High Cholesterol

Cholesterol is a waxy substance found in the fats (lipids) in your blood. Your body needs cholesterol to build healthy cells, but having too much cholesterol can increase your risk of diseased arteries.
Cholesterol is carried through your blood attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. You may have heard of different types of cholesterol, based on what type of cholesterol the lipoprotein carries. They are:
  • Low-density lipoprotein (LDL). LDL, or “bad,” cholesterol transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow.
  • Very-low-density lipoprotein (VLDL). This type of lipoprotein contains the most triglycerides, a type of blood fat. VLDL cholesterol makes LDL cholesterol larger in size.
  • High-density lipoprotein (HDL). HDL, or “good,” cholesterol picks up excess cholesterol and takes it back to your liver.

When your cholesterol level is high, fatty deposits may develop in your blood vessels. Eventually, these deposits make it difficult for blood to flow through your arteries. A dangerous accumulation of cholesterol and other deposits (plaques) may form on your artery walls, creating a condition called atherosclerosis. Your heart may not get as much oxygen-rich blood as it needs, increasing the risk of a heart attack. Decreased blood flow to your brain can cause a stroke.


High cholesterol can be inherited, but it’s often the result of unhealthy lifestyle choices. High cholesterol has no symptoms. A blood test is the only way to detect it.

These risk factors increase your risk of high cholesterol:

  • Tobacco use. Cigarette smoking damages the walls of your blood vessels, making them likely to accumulate fatty deposits.
  • Obesity. Having a body mass index (BMI) of 30 or greater puts you at increased risk.
  • Large waist circumference. Your risk increases if you are a man with a waist circumference of at least 40 inches or a woman with a waist circumference of at least 35 inches.
  • Poor diet. Foods that are high in cholesterol, such as red meat and full-fat dairy products, will increase your total cholesterol. Foods containing saturated fat and trans fats also can raise your cholesterol level.
  • Lack of exercise. Exercise helps boost HDL cholesterol while lowering LDL cholesterol.
  • Diabetes. High blood sugar contributes to higher LDL cholesterol and lower HDL cholesterol. It also damages your arteries.

Lifestyle changes are the first line of treatment for high cholesterol. If they’re ineffective, medication is prescribed. The specific drug or combination of drugs you take will depend on a variety of factors, including your age, your current health and possible side effects of the medication.

  1. Statins. They are the commonly prescribed medications to treat high cholesterol. Statins work by blocking a substance your liver needs to make cholesterol. This causes your liver to remove cholesterol from your blood. Statins may also help your body reabsorb cholesterol from built-up deposits on your artery walls.
  2. Bile acid-binding resins. Your liver uses cholesterol to make bile acids, needed for digestion. The medications lower cholesterol by affecting the production of bile acids.
  3. Cholesterol absorption inhibitors. Your small intestine absorbs cholesterol from your diet and releases it into your bloodstream. It reduces blood cholesterol by limiting the absorption of dietary cholesterol.
  4. Combination cholesterol absorption inhibitor and statin.
  5. Fibrates. It reduces your liver’s production of very-low-density lipoprotein (VLDL) cholesterol and speeds the removal of triglycerides from your blood.
  6. Niacin. It limits your liver’s ability to produce LDL and VLDL cholesterol. Most doctors recommend it only for people who can’t take statins.
  7. Omega-3 fatty acid supplements. Fatty acids may help lower triglycerides.

Tolerance to cholesterol medications varies from person to person. Common side effects are muscle pains, stomach pain, constipation, nausea, and diarrhea. You may have periodic liver function tests to monitor the medication’s effect on your liver.

Lifestyle changes also are essential to improve your cholesterol level. To bring your numbers down:

  • Lose excess weight if you’re overweight.
  • Eat a healthy diet that’s low in cholesterol, saturated fat, and trans fat.
  • Exercise most days of the week for at least 30 minutes.
  • Quit smoking if you use tobacco.

Total cholesterol: Below 200 mg/dL* is best.
LDL cholesterol: 100 to 129 is near ideal. Lower numbers are better if you have heart disease or are at risk.
HDL cholesterol: 60 mg/dL and above is best.
Triglycerides: Below 150 mg/dL is best.
*Cholesterol is measured in milligrams of cholesterol per deciliter (mg/dL) of blood.

        Excerpt From: The Mayo Clinic. “Mayo Clinic A to Z Health Guide”.