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Good heart health is like a building block: It’s cumulative. This is particularly true when it comes to high cholesterol.

Cholesterol is a fatty substance your liver makes. It’s also found in certain foods. Your body needs some cholesterol to function properly. But having too much of the bad type of cholesterol — low-density lipoprotein (LDL) — puts you at risk for having a heart attack or stroke.

According to the Centers for Disease Control and Prevention (CDC), having high cholesterol raises your risk for heart disease.

Sex and gender exist on spectrums. This article will use the terms “men,” “women,” or both to refer to sex assigned at birth. Click here to learn more.

Your total cholesterol level is the overall amount of cholesterol found in your blood. It consists of:

  • low-density lipoproteins (LDLs)
  • high-density lipoproteins (HDLs)
  • triglycerides

LDL is also called “bad” cholesterol because it blocks your blood vessels and increases your risk for heart disease. HDL is considered “good” cholesterol because it helps protect you from heart disease. The higher your HDL, the better.

Total cholesterol also includes a triglyceride count. These are another type of fat that can build up in the body and are considered the “building blocks” of cholesterol.

High levels of triglycerides and low levels of HDL raise your risk for heart disease.

The American Heart Association recommends that all adults have their cholesterol checked every 4 to 6 years, starting at age 20, which is when cholesterol levels can start to rise.

As we age, cholesterol levels tend to climb. Men are generally at a higher risk than women for higher cholesterol. However, a woman’s risk goes up after she enters menopause.

For those with high cholesterol and other cardiac risk factors, such as diabetes, more frequent testing is recommended.

Cholesterol chart for adults

According to the 2018 guidelines on the management of blood cholesterol published in the Journal of the American College of Cardiology (JACC), these are the acceptable, borderline, and high measurements for adults.

All values are in mg/dL (milligrams per deciliter) and are based on fasting measurements.

Total cholesterolHDL cholesterolLDL cholesterolTriglycerides
GoodLess than 200 (but the lower the better)Ideal is 60 or higher; 40 or higher for men and 50 or higher for women is acceptableLess than 100; below 70 if coronary artery disease is presentLess than 149; ideal is <100
Borderline to moderately elevated200–239n/a130–159150–199
High240 or higher60 or higher
160 or higher; 190 considered very high
200 or higher; 500 considered very high
Lown/aless than 40 for men and less than 50 for womenn/an/a

Cholesterol levels in men vs. women

Generally, guidelines are similar for men and women over the age of 20, though they differ when it comes to HDL cholesterol, as seen above. Women should aim for higher levels of HDL cholesterol.

Children who are physically active, eat a nutrient-dense diet, are not overweight, and do not have a family history of high cholesterol are at a lower risk for having high cholesterol.

Current guidelines recommend that all children have their cholesterol checked between ages 9 and 11 years, and then again between ages 17 and 21 years.

Children with more risk factors, such as having diabetes, obesity, or a family history of high cholesterol, should be checked between ages 2 and 8 years, and again between ages 12 and 16 years.

Cholesterol chart for children

According to the JACC, the following are the recommended cholesterol levels for children:

All values are in mg/dL:

Total cholesterolHDL cholesterolLDL cholesterolTriglycerides
Good170 or lessGreater than 45Less than 110Less than 75 in children 0–9; less than 90 in children 10–19
Borderline170–19940-45110–12975–99 in children 0–9; 90–129 in children 10–19
High200 or highern/a130 or higher100 or more in children 0–9; 130 or more in children 10–19
Lown/aLess than 40n/an/a

Your doctor may recommend a plan of treatment for high cholesterol that includes lifestyle modifications and potentially medication. This will vary based on factors like other medications you may be taking, your age, sex, and general health.

Here are some medications more commonly prescribed for high cholesterol:

  • Statins. Statins lower the LDL cholesterol levels by slowing the production of cholesterol by the liver.
  • Bile acid sequestrants. Bile acid sequestrants are substances used in digestion. These resins can reduce cholesterol levels in the blood by binding to bile acids and removing them, forcing the body to break down LDL cholesterol to create bile acids instead.
  • Cholesterol absorption inhibitors. Cholesterol absorption inhibitors can block the absorption of cholesterol from the diet, sometimes in conjunction with statins.
  • Bempedoic acid. Bempedoic acid helps to stop an enzyme in the liver, ATP citrate lyase, from making cholesterol. This drug is often combined with statins for increased benefit for those with familial hypercholesterolemia, an inherited condition that can cause early heart disease.
  • PCSK9 inhibitors. Also used frequently with familial hypercholesterolemia, PCSK9 inhibitors, which are injected drugs, help the liver absorb and remove more LDL cholesterol from the blood.

Medications can also be used to treat contributing factors to cholesterol like triglycerides. These may be used in addition to some of the medications above.

“One misconception is that people can have poorly controlled cholesterol for years and then decide to take action. By then the plaque could already have built up,” says Dr. Eugenia Gianos, director of cardiovascular prevention for Northwell Health in New York.

The good news is that lifestyle changes are reasonably effective in helping you reduce cholesterol levels. They’re also fairly straightforward and can be done at any age and within most abilities.

  • Exercise if you can. Physical activity can help you lose weight and boost your HDL cholesterol. Aim for 30 to 60 minutes a day of moderate cardiovascular exercise, such as biking, jogging, swimming, and dancing, at least 5 times a week.
  • Eat more fiber. Try to add more fiber to your diet, such as replacing white bread and pasta with whole grains.
  • Eat healthy fats: Healthy fats include olive oil, avocado, and certain nuts. These are all fats that won’t raise your LDL levels.
  • Limit your cholesterol intake. Reduce the amount of high-saturated fatty foods like cheese, whole milk, and high-fat red meats.
  • If you smoke, consider quitting. Smoking decreases HDL cholesterol. Quitting can help you better manage your cholesterol levels.
  • Limit your alcohol intake. The American Heart Association recommends drinking alcohol in moderation, which means, on average, no more than two drinks per day for men and no more than one drink per day for women. Drinking too much alcohol can raise levels of triglyceride fats in the bloodstream and lead to conditions such as hypertension (high blood pressure) and atrial fibrillation.
  • Get to a healthy-for-you weight. Losing excess body weight can help lower your cholesterol levels.
  • Check your levels. You can see a doctor or use an at-home test kit to check your cholesterol levels. You can purchase a testing kit online from LetsGetChecked here.

There are few noticeable symptoms of high cholesterol. Emergency symptoms such as a stroke or heart attack may be the only indicator of damage from high cholesterol. This means that regular monitoring by a doctor is essential.

Most people should get their cholesterol checked with a blood test every 4 to 6 years. Your doctor may recommend more frequent screening if you live with any of the following:

  • a history of heart conditions
  • family history of high cholesterol
  • high blood pressure
  • if you smoke
  • have overweight or obesity

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