According to data from the Centers for Disease Control and Prevention (CDC), nearly 94 million adults aged 20 and older in the United States have what can be considered borderline high cholesterol. However, because this condition often presents with no real symptoms, you may not even know you have it until you visit a doctor. If you want to understand what cholesterol is, why it matters for your health, and what the optimal levels are, this article will explain everything. If you’re curious about what causes high cholesterol, what to do if you’ve been diagnosed with it, and whether there are ways to improve it (hint: there are), read on to discover all the answers.
Cholesterol is a type of lipid. It is a waxy, fat-like substance naturally produced by the liver. It is essential for building cell membranes, certain hormones, and vitamin D.
Cholesterol does not dissolve in water, so it cannot travel through the bloodstream on its own. To help transport cholesterol, the liver produces lipoproteins.
Lipoproteins are particles made of fats and proteins. They transport cholesterol and triglycerides—another type of lipid—through the bloodstream. The two main types of lipoproteins are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
LDL cholesterol refers to cholesterol carried by low-density lipoproteins. If there is too much LDL cholesterol in your blood, you may be diagnosed with high cholesterol. If untreated, high cholesterol can lead to serious health problems, including heart attack and stroke.
High cholesterol rarely causes symptoms at the beginning. That’s why it’s important to have your cholesterol levels checked regularly.
In most cases, high cholesterol is a “silent” condition. It usually does not cause any symptoms. Many people don’t realize they have high cholesterol until a serious complication develops, such as a heart attack or stroke.
This is why regular cholesterol screening is so important. If you’re 20 or older, ask your doctor whether you should have your cholesterol levels checked regularly. Learn how this test can save your life.
Eating too many foods high in cholesterol, saturated fats, and trans fats can increase the risk of high cholesterol. Living with obesity also raises the risk. Other lifestyle factors include physical inactivity and smoking.
Genetics can also play a role. Specific genes inherited from your parents influence how your body processes cholesterol and fats. If your parents have high cholesterol, you may be at higher risk as well.
In rare cases, high cholesterol is caused by familial hypercholesterolemia, a genetic disorder that prevents the body from removing LDL efficiently. According to the National Human Genome Research Institute, most adults with this condition have total cholesterol levels over 300 mg/dL and LDL levels over 200 mg/dL.
Other health conditions—such as diabetes and hypothyroidism—can also increase the risk of high cholesterol and related complications.
LDL cholesterol is often called “bad cholesterol.” It carries cholesterol to your arteries. If LDL levels are too high, cholesterol can accumulate on artery walls.
These build-ups are called plaques. They can narrow the arteries, restrict blood flow, and increase the risk of blood clots. A clot that blocks an artery in the heart or brain can cause a heart attack or stroke.
HDL cholesterol is known as “good cholesterol.” It helps transport LDL cholesterol back to the liver, where it can be removed from the body. This prevents cholesterol from building up in the arteries.
Healthy HDL levels help reduce the risk of blood clots, heart disease, and stroke.
Triglycerides are another type of lipid, different from cholesterol. Your body uses cholesterol for cell structure and hormone production, while triglycerides serve as an energy source.
When you consume more calories than your body needs, it converts excess calories into triglycerides. These are stored in fat cells. Lipoproteins help circulate triglycerides in the blood.
If you regularly eat more calories than your body burns, triglyceride levels can become too high, increasing the risk of heart disease and stroke.
A simple blood test can measure both triglycerides and cholesterol.
If you are 20 years or older, the American Heart Association recommends checking your cholesterol at least once every 4–6 years. If you previously had elevated cholesterol or other cardiovascular risk factors, your doctor may advise more frequent testing.
A lipid panel measures total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. Total cholesterol is the overall amount of cholesterol in your blood.
If your total or LDL cholesterol is too high, your doctor may diagnose you with high cholesterol. High cholesterol becomes dangerous when LDL is too high and HDL is too low.
A diagnosis of high cholesterol does not automatically mean you will need medication. If you do need treatment, many factors influence which medication your doctor prescribes.
Generally, doctors categorize cholesterol levels as desirable, borderline high, or high.
These are general guidelines—your treatment plan will depend on your personal health factors.
Your body needs some cholesterol, including LDL, to function properly. However, very high LDL levels raise the risk of serious health problems.
In 2018, the American College of Cardiology and the American Heart Association updated their guidelines for managing high cholesterol.
These guidelines consider not only cholesterol levels but also family history and other risk factors to estimate the overall likelihood of cardiovascular events in the next 10 years.
Your risk is higher if you:
are overweight or obese
consume many foods high in saturated or trans fats
have limited physical activity
smoke
have a family history of high cholesterol
have diabetes, kidney disease, or hypothyroidism
High cholesterol can affect people of all ages, genders, and ethnic backgrounds.
If untreated, high cholesterol can lead to plaque buildup in the arteries. Over time, this causes atherosclerosis, a serious condition that narrows the arteries.
Atherosclerosis can:
reduce blood flow
increase the risk of dangerous blood clots
This may lead to life-threatening complications, such as:
stroke
heart attack
angina (chest pain)
high blood pressure
peripheral artery disease
chronic kidney disease
High cholesterol can also disrupt bile balance and increase the risk of gallstones.
If your cholesterol is elevated, your doctor may recommend lifestyle changes. These can include modifying your diet, increasing your physical activity, or adjusting daily habits. If you smoke, quitting will be strongly advised.
Your doctor may also prescribe medication or refer you to a specialist.
To achieve and maintain healthy cholesterol levels, your doctor may advise you to:
limit foods high in cholesterol, saturated fats, and trans fats
choose lean protein sources such as poultry, fish, and legumes
eat a variety of high-fiber foods such as fruits, vegetables, and whole grains
avoid fried foods and choose baking, steaming, grilling, or roasting instead
avoid fast food and sugary packaged snacks
Foods high in cholesterol, saturated fats, or trans fats include:
red meat, organ meats, egg yolks, and full-fat dairy products
processed foods made with cocoa butter or palm oil
fried foods such as chips, fried chicken, and onion rings
certain baked goods such as cookies and pastries
Eating fish and other foods rich in omega-3 fatty acids can also help reduce LDL levels. Examples include salmon, mackerel, and herring. Omega-3s are also found in walnuts, almonds, ground flaxseed, and avocados.
In some cases, doctors prescribe medications to lower cholesterol.
Statins are the most commonly prescribed drugs. They block the liver from producing more cholesterol.
Examples:
atorvastatin (Lipitor)
fluvastatin (Lescol)
rosuvastatin (Crestor)
simvastatin (Zocor)
Other medications include:
niacin
bile acid sequestrants: colesevelam (Welchol), colestipol (Colestid), cholestyramine (Prevalite)
cholesterol absorption inhibitors such as ezetimibe (Zetia)
PCSK9 inhibitors such as alirocumab (Praluent) and evolocumab (Repatha)
Some combination medications reduce cholesterol absorption from food while limiting production in the liver. One example is ezetimibe + simvastatin (Vytorin).
https://www.healthline.com/health/high-cholesterol#treatment
