Definition
Cholesterol is a naturally occurring fat that the body needs to produce important structures and chemicals. It is one of the main components of cell membranes, the outer lining that protects the internal structures that make body cells work and function properly.
About 40% of men and 30% of Hispanic women have high cholesterol in the U.S.
Alternative Names
Hypercholesterolemia; Hyperlipidemia
Causes
Many factors can affect the cholesterol levels in your blood. You can control some factors, but not others.
Symptoms
High blood cholesterol is a condition in which you have too much cholesterol in your blood. By itself, the condition usually has no signs or symptoms. Thus, many people don’t know that their cholesterol levels are too high.
Exams and Tests
Your doctor will diagnose high blood cholesterol by checking the cholesterol levels in your blood. A blood test called a lipoprotein panel can measure your cholesterol levels. Before the test, you’ll need to fast (not eat or drink anything but water) for 9 to 12 hours.
The lipoprotein panel will give your doctor information about your:
• Total cholesterol. Total cholesterol is a measure of the total amount of cholesterol in your blood, including low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.
• LDL cholesterol. LDL, or “bad,” cholesterol is the main source of cholesterol buildup and blockages in the arteries.
• HDL cholesterol. HDL, or “good,” cholesterol helps remove cholesterol from your arteries.
• Triglycerides (tri-GLIH-seh-rides). Triglycerides are a type of fat found in your blood. Some studies suggest that a high level of triglycerides in the blood may raise the risk of coronary heart disease, especially in women.
If it’s not possible to have a lipoprotein panel, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels.
Testing for total and HDL cholesterol does not require fasting. If your total cholesterol is 200 mg/dL or more, or if your HDL cholesterol is less than 40 mg/dL, your doctor will likely recommend that you have a lipoprotein panel. (Cholesterol is measured as milligrams (mg) of cholesterol per deciliter (dL) of blood.)
Triglycerides also can raise your risk for heart disease. If your triglyceride level is borderline high (150–199 mg/dL) or high (200 mg/dL or higher), you may need treatment.
Factors that can raise your triglyceride level include:
• Overweight and obesity
• Lack of physical activity
• Cigarette smoking
• Excessive alcohol use
• A very high carbohydrate diet
• Certain diseases and medicines
• Some genetic disorders
High blood cholesterol is treated with lifestyle changes and medicines. The main goal of treatment is to lower your low-density lipoprotein (LDL) cholesterol level enough to reduce your risk for coronary heart disease, heart attack, and other related health problems.
Your risk for heart disease and heart attack goes up as your LDL cholesterol level rises and your number of heart disease risk factors increases.
Some people are at high risk for heart attacks because they already have heart disease. Other people are at high risk for heart disease because they have diabetes or more than one heart disease risk factor.
Talk with your doctor about lowering your cholesterol and your risk for heart disease. Also, check the list to find out whether you have risk factors that affect your LDL cholesterol goal:
• Cigarette smoking
• High blood pressure (140/90 mmHg or higher), or you’re on medicine to treat high blood pressure
• Low high-density lipoprotein (HDL) cholesterol (less than 40 mg/dL)
• Family history of early heart disease (heart disease in father or brother before age 55; heart disease in mother or sister before age 65)
• Age (men 45 years or older; women 55 years or older)
Based on your medical history, number of risk factors, and risk score, figure out your risk of getting heart disease or having a heart attack using the table below.
While you’re being treated for high blood cholesterol, you’ll need ongoing care. Your doctor will want to make sure your cholesterol levels are controlled. He or she also will want to check for other health problems.
If needed, your doctor may prescribe medicines for other health problems. Take all medicines exactly as your doctor prescribes. The combination of medicines may lower your risk for heart disease and heart attack.
While trying to manage your cholesterol, take steps to manage other heart disease risk factors too. For example, if you have high blood pressure, work with your doctor to lower it.
If you smoke, quit. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke. If you’re overweight or obese, try to lose weight. Your doctor can help you create a reasonable weight-loss plan.
Possible Complications
Complications with high cholesterol include:
• Chest pain
• Heart attack
• Stroke
When to Contact a Medical Professional
Sometimes the first sign that you have high cholesterol or other risk factors for heart disease is a heart attack, a stroke, or a transient ischemic attack (TIA). If you have any symptoms of these, call 911 or other emergency services.
Preventions
Factors You Can Control
Diet
Cholesterol is found in foods that come from animal sources, such as egg yolks, meat, and cheese. Some foods have fats that raise your cholesterol level. Limiting foods with cholesterol, saturated fat, and trans fats can help you control your cholesterol levels.
Physical Activity and Weight
Lack of physical activity can lead to weight gain. Being overweight tends to raise your LDL level, lower your HDL level, and increase your total cholesterol level.also can help you raise your HDL cholesterol level.
Factors You Can’t Control
Heredity
High blood cholesterol can run in families. An inherited condition called familial hypercholesterolemia causes very high LDL cholesterol. (“Inherited” means the condition is passed from parents to children through genes.) This condition begins at birth, and it may cause a heart attack at an early age.
Age and Sex
Starting at puberty, men often have lower levels of HDL cholesterol than women. As women and men age, their LDL cholesterol levels often rise. Before age 55, women usually have lower LDL cholesterol levels than men. However, after age 55, women can have higher LDL levels than men.
Take control of your cholesterol to lower your heart disease risk. According to research or other evidence, the following self-care steps may be helpful:
What You Need To Know:
- Cut the bad fats
Foods that contain saturated fat, hydrogenated fat, and cholesterol (such as animal products, fried foods, and baked snacks) can raise cholesterol - Reduce risk with fiber
Add whole grains, legumes, fruits, and vegetables to your meals to reduce heart disease risk - Get some supplemental garlic
600 to 900 mg a day of a standardized garlic extract may help lower cholesterol and prevent hardening of the arteries - Add soy protein to your diet
30 grams (about 1 ounce) a day of powdered soy protein added to food or drinks can help lower cholesterol - Check out natural vegetable fats (plant sterols and stanols)
Take 1.6 grams a day as a supplement or in specially fortified margarines to help reduce cholesterol - Raise “good” cholesterol with exercise
Start a regular exercise program to help raise HDL cholesterol
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full high cholesterol article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.