High Cholesterol

The heart with a close-up of a normal artery and an artery with plaque buildup.

High cholesterol is a condition in which the blood has high levels of a white, waxy substance similar to fat (cholesterol). The liver makes all the cholesterol that the body needs. The human body needs small amounts of cholesterol to help build cells. A person gets extra or excess cholesterol from the food that he or she eats.

The blood carries cholesterol from the liver to the rest of the body. If you have high cholesterol, deposits (plaques) may build up on the walls of your arteries. Arteries are the blood vessels that carry blood away from your heart. These plaques make the arteries narrow and stiff.

Cholesterol plaques increase your risk for heart attack and stroke. Work with your health care provider to keep your cholesterol levels in a healthy range.

What increases the risk?

The following factors may make you more likely to develop this condition:

  • Eating foods that are high in animal fat (saturated fat) or cholesterol.

  • Being overweight.

  • Not getting enough exercise.

  • A family history of high cholesterol (familial hypercholesterolemia).

  • Use of tobacco products.

  • Having diabetes.

What are the signs or symptoms?

In most cases, high cholesterol does not usually cause any symptoms.

In severe cases, very high cholesterol levels can cause:

  • Fatty bumps under the skin (xanthomas).

  • A white or gray ring around the black center (pupil) of the eye.

How is this diagnosed?

This condition may be diagnosed based on the results of a blood test.

  • If you are older than 20 years of age, your health care provider may check your cholesterol levels every 4–6 years.

  • You may be checked more often if you have high cholesterol or other risk factors for heart disease.

The blood test for cholesterol measures:

  • “Bad” cholesterol, or LDL cholesterol. This is the main type of cholesterol that causes heart disease. The desired level is less than 100 mg/dL (2.59 mmol/L).

  • “Good” cholesterol, or HDL cholesterol. HDL helps protect against heart disease by cleaning the arteries and carrying the LDL to the liver for processing. The desired level for HDL is 60 mg/dL (1.55 mmol/L) or higher.

  • Triglycerides. These are fats that your body can store or burn for energy. The desired level is less than 150 mg/dL (1.69 mmol/L).

  • Total cholesterol. This measures the total amount of cholesterol in your blood and includes LDL, HDL, and triglycerides. The desired level is less than 200 mg/dL (5.17 mmol/L).

How is this treated?

Treatment for high cholesterol starts with lifestyle changes, such as diet and exercise.

  • Diet changes. You may be asked to eat foods that have more fiber and less saturated fats or added sugar.

  • Lifestyle changes. These may include regular exercise, maintaining a healthy weight, and quitting use of tobacco products.

  • Medicines. These are given when diet and lifestyle changes have not worked. You may be prescribed a statin medicine to help lower your cholesterol levels.

Follow these instructions at home:

Eating and drinking

A plate with examples of foods in a healthy diet.
  • Eat a healthy, balanced diet. This diet includes:

    • Daily servings of a variety of fresh, frozen, or canned fruits and vegetables.

    • Daily servings of whole grain foods that are rich in fiber.

    • Foods that are low in saturated fats and trans fats. These include poultry and fish without skin, lean cuts of meat, and low-fat dairy products.

    • A variety of fish, especially oily fish that contain omega-3 fatty acids. Aim to eat fish at least 2 times a week.

  • Avoid foods and drinks that have added sugar.

  • Use healthy cooking methods, such as roasting, grilling, broiling, baking, poaching, steaming, and stir-frying. Do not fry your food except for stir-frying.

  • If you drink alcohol:

    • Limit how much you have to:

      • 0–1 drink a day for women who are not pregnant.

      • 0–2 drinks a day for men.

    • Know how much alcohol is in a drink. In the U.S., one drink equals one 12 oz bottle of beer (355 mL), one 5 oz glass of wine (148 mL), or one 1½ oz glass of hard liquor (44 mL).

Lifestyle

Illustration of a person walking a dog.
  • Get regular exercise. Aim to exercise for a total of 150 minutes a week. Increase your activity level by doing activities such as gardening, walking, and taking the stairs.

  • Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.

  • Keep all follow-up visits. This is important.

Where to find more information

Contact a health care provider if:

  • You have trouble achieving or maintaining a healthy diet or weight.

  • You are starting an exercise program.

  • You are unable to stop smoking.

Get help right away if:

  • You have chest pain.

  • You have trouble breathing.

  • You have discomfort or pain in your jaw, neck, back, shoulder, or arm.

  • You have any symptoms of a stroke. “BE FAST” is an easy way to remember the main warning signs of a stroke:

    • B – Balance. Signs are dizziness, sudden trouble walking, or loss of balance.

    • E – Eyes. Signs are trouble seeing or a sudden change in vision.

    • F – Face. Signs are sudden weakness or numbness of the face, or the face or eyelid drooping on one side.

    • A – Arms. Signs are weakness or numbness in an arm. This happens suddenly and usually on one side of the body.

    • S – Speech. Signs are sudden trouble speaking, slurred speech, or trouble understanding what people say.

    • T – Time. Time to call emergency services. Write down what time symptoms started.

  • You have other signs of a stroke, such as:

    • A sudden, severe headache with no known cause.

    • Nausea or vomiting.

    • Seizure.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • Cholesterol plaques increase your risk for heart attack and stroke. Work with your health care provider to keep your cholesterol levels in a healthy range.

  • Eat a healthy, balanced diet, get regular exercise, and maintain a healthy weight.

  • Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes.

  • Get help right away if you have any symptoms of a stroke.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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