What is high cholesterol?

Cholesterol is a waxy, fat-like substance that the body uses to make cell membranes, hormones, vitamin D, digestive acids, and myelin, a protective layer that covers nerve cells. The body requires a certain amount of cholesterol to remain healthy, but too much cholesterol can build up inside blood vessels, form arterial plaque, and cause blood vessels to narrow and harden. This can lead to cardiovascular disease, heart attack, and stroke.

What are the types of cholesterol?

To understand how cholesterol levels can affect your health, it helps to understand the different types of cholesterol found in the body and how healthcare providers measure cholesterol levels.

There are two main types of cholesterol, which are sometimes referred to as “bad” and “good” cholesterol.

• LDL (low-density lipoprotein). This is called the “bad cholesterol” because elevated levels contribute to the buildup of arterial plaque.
• HDL, or high-density lipoprotein. This is called the “good cholesterol” because having higher levels is associated with a lower risk of cardiovascular disease. HDL helps move LDL out of the blood.

Both LDL and HDL can be measured with a blood test called a lipid panel.

This test will also include total cholesterol and triglycerides. Triglycerides are a type of fat found in the blood. The body uses triglycerides for energy, but higher levels are associated with a greater risk of heart disease. Total cholesterol is calculated based on LDL, HDL, and triglyceride levels.

Where does cholesterol come from?

Most of the cholesterol in the body is made in the liver. The liver is the body’s largest internal organ and performs over 500 functions. Cholesterol also comes from the foods a person eats. Diet and other lifestyle habits have a significant impact on a person’s cholesterol levels.

Food high in saturated fat can increase cholesterol levels. Red meat, processed meat, fried foods, and baked goods that contain large amounts of butter can increase LDL.

Diets high in sugary foods and beverages can also contribute to higher triglyceride levels, higher blood pressure, and inflammation that can damage the heart and blood vessels. Diets high in sugary foods also increase the risk of diabetes and obesity, which raise the risk of unhealthy cholesterol levels.

What should your cholesterol levels be?

Cholesterol levels are measured in milligrams (mg) of a substance in one-tenth of a liter (a deciliter or dL) of blood.

Your best source of information about your cholesterol levels will be your healthcare provider. The Centers for Disease Control and Prevention includes these guidelines for optimal levels:

• Total cholesterol: around 150 mg/dL
• “Bad” LDL: around 100 mg/dL
• “Good” HDL: at least 40 mg/dL for males and at least 50 mg/dL for females
• Triglycerides: less than 150 mg/dL

A total cholesterol over 200 is considered high.

Once again, a healthcare provider will be your best source of information. Target numbers can vary from person to person. For example, LDL and triglyceride targets may need to be lower if you have cardiovascular disease, diabetes, or other risk factors or medical history that affect the health of your heart.

LDL and triglycerides are also not the only important numbers. Based on your medical history and overall health, a healthcare provider may recommend targets for blood glucose levels, blood pressure, and weight.

What if you need to lower your cholesterol levels?

If you have high cholesterol, your healthcare provider will recommend a treatment plan to help you improve cholesterol numbers.

Nearly every treatment plan for high cholesterol will focus on lifestyle changes. These include following a heart healthy diet, exercising more, quitting smoking (if you smoke), and managing any coexisting health conditions.

Many people with high cholesterol will also be prescribed a medication to help improve their cholesterol. Some people may take more than one medication.

To get the most benefit from a medication, you will need to take every dose of that medication as directed. Always be honest with your healthcare provider if you have missed doses, stopped taking a medication, or are struggling with your treatment plan. These are common challenges when treating high cholesterol. Your healthcare provider needs this information to help give you the best care possible.