this condition.

Talk with a healthcare professional before taking any herbal or nutritional supplements. In some cases, they might

interact with other medications

you’re taking.

You can’t control the genetic risk factors for high cholesterol, but you can manage your lifestyle.

To lower your risk of developing high cholesterol:

Eat a nutritious diet that’s low in cholesterol and animal fats, and high in fiber.

Avoid excessive alcohol consumption.

Maintain a moderate weight.

Exercise regularly.

Avoid smoking, or try a

smoking cessation program

.

Follow your doctor’s recommendations for routine cholesterol screening. If you have a higher risk of developing high cholesterol or coronary heart disease, they will likely encourage regular testing.

High cholesterol often has no symptoms. But without treatment, it can cause serious health issues.

A healthcare professional can help you manage high cholesterol levels and, in many cases, avoid complications.

Ask a doctor to test your cholesterol levels, especially if you’re over age 20. Practicing healthy lifestyle choices like exercising and not smoking while eating nutritious, whole foods will help you manage your health and cholesterol.