Cholesterol is a fatty substance that circulates in your bloodstream. Most cholesterol—70 percent—is synthesized by the liver; 30 percent comes from the food that we eat. There are two types of cholesterol: low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol. LDL cholesterol is the “bad” cholesterol that can clog your arteries and significantly raise your risk for heart disease and related conditions. HDL cholesterol is actually good because it rids the body of LDL cholesterol. Triglycerides are another type of fat found in the bloodstream. Extra calories that your body doesn’t use get stored as triglycerides.
Total cholesterol is a measurement of HDL and LDL levels. Optimal levels of total cholesterol are considered to be anything less than 200 mg/DL. Anything above 240 is dangerously high; between 200 and 240 is borderline high.
Learn more about optimal cholesterol levels.
According to the U.S. Centers for Disease Control and Prevention (CDC), about one in every six Americans adults (102.2 million people) have total cholesterol levels over 240 mg/dL.
Causes and Risk Factors
Diet plays a huge role in contributing to high cholesterol. Foods with trans fats or high levels of saturated fat increase LDL cholesterol. High-calorie diets in general can increase cholesterol. Being overweight or obese significantly increases your risk for high cholesterol, as does smoking cigarettes. Living a sedentary lifestyle—not getting enough exercise—will also contribute to high cholesterol.
High cholesterol tends to run in families. Although it is often due to shared eating and lifestyle habits, there are some rare cases (one in 500) where high cholesterol is a genetic, inherited disease.
Diabetics are more likely than others to have high levels of LDL cholesterol. When high cholesterol is due to diabetes, it is called diabetic dyslipidemia.
Diagnosis
High cholesterol has no symptoms, which makes it all the more dangerous. However, there may be some physical signs of high cholesterol, including yellow deposits of cholesterol in the skin. This is often found below the eyes or on the Achilles tendon and is known as xanthoma. Cholesterol deposits form in the retina if the cholesterol is very high. Generally, the only way to know that you have the condition is by going to the doctor and getting your blood tested. This is why it is essential to have your cholesterol levels checked regularly, especially if you have a higher risk. Early detection and management of high cholesterol can help you avoid dangerous complications, including:
- atherosclerosis
- coronary artery disease
- heart attack
- stroke
- peripheral artery disease
Treatment
Treatment for high cholesterol will most likely start with lifestyle modification. A heart-healthy diet that boosts good HDL cholesterol and limits sodium and bad fats can significantly decrease LDL and overall cholesterol levels. Exercise and weight loss are also key aspects of most high cholesterol treatment plans.
If lifestyle changes don’t work, your doctor may prescribe cholesterol-lowering medications including:
- statins
- combination statins
- bile-acid-binding resins
- selective cholesterol absorption inhibitors
- fibrates
- omega-3 fatty acid (fish oil)
- niacin (nicotinic acid)
