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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 healthcare 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?
There are no symptoms of this condition.
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.
- "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 or higher.
- These are fats that your body can store or burn for energy. The desired level is less than 150 mg/dL.
- 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.
How is this treated?
This condition may be treated with:
- 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.
- 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
- 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 two 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.
Lifestyle
- 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, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health are provider.
General instructions
- Take over-the-counter and prescription medicines only as told by your healthcare provider.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a healthcare 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 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. 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, such as cigarettes, e-cigarettes, and chewing tobacco.
- 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 healthcare provider. Make sure you discuss any questions you have with your health care provider.
References:
Anstey K.J., Ashby-Mitchell K., Peters R.: Updating the evidence on the association between serum cholesterol and risk of late-life dementia: review and meta-analysis. J. Alzheimers Dis. 2017; 56: pp. 215-228.
Ference B.A., Ginsberg H.N., Graham I., Ray K.K., Packard C.J., Bruckert E., et. al.: Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur. Heart J. 2017;
Ference B.A., Graham I., Tokgozoglu L., Catapano A.L.: Impact of lipids on cardiovascular health: JACC health promotion series. J. Am. Coll. Cardiol. 2018; 72: pp. 1141-1156.
Laitinen T.T., Nuotio J., Juonala M., Niinikoski H., Rovio S., Viikari J.S.A., et. al.: Success in achieving the targets of the 20-year infancy-onset dietary intervention: association with insulin sensitivity and serum lipids. Diabetes Care 2018; 41: pp. 2236-2244.
Peters S.A., Singhateh Y., Mackay D., Huxley R.R., Woodward M.: Total cholesterol as a risk factor for coronary heart disease and stroke in women compared with men: a systematic review and meta-analysis. Atherosclerosis 2016; 248: pp. 123-131.
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