Cholesterol is an important substance in your body. It helps make cells and performs other functions involving vitamins and hormones.

But when levels of LDL (bad) cholesterol become too high, it can become a risk factor for cardiovascular disease. Conversely, higher levels of HDL (good) cholesterol are considered beneficial for cardiovascular health.

A simple blood test can determine your levels of LDL and HDL cholesterol. The results of cholesterol tests can determine whether you need to start taking medications or adopt certain lifestyle changes to bring your cholesterol levels into a healthy range.

Let’s take a closer look at cholesterol levels, what’s considered a healthy range, and what you can do to help lower your cholesterol.

The two main types of cholesterol are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

LDL cholesterol is considered the “bad” type of cholesterol because it forms harmful plaques along the walls of your arteries. This can narrow the arteries, making it harder for blood to flow properly.

HDL is considered the “good” cholesterol because its main job is to escort LDL cholesterol out of your body.

Cholesterol levels are measured by a standard lipid profile blood test in milligrams per deciliter (mg/dL). When you have your cholesterol checked, your blood test should include your:

  • LDL cholesterol levels
  • HDL cholesterol levels
  • triglycerides, a type of fat that stores excess calories
  • total cholesterol, which includes your LDL and HDL levels, as well as 20% of your triglycerides

A cholesterol test is recommended every 1 to 2 years for:

  • men ages 35 and up
  • women ages 45 and up, especially if they’re at increased cardiovascular risk

It’s recommended that younger adults get a cholesterol test every 5 years.

Keeping your cholesterol levels in a healthy range is one way to lower your risk of atherosclerosis, a condition in which plaques narrow the arteries and reduce blood flow to organs and tissue throughout the body. Atherosclerosis is a major risk factor for heart attack and stroke.

The National Institutes of Health recommends the following cholesterol levels based on your age and gender.

Recommended levels for people age 20 or older

  • LDL: less than 100mg/dL
  • HDL: 40mg/dL or higher (for men); 50mg/dL or higher (for women)
  • Triglycerides: less than 150 mg/dL
  • Total cholesterol: 125 to 200mg/dL

Recommended levels for people age 19 or younger

  • LDL: less than 100 mg/dL
  • HDL: greater than 45 mg/d
  • Triglycerides: less than 150 mg/dL
  • Total cholesterol: less than 170mg/dL

Your cholesterol levels are affected by genetics, dietary choices, and lifestyle factors like:

  • a sedentary lifestyle
  • smoking
  • consuming too much alcohol
  • carrying excess weight

For some people, lifestyle changes can be enough to bring cholesterol levels into the healthy range, according to a 2019 study.

Lifestyle changes to lower cholesterol often include:

  • getting at least 30 to 45 minutes of moderate-intensity aerobic exercise most days of the week
  • following a heart-healthy diet that’s low in saturated fat
  • losing weight if you carry excess weight
  • quitting smoking, as smoking can harden your arteries and increase the risk of cholesterol plaque formation in your arteries
  • keeping stress levels under control as too much stress may increase LDL cholesterol

When is cholesterol medication needed?

If lifestyle changes don’t help lower your cholesterol, your doctor may consider prescribing medication.

The American Heart Association (AHA) suggests that a statin is the most effective means of lowering LDL cholesterol levels. This medication interferes with cholesterol production in your liver.

Other medications used to bring down LDL levels include:

For individuals with specific risk factors for cardiovascular disease, the AHA and American College of Cardiology have specific guidelines for when cholesterol levels should trigger the use of statins or other cholesterol-lowering medications.

According to the guidelines:

  • Individuals considered at very high risk for atherosclerotic cardiovascular disease and who have LDL levels of 70 mg/dL or higher should consider adding the medication ezetimibe to their statin regimen.
  • Individuals with LDL levels greater than 190 mg/dL should consider high intensity statin use. If that fails to bring LDL levels below 100 mg/dL and there are other cardiovascular risk factors present, the addition of ezetimibe to statin therapy should be considered.
  • People with type 2 diabetes, ages 40 to 75, should start moderate-intensity statin therapy if they have LDL levels of 70 mg/dL or greater.

Your cholesterol levels are key indicators of your cardiovascular health and your risk profile for heart attack and stroke. Fortunately, a blood test can easily check your LDL, HDL, and total cholesterol levels.

The results of that test can be used to determine whether medications or other interventions are needed to bring your cholesterol levels into a healthy range.

If you have questions about your risk for heart attack or other complications, talk with your doctor about whether you need to start making lifestyle changes or taking medications to lower your risks and preserve the health of your heart and arteries.