High cholesterol is a common health concern that can increase your risk of heart disease and stroke. Because it usually doesn't cause noticeable symptoms, many people don't know their cholesterol levels are elevated until they have a blood test.
Understanding your cholesterol numbers and what they mean for your overall heart health can help you take steps to reduce your risk. Learn how cholesterol is measured, when to get tested and which lifestyle changes and treatments may help.
What Is Cholesterol and Why Does It Matter?
Cholesterol is a waxy, fat-like substance found in your blood and throughout your body. Your body needs cholesterol to build healthy cells, produce certain hormones and support digestion. Your liver makes the cholesterol your body needs, but cholesterol also comes from certain foods.
Although cholesterol is essential for normal body function, having too much of certain types can affect your heart health. High levels of low-density lipoprotein (LDL) cholesterol can contribute to plaque buildup inside the arteries, a condition called atherosclerosis.
Over time, plaque can narrow the arteries and restrict blood flow. If a plaque ruptures and a blood clot forms, it can cause a heart attack or stroke. Managing your cholesterol levels is an important part of reducing your cardiovascular risk.
What's the Difference Between LDL, HDL and Triglycerides?
Cholesterol travels through your bloodstream in particles called lipoproteins. A blood test known as a lipid panel measures several types of cholesterol and fats that help your healthcare professional assess your cardiovascular health.
LDL (Low-Density Lipoprotein) Cholesterol: Often called "bad" cholesterol, LDL can contribute to plaque buildup in the arteries when levels are elevated. Lowering LDL is one of the main goals of cholesterol management because it can reduce the risk of heart attack and stroke.
HDL (High-Density Lipoprotein) Cholesterol: Commonly called "good" cholesterol, HDL helps transport cholesterol from the bloodstream and tissues back to the liver. However, a high HDL level does not necessarily cancel out the risks associated with elevated LDL cholesterol or other cardiovascular conditions.
Triglycerides: Triglycerides are a type of fat your body uses for energy. Elevated levels can be associated with an increased risk of cardiovascular disease, especially when combined with other risk factors. Very high triglyceride levels can also increase the risk of pancreatitis, a serious inflammation of the pancreas.
Total Cholesterol: This measurement reflects the overall amount of cholesterol in your blood. While it provides useful information, it does not tell the whole story about your heart health.
What Do Your Cholesterol Numbers Mean?
Your cholesterol results provide important information about your cardiovascular health, but there is no single cholesterol target that is right for everyone.
According to updated guidelines from the American College of Cardiology and American Heart Association, recommended LDL cholesterol levels depend on your individual risk of developing cardiovascular disease.
For example, some adults with borderline or intermediate cardiovascular risk may have an LDL cholesterol treatment goal below 100 milligrams per deciliter (mg/dL). People at higher risk may benefit from an LDL level below 70 mg/dL, while certain patients with established cardiovascular disease and a very high risk of another cardiovascular event may have a goal below 55 mg/dL.
These are examples of treatment goals, not universal thresholds for diagnosing high cholesterol. Your healthcare professional will consider your cholesterol levels along with other factors, including:
- Age and family history of heart disease
- Blood pressure
- Diabetes or chronic kidney disease
- Smoking or tobacco use
- Previous heart attack, stroke or other cardiovascular disease
- Other medical conditions that may affect cardiovascular risk
Healthcare professionals may use a cardiovascular risk assessment, such as the American Heart Association's PREVENT risk equations, to estimate your likelihood of developing cardiovascular disease and help guide treatment decisions.
For some patients, additional testing, such as a coronary artery calcium scan, may help clarify cardiovascular risk when treatment decisions are uncertain.
When Should You Have Your Cholesterol Checked?
Because high cholesterol rarely causes symptoms, regular screening is one of the best ways to identify elevated levels before complications develop.
Current cholesterol management guidelines recommend that adults begin cholesterol screening in early adulthood. Adults ages 19 and older should have a lipid panel, with repeat testing generally recommended about every five years for those at low cardiovascular risk. More frequent testing may be necessary depending on your results, medical history or existing health conditions.
Your healthcare professional may recommend additional testing if you have:
- A family history of high cholesterol or early heart disease
- Diabetes, high blood pressure or chronic kidney disease
- A personal history of heart disease or stroke
- Previously elevated cholesterol levels
- Other risk factors for cardiovascular disease
The updated guidelines also recommend that adults have their lipoprotein(a), or Lp(a), measured at least once in their lifetime. Lp(a) is a cholesterol-related particle largely influenced by genetics. Elevated levels can increase the risk of heart disease and stroke, even when traditional cholesterol measurements appear normal.
