What Is High Cholesterol?

Cholesterol is a waxy substance that supports many functions in your body, including building healthy cells. There are two main types of cholesterol: low-density lipoprotein (LDL), or "bad" cholesterol, and high-density lipoprotein (HDL), or "good" cholesterol.

Too much LDL cholesterol or too little HDL cholesterol can cause plaque to build up in your arteries. Without management, this buildup can eventually lead to cardiovascular disease.

Signs and Symptoms of High Cholesterol

Causes and Risk Factors of High Cholesterol

Lifestyle habits like eating an unhealthy diet and not exercising regularly are the most common causes of high cholesterol. But other factors like your family history, certain medical conditions, and race or ethnicity can also increase your risk.

Lifestyle Habits

• A diet high in saturated fat
• Lack of physical activity
• Smoking
• Excessive alcohol intake

Medical Conditions

• Chronic kidney disease
• Type 2 diabetes
• Hypothyroidism
• Overweight and obesity

Medications

• Diuretics like thiazide that treat high blood pressure
• Beta-blockers that treat high blood pressure or relieve angina
• Arrhythmia medications like amiodarone
• Corticosteroids like prednisone for treating inflammatory diseases

  [5]

• Retinoids to treat acne or psoriasis
• Immunosuppressive drugs like cyclosporine to prevent rejection after organ transplant or treat inflammatory diseases
• HIV drugs like protease inhibitors
• Chemotherapy medications to treat cancer

Other Factors That Increase Your Risk

• Family History If other members of your family have high cholesterol, you are more likely to have high cholesterol. Although rare, some people also have an inherited genetic condition called familial hypercholesterolemia (FH) that causes very high LDL cholesterol at a young age.
• Age As you age, your body can't clear cholesterol from your blood as well, leading to higher cholesterol levels.
• Sex Until menopause, women tend to have lower LDL cholesterol than men. Men at any age have lower HDL cholesterol than women.

How Is High Cholesterol Diagnosed?

• Eating habits
• Physical activity level
• Family history
• Current medications

To test for high cholesterol, your doctor may order a blood test called a lipid profile, or lipid panel. You may need to fast (not eat or drink) for 8 to 12 hours before your blood is drawn.

An HDL level of 50 to 80 mg/dL for women and 40 to 80 mg/dL for men is considered normal.

• People under age 45 should be screened every 5 years.
• Women ages 55 to 65 and men ages 45 to 65 should be screened every 1 to 2 years.
• People over age 65 should be screened every year.

Treatment and Medication Options for High Cholesterol

The main treatments for high cholesterol are lifestyle changes to improve cardiovascular health, like eating a healthy diet and getting regular exercise, and medications to lower cholesterol, like statins.

Lifestyle Changes

• Eat a Heart-Healthy Diet Reduce your intake of saturated and trans fats and increase your fiber intake. Focus on plant-based foods, whole grains, and lean proteins.
• Get Regular Exercise Getting 150 minutes of moderate-intensity physical activity per week helps clear cholesterol from your blood and reduce your risk of heart disease and stroke.
• Maintain a Healthy Weight Losing weight can help lower your cholesterol.
• Quit Smoking Smoking lowers your HDL cholesterol and worsens other problems, like high blood pressure and diabetes.
• Limit Alcohol Intake Having more than one drink a day for women or more than two drinks a day for men can raise your total cholesterol.

  [1]

• Get Enough Sleep Poor sleep is linked to lower HDL and higher LDL and triglycerides.

Medications

• Statins inhibit cholesterol production in your liver and help remove LDL cholesterol from your bloodstream. Examples include atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor).
• Cholesterol absorption inhibitors, such as ezetimibe (Zetia), lower the amount of cholesterol absorbed from food into your blood stream.
• PCSK9 inhibitors help your liver absorb more LDL cholesterol, lowering cholesterol in your blood. Examples include alirocumab (Praluent), evolocumab (Repatha), and inclisiran (Leqvio).
• Bempedoic acid (Nexletol) works similarly to statins by inhibiting an enzyme involved in cholesterol production in the liver. It may be an option if you experience serious side effects of statins.
• Bile acid sequestrants prompt your liver to use up extra cholesterol to make more bile acids. This lowers cholesterol in your blood. Examples include cholestyramine (Prevalite), colesevelam (Welchol), and colestipol (Colestid).
• Fibrates speed up the removal of triglycerides from your blood and also help to increase HDL cholesterol. Examples include fenofibrate (Lipofen) and gemfibrozil (Lopid).

Lifestyle Changes and Prevention of High Cholesterol

Regular screenings can also help you maintain healthy cholesterol levels. In general, healthy adults should check their cholesterol every four to six years. But your doctor may recommend more frequent screenings depending on your age, overall health, and other risk factors.

How Long Does High Cholesterol Last?

Complications of High Cholesterol

• Coronary artery disease
• Carotid artery disease
• Heart attack
• Stroke
• Peripheral artery disease

The Takeaway

• Cholesterol is a waxy substance your body needs to build healthy cells. High cholesterol is when you have too much cholesterol in your blood.
• Common causes of high cholesterol include a diet high in saturated fat, smoking, obesity, age, and family history.
• Medications and lifestyle changes like eating a healthy diet, getting physical activity, avoiding smoking, and maintaining a healthy weight can help treat or prevent high cholesterol.
• Without treatment, high cholesterol can lead to health problems like heart disease, heart attack, and stroke. Regular screenings can help you manage your cholesterol and avoid long-term complications.