What is high cholesterol?
Cholesterol is a type of fat. Your body needs it for many things, such as making new cells. But too much cholesterol in your blood increases your chances of having a heart attack and stroke.
You get cholesterol from the foods you eat and from your liver. Your liver makes most of the cholesterol your body needs.
- Desirable cholesterol is less than 200 milligrams per deciliter (mg/dL).
- Borderline-high cholesterol is 200 to 239.
- High cholesterol is 240 or higher.
What are the different kinds of cholesterol?
Cholesterol travels through your blood attached to a protein. This cholesterol- protein package is called a lipoprotein. Lipoproteins are either high-density or low-density, based on how much protein and fat they have.
Low-density lipoproteins (LDL) are mostly fat with only a small amount of protein. LDL is the bad kind of cholesterol because it can clog your arteries. If you have high cholesterol, your doctor will want you to lower your LDL.
- LDL levels:
- Best LDL is less than 100 mg/dL.
- Near best LDL is 100 to 129.
- Borderline-high LDL is 130 to 159.
- High LDL is 160 to 189.
- Very high LDL is 190 and above.
See an illustration of a clogged artery (atherosclerosis) .
High-density lipoproteins (HDL) help clear the bad cholesterol from your blood and keep it from clogging your arteries. HDL is the good kind of cholesterol. High levels of HDL (60 or above) can protect you from a heart attack.
- HDL levels:
- Desirable or high HDL is 60 mg/dL or above.
- Undesirable or low HDL is less than 40.
Triglycerides are another type of fat in your blood. If you have high triglycerides and high LDL, your chances of having a heart attack are higher.
- Triglyceride levels:
- Borderline high is 150 to 199 mg/dL.
- High is 200 or above.
- Very high is 500 or higher.
What causes high cholesterol?
High cholesterol may run in your family. The foods you eat also may cause high cholesterol.
- Your diet. Eating too much saturated fat and cholesterol can cause high cholesterol. Saturated fat and cholesterol come from animal foods such as beef, pork, veal, milk, eggs, butter, and cheese. Many packaged foods contain saturated fat such as coconut oil, palm oil, or cocoa butter. You will also find saturated fat in stick margarine and vegetable shortening. Cookies, crackers, chips, and other snacks usually contain partially hydrogenated vegetable oil or trans fat, which can raise cholesterol.
- Your weight. Being overweight may raise triglycerides and lower HDL.
- Your activity level. Not exercising may raise LDL and lower HDL.
- Your overall health. Having diseases such as low thyroid can raise cholesterol. Cigarette smoking may lower HDL.
- Your age. After you reach age 20, your cholesterol starts to rise. In men, cholesterol levels usually level off after age 50. In women, cholesterol levels stay fairly low until menopause. After that, they rise to about the same level as in men.
- Your family. A disease called a lipid disorder can also cause high cholesterol. This rare problem is inherited from family members, and it changes how your body handles cholesterol. If you have a lipid disorder, your cholesterol may be well over 250 mg/dL. It may be harder to treat.
What are the symptoms?
High cholesterol doesn't make you feel sick. But if cholesterol builds up in your arteries, it can block blood flow to your heart or brain and cause a heart attack or stroke.
In some people, cholesterol deposits called xanthomas may form under the skin. They look like small bumps.
How is high cholesterol diagnosed?
Your doctor will use a blood test to check your cholesterol.
- A lipoprotein analysis is the most complete test. It measures your total cholesterol: HDL, LDL, and triglycerides. You cannot have food for 12 hours before this test.
- A simple cholesterol test can measure your total cholesterol and HDL. You can eat before this test. Sometimes doctors do this test first and then order a lipoprotein analysis if you have high cholesterol or low HDL.
How is it treated?
You and your doctor may decide first to treat your high cholesterol without medicine. Changes to your lifestyle and diet may be all you need. These changes include eating foods low in saturated fat, being more active, losing weight if you need to, and quitting smoking if needed.
If you cannot lower your cholesterol enough after trying lifestyle changes for a few months, you may need to take a medicine called a statin.
If you have high blood pressure, diabetes, or coronary artery disease (CAD), your doctor may want you to take a statin right away. This is because your chance of having a heart attack is higher.
Use this Interactive Tool: Are You at Risk for a Heart Attack?
Research shows that people who have a high risk for heart attack could benefit from taking higher doses of statins to lower their LDL cholesterol as much as possible. The more these people can lower their LDL, the less likely they are to have a heart attack.
Things that increase your risk for heart attack include:
- Having high blood pressure.
- Having low HDL (good) cholesterol.
- Having peripheral arterial disease, which is narrowing of the arteries that supply blood to the legs, abdomen, pelvis, arms, or neck.
- Having diabetes.
- Having a family history of heart disease.
- Being age 45 or older if you are a man, and age 55 or older if you are a woman