What Is High Cholesterol?

Cholesterol is a type of fat (lipid) in your blood. Your cells need cholesterol, and your body makes all it needs. But you also get cholesterol from the food you eat.

If you have too much cholesterol, it starts to build up in your arteries . (Arteries are the blood vessels that carry blood away from the heart.) This is called hardening of the arteries, or atherosclerosis . It is usually a slow process that gets worse as you get older.

To understand what happens, think about how a clog forms in the pipe under a kitchen sink. Like the buildup of grease in the pipe, the buildup of cholesterol narrows your arteries and makes it harder for blood to flow through them. It reduces the amount of blood that gets to your body tissues, including your heart. This can lead to serious problems, including heart attack and stroke.

Your cholesterol is measured by a blood test:

• High cholesterol is 240 or above.
• Borderline-high is 200 to 239.
• Best is less than 200.

What are the different kinds of cholesterol?

• LDL is the “bad” cholesterol, the kind that can clog your arteries. This is the cholesterol you need to lower, if you have high cholesterol.
• HDL is the “good” cholesterol. HDL helps clear fat from your blood. A high level of HDL can help protect you from a heart attack.
• Triglycerides are another type of fat in your blood. If you have high triglycerides and high LDL, your chances of having a heart attack are higher.

What are the symptoms?

High cholesterol doesn't make you feel sick. By the time you find out you have it, it may already be clogging your arteries. So it is very important to start treatment even though you may feel fine.

What causes high cholesterol?

Many things can cause high cholesterol, including:

• The foods you eat. Eating too much saturated fat, trans fat, and cholesterol can raise your cholesterol. Saturated fat and cholesterol are in foods that come from animals (such as meats, whole milk, egg yolks, butter, and cheese). Trans fats are in many packaged and snack foods, such as cookies, crackers, and chips.
• Being overweight.
• Being inactive.
• Age. Cholesterol starts to rise after age 20.
• Family history. If family members have or had high cholesterol, you may also have it.
• Overall health. Diseases such as hypothyroidism can raise cholesterol.

How is high cholesterol diagnosed?

You need a blood test to check your cholesterol. There are several kinds of tests:

• A fasting cholesterol test is the most complete test because it measures all of the fats in your blood, including LDL and HDL cholesterol, and triglycerides. You cannot have food for 9 to 12 hours before this test.
• A direct LDL test measures your LDL level only. You can have this test done at any time, even if you recently had a meal or snack.
• A simple cholesterol test can measure total cholesterol and HDL. You can eat before this test. Sometimes doctors do this test first.

How is it treated?

If you have high cholesterol, you need treatment to lower your risk of heart attack and stroke. The two main treatments are lifestyle changes and medicine.

Some lifestyle changes are important for everyone with high cholesterol. Your doctor will probably want you to:

• Eat a heart-healthy diet that includes plenty of fish, fruits, vegetables, beans, high-fiber grains and breads, and healthy fats like olive oil.
• Lose weight, if you need to. Losing just 5 lb to 10 lb (2.3 kg to 4.5 kg) can lower your cholesterol. Losing weight can also help lower your blood pressure.
• Get regular exercise on most, if not all, days of the week. Walking is great exercise that most people can do. A good goal is 30 minutes or more a day.
• Don't smoke. Quitting can help raise your HDL and improve your heart health.

Changing old habits may not be easy, but it is very important to help you live a healthier and longer life. Having a plan can help. Start with small steps. For example, commit to adding one fruit or one vegetable a day for a week. Instead of having dessert, take a short walk.

If these lifestyle changes don't lower your cholesterol enough, or if your risk of heart attack is high, you may also need to take a cholesterol-lowering medicine, such as a statin. Knowing your heart attack risk is important, because it helps you and your doctor decide how to treat your cholesterol.