Everyone has good (HDL) and bad (LDL) cholesterol. These fatty substances are made naturally in your body but can also come from the foods you eat.
A certain level of LDL cholesterol is OK, but too much can raise your chances of developing all kinds of health problems.
In this article, you will learn the difference between the types of cholesterol, why cholesterol can be harmful, what the ideal ranges are for LDL cholesterol, and how to lower your cholesterol naturally and with medications.
Low-density lipoprotein (LDL) is a fatty, wax-like substance that can be found throughout your body. Your liver makes cholesterol naturally to help move proteins through the blood and to all your tissues.
Cholesterol can also be found in food, though. Too much of certain types of cholesterol can affect your health.
LDL cholesterol is usually referred to as “bad cholesterol.” It’s made up of a combination of fats and proteins that can easily build up in your blood vessels.
If you develop too much cholesterol in your blood vessels, it can make it difficult for blood to pass through the vessels to different parts of your body. Blood vessels that become narrowed by cholesterol can make your heart need to work harder to pump blood.
Dangerous plaques can also form. If pieces of these plaques break off, they can lead to problems like heart attack or stroke.
Not all cholesterol is considered “bad.”
High-density lipoproteins — or HDL cholesterol — is often referred to as the “good” cholesterol.
While LDL cholesterol can easily build up in your blood vessels, potentially leading to coronary artery disease or atherosclerosis, HDL cholesterol helps carry LDL to your liver where it’s eventually removed from the body.
According to clinical guidelines, most people should aim for LDL cholesterol levels
The American College of Cardiology and the American Heart Association recommends LDL levels
Everyone is unique, though. A healthcare professional can make recommendations for you based on your individual health and cardiovascular risk factors.
LDL cholesterol numbers
An LDL test will determine your levels of LDL cholesterol. Many doctors rank levels in the following way:
- Ideal: Less than 100 mg/dL
- Near optimal/above optimal: 100–129 mg/dL
- Borderline high: 130–159 mg/dL
- High: 160–189 mg/dL
- Very high: 190 mg/dL and above
Depending on your test results, a doctor can suggest any diet, lifestyle changes, or medications if necessary.
Cholesterol is tested by having a blood sample taken in a lab or medical office.
A cholesterol test, or lipid panel, can be done with or without fasting. If your doctor requests a fasting test, you will need to avoid eating or drinking anything other than water for about 12 hours beforehand.
According to the National Library of Medicine, your first cholesterol test is typically done when you’re between 9 and 11 years old. If you have a family history of high cholesterol or heart conditions, you may be tested as early as age 2.
Tests are recommended every 5 years after the initial test. After age 45 for men and 55 for women, cholesterol tests should be increased to every 1 to 2 years.
Many things can affect your LDL cholesterol levels. Some things that contribute to higher LDL levels include:
- eating foods high in cholesterol, saturated fats, and trans fats
- inactivity or low levels of exercise
- obesity or overweight
- cigarette smoking
- older age
- a family history (aka genetics)
- certain underlying medical conditions
- certain medications
- race
- sex
Although you cannot control all of these risk factors, your doctor may make recommendations focusing on the ones you can, such as diet and lifestyle changes.
A heart-healthy diet, exercise, and weight loss are the most common lifestyle recommendations for lowering cholesterol levels. These are typically recommended first if your cholesterol levels are elevated or moving in that direction.
LDL levels that are considered high or extremely high are treated with medication. Often, a doctor may recommend a combination of medication, diet, and exercise changes for someone with high LDL levels.
Medical management of cholesterol aims to reduce LDL levels by
Medications that may be used to lower LDL cholesterol levels include:
| Medication type | Examples |
| Statins | atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevachor or Altoprev), pravastatin (Pravachol), rosuvastatin calcium (Crestor), simvastatin (Zocor) |
| Cholesterol absorption inhibitors | ezetimibe |
| Bile acid sequestrants | cholestyramine (Questran or Prevalite), colestipol (Colestid), colesevelam (Welchol) |
| PCSK9 inhibitors | alirocumab, evolocumab, inclisiran |
| Adenosine triphosphate-citrate lyase (ACL) inhibitors | bempedoic acid (Nexletol), bempedoic acid and ezetimibe (Nexlizet) |
| Fibrates | gemfibrozil (Lopid), fenofibrate (Antara or Tricor), clofibrate (Atromid-S) |
| Niacin | vitamin B3 |
Some people may also be prescribed omega-3 fatty acid ethyl esters such as Lovaza, Vascepa, Epanova, or Omtryg. However, these are typically used for people with high triglyceride levels and
It can take about 3 to 6 months to see your LDL cholesterol levels drop through diet and exercise changes alone. Medications typically work quicker, though it will depend on what type you use and whether you also combine it with the recommended lifestyle changes.
You may see your LDL cholesterol drop in as little as 6 to 8 weeks with some medications.
What is the ideal range for LDL cholesterol?
For most people, the ideal range for LDL cholesterol is under 100 mg/dL.
Is there a goal LDL level for people with diabetes?
People with diabetes and other conditions that can increase their chances of developing cardiovascular disease should aim for an LDL cholesterol level below 70 mg/dL.
How fast can you lower your LDL levels?
It can take around 2 months with medications or as long as 6 months with lifestyle changes to see a decrease in your LDL levels. Reach out to a doctor to discuss the best treatment options for your individual health and LDL levels.
LDL cholesterol is the type of cholesterol that’s considered “bad” because it can block your arteries and lead to the formation of plaques. Having high LDL cholesterol may increase your risk of stroke, heart attack, and other cardiovascular diseases.
The recommendation for most people is to keep cholesterol levels below 100 mg/dL, which you can do with a balanced diet and exercise. If you have conditions that can increase your risk of cardiovascular disease, experts recommend maintaining LDL levels below 70 mg/dL.