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What is cholesterol?

Cholesterol is a waxy substance that circulates in your blood. Your body uses it to create cells, hormones, and vitamin D. Your liver creates all the cholesterol you need from fats in your diet.

Cholesterol doesn’t dissolve in the blood. Instead, it bonds to carriers called lipoproteins, which transport it between cells. Lipoproteins are made up of fat on the inside and protein on the outside.

There are two main types of cholesterol carried by different types of lipoproteins. Low-density lipoproteins (LDL) are sometimes called “bad” cholesterol. High levels of LDL cholesterol can build up in your arteries, causing heart disease.

High-density lipoproteins (HDL) are referred to as “good” cholesterol. HDL cholesterol carries cholesterol from other parts of your body back to the liver. Your liver then processes the cholesterol out of your body. It’s important to have healthy levels of both types of cholesterol.

Understand the Difference Between Good and Bad Cholesterol »

If your cholesterol levels are too high, deposits can occur in your arteries. These fatty deposits on the walls of your blood vessels can harden and narrow the blood vessels. This is a condition called atherosclerosis. Narrower vessels transport less oxygen-rich blood. If oxygen can’t reach your heart muscle, you can have a heart attack. If that happens in your brain, you can have a stroke.

Cholesterol levels are measured in milligrams (mg) per tenth-liter (dL) of blood. Healthy total cholesterol levels — the sum of your HDL and LDL — should stay below 200 mg/dL.

To break down that number, your acceptable level of LDL (“bad”) cholesterol should be less than 160 mg/dl, 130 mg/dL, or 100 mg/dl. The difference in numbers really depends on your individual risk factors for heart disease.

Your HDL (“good”) cholesterol should be at least 35 mg/dL, and preferably higher. That’s because the more HDL, the better protection you have against heart disease.

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Over 73.5 million Americans, roughly 32 percent of the American population, have high levels of LDL cholesterol. Of these people, only one in three has their condition under control, and only half are receiving treatment for high cholesterol.

People with high cholesterol have twice the risk of heart disease as people with healthy levels of cholesterol. Statins are the most widely-used drugs to treat high cholesterol.

Everyone should get their cholesterol checked, starting at the age of 20. And then again, every five years. However, risk levels normally don’t rise until later in life. Men should begin monitoring their cholesterol levels more closely starting at age 45. Women tend to have lower cholesterol levels than men until menopause, at which point their levels begin to rise. For this reason, women should begin getting checked regularly around age 55.

There are a number of factors that put you at risk for developing high cholesterol. Some, you can’t do anything about. Cholesterol levels rise with age, especially in women after menopause. Heredity also plays a factor since your genes partially determine how much cholesterol your liver makes. Look out for a family history of high cholesterol, high blood pressure, or early heart disease.

You can do something about the other risks. Physical activity reduces cholesterol levels, as does reducing the amount of saturated fat in your diet. Losing weight also helps. If you smoke cigarettes, quit — the habit does damage to your blood vessels.

Lose weight and exercise

The Surgeon General recommends you exercise at least two hours and 30 minutes per week, or for 30 minutes most days. Exercise lowers your LDL levels and boosts your HDL levels. It also helps you lose weight, which can help lower your cholesterol levels. If you’re overweight, you don’t have to lose it all. Just 5 to 10 percent of your body weight can have a big impact on lowering your cholesterol.

Eat a heart-healthy diet

Try to reduce the amount of saturated fats in your diet, which your body coverts into cholesterol. Saturated fats are found in dairy and fatty meats, so switch to lean, skinless meats. Avoid trans-fats, found in commercially-packaged baked goods like cookies and crackers. Load up on whole grains, fruits, nuts, and vegetables.

Get your cholesterol tested, especially if you’re at risk. If your levels are high or borderline, work with your doctor to find out the best treatment plan for you. Your doctor may prescribe you statins. If you take your statins as prescribed, they can significantly lower your LDL levels. Over 30 million Americans take statins. Other medications are also available to treat high cholesterol if statins alone are ineffective or if you have a contraindication to statin use.