Most cholesterol tests involve a simple blood draw. Some tests require fasting, while others do not. Your healthcare professional can let you know whether you need to fast before your appointment.
How Can You Lower Cholesterol Naturally?
Healthy lifestyle habits are an important part of managing cholesterol and protecting your heart. Even small, consistent changes can support better cardiovascular health over time.
Consider these heart-healthy habits:
- Limit saturated fats. Reduce foods high in saturated fat, such as fatty cuts of meat, butter and certain full-fat dairy products. Choose healthier unsaturated fats found in foods such as olive oil, avocados and nuts.
- Eat more fiber. Soluble fiber found in oats, beans, lentils and certain fruits can help lower LDL cholesterol.
- Choose a balanced diet. Focus on vegetables, fruits, whole grains, lean proteins and healthy fats while limiting highly processed foods that are high in saturated fat.
- Stay physically active. Aim for at least 150 minutes of moderate-intensity aerobic activity each week, when appropriate for your health. Activities such as brisk walking, swimming or cycling can support cardiovascular health.
- Avoid tobacco products. Smoking and tobacco use increase cardiovascular risk. Quitting can help protect your heart and blood vessels.
- Prioritize sleep. Getting adequate, consistent sleep supports heart health and helps manage other cardiovascular risk factors.
- Manage other health conditions. Keeping blood pressure, diabetes and other chronic conditions under control can help lower your overall cardiovascular risk.
Although lifestyle changes can improve cholesterol levels, they may not be enough for everyone. Some people have inherited cholesterol conditions or other health factors that require medication in addition to healthy habits.
How Is High Cholesterol Treated?
Treatment for high cholesterol depends on your LDL levels, overall cardiovascular risk, medical history and response to lifestyle changes. Your healthcare professional may recommend medication when additional cholesterol reduction is needed.
Statins: Statins are commonly prescribed medications that reduce cholesterol production in the liver and lower LDL cholesterol levels. They are often the first medication recommended for people who need cholesterol-lowering treatment because they have been shown to reduce the risk of heart attack and stroke.
Ezetimibe: This medication reduces cholesterol absorption in the small intestine. It may be prescribed when additional LDL reduction is needed or when statins are not suitable for a particular patient.
PCSK9 inhibitors: These medications help the liver remove more LDL cholesterol from the bloodstream. They may be recommended for certain patients with very high cholesterol levels or elevated cardiovascular risk.
Bempedoic acid: This medication lowers LDL cholesterol by reducing cholesterol production in the liver. It may be an option for certain patients who need additional LDL reduction or cannot tolerate recommended statin therapy.
Your healthcare professional will help determine which treatment is appropriate based on your health history and individual needs. Some patients may benefit from a combination of medications to reach their recommended cholesterol goals.
If you experience side effects from cholesterol medication, speak with your healthcare professional before stopping treatment. Adjusting the dose or changing medications may help address side effects while continuing to protect your heart health.
When Should You Talk to Your Doctor About Cholesterol?
You don't need to experience symptoms to have a conversation about cholesterol. Because elevated cholesterol can develop silently over time, discussing your numbers during routine healthcare visits can help you understand your risk and identify steps to protect your health.
Consider speaking with your healthcare professional if you:
- Haven't had your cholesterol checked recently
- Have received elevated cholesterol results
- Have a family history of high cholesterol, heart attack or stroke
- Have diabetes, high blood pressure or other cardiovascular risk factors
- Have questions about cholesterol medication or treatment side effects
- Want guidance on making heart-healthy lifestyle changes
Your healthcare professional can explain your test results, assess your cardiovascular risk and recommend whether lifestyle changes, medication or additional testing may be beneficial.
Take Steps Toward Better Heart Health
High cholesterol may not cause noticeable symptoms, but understanding and managing your levels can make an important difference in your long-term cardiovascular health. Regular screening, healthy habits and appropriate treatment can help reduce your risk of heart disease and stroke.
At Broward Health, our cardiology specialists provide comprehensive heart and vascular care, including evaluation and management of high cholesterol and other cardiovascular risk factors. Our team works with patients to develop personalized care plans that support long-term heart health.
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