(Cholesterol, High; Hypercholesterolemia)
Cholesterol is a type of fat in the blood. High cholesterol is when there is too much of this fat. There are two types:
- LDL or "bad cholesterol"—causes fats to build up in blood vessels.
- HDL or "good cholesterol"—removes fats from the blood.
High LDL cholesterol can raise the risk of stroke and heart disease. High HDL cholesterol can lower the risk of stroke and heart disease.
Cholesterol is made in the liver and comes from food we eat. High cholesterol may be caused by:
- Changes in liver
- Genes that affect how the body makes cholesterol or uses cholesterol from food
- Health issues or medical care
- Behaviors like food choice and activity
One or more of these things can cause high cholesterol.
Things that raise the risk of high cholesterol are:
- Family members with high cholesterol
- Lifestyle habits such as:
- Physical inactivity—can increase LDL and decrease HDL
- Cigarette smoking—can decrease HDL
- Excess alcohol intake
- Diets that are very high in sugar or certain fats
- Certain health issues such as:
- Metabolic syndrome
- Type 2 diabetes
- Some diseases of the kidneys, liver, or thyroid
- Having extra weight
- Certain medicines such as:
- Progestins in birth control pills
- Steroids and corticosteroids
- Protease inhibitors to treat HIV
High cholesterol levels usually do not cause symptoms.
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Cholesterol can be measured in the blood. The test is done as part of a regular screening. For healthy adults this may be done every few years. Those with risk factors for heart disease may be screened more often.
Children may be screened if they have a higher weight or have a family history of high cholesterol.
Cholesterol screening is part of a blood test that will include:
The goal of treatment is to lower cholesterol levels. This will also help lower the risk for heart disease and stroke. Treatment options include:
Statins are a medicine that may help lower cholesterol. They may reduce the risk of heart attack and stroke.
Even when using medicine to help with cholesterol levels, diet and exercise are key.
Other steps that can help lower cholesterol levels include:
To help reduce the chance of having high cholesterol, talk to the doctor about:
- When to get blood tests
- How to eat a healthier diet
- What type of exercise is best
- How to quit smoking, vaping, or drinking alcohol
- How to control health problems such as diabetes
- Balder, J., Rimbert, A., et al. Genetics, lifestyle, and low-density lipoprotein cholesterol in young and apparently healthy women. Circulation, 2018; 137 (8): 820-831.
- High blood cholesterol. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/high-blood-cholesterol.
- Hypercholesterolemia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypercholesterolemia.
- Prevention and treatment of high cholesterol. American Heart Association website. Available at: https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia.
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