High Cholesterol - Overview
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What is high cholesterol?
Cholesterol is a type of fat called a lipid. The body uses it for many things, such as making new cells. Your body makes the cholesterol that it needs. You also get cholesterol from the foods you eat.
Your body needs some cholesterol. But if you have too much, it starts to build up in your arteries. (Arteries are the blood vessels that carry blood away from the heart.) This is called hardening of the arteries, or atherosclerosis 
. It is usually a slow process that gets worse as you get older.
To understand what happens, think about how a clog forms in the pipe under a kitchen sink. Like the buildup of grease in the pipe, the buildup of cholesterol narrows your arteries and makes it harder for blood to flow through them. It reduces the amount of blood that gets to your body tissues, including your heart. This can lead to serious problems, including heart attack and stroke.
A simple blood test tells you how much cholesterol you have. The test results are given in mg/dL of cholesterol but most people just say the numbers. Your cholesterol numbers help your doctor know your risk of heart attack. To know this risk, your doctor will also take into account other factors like your age, blood pressure, family history, and if you smoke.
For a general idea about your total cholesterol number, compare your number to the following:
- Best is less than200.
- Borderline-high is 200 to239.
- High is 240 or above.
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.
By the time you find out you have it, it may already be clogging your arteries. So it is very important to start treatment even though you may feel fine.
What are the different kinds of cholesterol?
Cholesterol travels through the blood attached to a protein. This package of cholesterol (a lipid) and protein 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 the "bad"cholesterol. LDL is mostly fat with only a small amount of protein. It can clogyour arteries. If you have high cholesterol, your doctor will want you to loweryour LDL.
- High-density lipoproteins (HDL) are the "good" cholesterol. HDL is more protein than fat.It helps clear the bad cholesterol from your blood so it does not clog yourarteries. A high level of HDL can protect you from a heart attack.
- Triglycerides are another typeof fat in the blood that can affect your health. If you have high triglyceridesand high LDL, your chances of having a heart attack are higher.
It may help to think of HDL as the "Healthy" cholesterol and LDL as the "Lousy" cholesterol. Or you could remember that HDL should be High and LDL should be Low.
Experts have come up with goals for each type of cholesterol. Your doctor will help you decide on cholesterol goals based on your risk of heart attack and stroke. Your doctor will help you know this risk. To find out your risk of a heart attack, you can use the Interactive Tool: Are You at Risk for a Heart Attack? 
- LDL should be low.Your LDL goal depends on your risk of heart attack and stroke. If you are atvery high risk, your goal may be less than 70. If you are at high risk, yourgoal is less than 100. If you are at moderate risk, your goal is less than 130.If you are at low risk, your goal is less than 160.
- HDL should be high. A good HDL goal is 40 or higher. HDL over60 helps protect against a heart attack. HDL below 40 increases your risk ofheart problems. A high HDL number can help offset a high LDLnumber.
- Triglycerides should be less than150. A level above 150 may increase your risk for heart problems.
What causes high cholesterol?
Many things can cause high cholesterol, including:
- Diet. Eating too much saturated fat, transfat, and cholesterol can raise your cholesterol. Saturated fat, trans fat, andcholesterol are in foods that come from animals (such as meats, whole milk, eggyolks, butter, and cheese), many packaged foods, and snack foods like cookies,crackers, and chips.
- Weight. Being overweight may raisetriglycerides and lower "good" HDL.
- Activity level. Notexercising may raise "bad" LDL and lower HDL.
- Overall health.Diseases such ashypothyroidism can raise cholesterol. Smoking maylower HDL.
- Age. Cholesterol starts to rise after age 20. In men,it usually levels off after age 50. In women, it stays fairly low untilmenopause. After that, cholesterol levels rise toabout the same levels as in men.
- Family. Some people inherit arare disease called alipid disorder. It can cause very high totalcholesterol, very low HDL, and high triglycerides. If you have this problem,you will need to start treatment at a young age.
How is high cholesterol diagnosed?
Doctors use a blood test to check cholesterol.
- A fasting cholesterol test (also called alipoprotein analysis) is the most complete test. It measures total cholesterol,HDL, LDL, and triglycerides. You cannot have food for 9 to 12 hours before thistest.
- A direct LDL test measures your LDL level only. You can havethis test done at any time, even if you recently had a meal orsnack.
- A simple cholesterol test can measure total cholesterol andHDL. You can eat before this test. Sometimes doctors do this test first. If itshows you have high cholesterol or low HDL, then you will get a fastingcholesterol test.
How is it treated?
The two main treatments are lifestyle changes and medicines. The goal of treatment is to lower your "bad" LDL cholesterol and reduce your risk of a heart attack. You may also need to raise your "good" HDL cholesterol. A high level of HDL helps reduce your risk of heart problems.
Some lifestyle changes are important for everyone with high cholesterol. Your doctor will probably want you to:
- Follow theTherapeutic Lifestyle Changes (TLC) diet. The goal isto reduce the amount of saturated fat you eat. Eating saturated fat raises yourcholesterol. The TLC diet helps you learn to make better food choices bypicking lean meats, low-fat or nonfat products, and good fats like olive andcanola oils.
- Lose weight, if you need to. Losing just 5 lb to 10lb (2.3 kg to 4.5 kg) can lower your cholesterol and triglycerides. Losingweight can also help lower your blood pressure.
- Be more active.Exercise can raise your "good" HDL and may help you control your weight.
- Quit smoking, if you smoke. Quitting can help raise your HDL andimprove your heart health.
Sometimes lifestyle changes are enough on their own. But if you try them for a few months and they don't lower your cholesterol enough, your doctor may prescribe a cholesterol-lowering medicine called a statin. You also may need medicines to lower triglycerides or raise HDL.
You may need to start taking medicine right away if your cholesterol is very high or if you have another problem that increases your chance of having a heart attack. People who have a high risk for heart attack 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.1 To find out your risk, use the Interactive Tool: Are You at Risk for a Heart Attack?
It is important to take your medicine just the way your doctor tells you to. If you stop taking your medicine, your cholesterol will go back up.
You will need to have your cholesterol checked regularly. Your results can help your doctor know if lifestyle changes have helped or if you need more or different medicines.
More information |
| Author: | Robin Parks, MS | Last Updated: July 11, 2008 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine Robert A. Kloner, MD, PhD - Cardiology | |
1995-2009 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
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