High cholesterol levels can be a risk factor for heart disease and stroke. While high levels of HDL cholesterol can be protective for heart health, high levels of LDL cholesterol can be harmful.

The body requires a certain amount of cholesterol to function properly, but high cholesterol levels can be a health risk.

This article discusses whether high cholesterol levels can be healthy. It also outlines the optimal cholesterol levels and looks at ways a person can manage high cholesterol.

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High cholesterol levels can increase the risk of heart disease and stroke. However, there are different types of cholesterol.

LDL

According to the Centers for Disease Control and Prevention (CDC), low-density lipoprotein (LDL) cholesterol can have negative effects on health.

High LDL levels can cause plaque to build up in the arteries, which increases the risk of heart disease and stroke.

HDL

High-density lipoprotein (HDL) cholesterol has positive effects on health, as it transports LDL cholesterol away from the arteries. And higher levels of HDL cholesterol can help to protect against heart disease and stroke.

Given these protective effects, having higher HDL levels is considered healthy. The higher the levels of HDL cholesterol a person has, the lower their risk of heart disease.

Triglycerides

Triglycerides are a type of fat in the blood. High levels of triglycerides with unhealthy cholesterol levels can increase the risk of heart attack and stroke.

Having high triglyceride levels in combination with low HDL levels or high LDL levels may also increase the risk of heart attack and stroke.

Total cholesterol

According to the American Heart Association (AHA), total cholesterol is the sum of LDL and HDL levels plus 20% of triglyceride levels.

Attaining normal levels of total cholesterol is not as important as a person’s overall risk factors for cardiovascular disease.

People can have a lipid panel, or lipid profile, test to measure LDL cholesterol, HDL cholesterol, triglycerides, and total cholesterol levels.

These numbers are general guidelines. A person can talk about their cholesterol ranges with a healthcare professional.

According to the CDC, optimal levels of cholesterol are:

Levels in milligrams per deciliter (mg/dL)
LDL100 mg/dL
HDL40 mg/dL for males and 50 mg/dL for females
Triglyceridesbelow 150 mg/dL
Total cholesterolaround 150 mg/dL

LDL cholesterol

According to John Hopkins Medicine, the ranges for LDL cholesterol levels in adults are as follows:

LDL levels (mg/dL)
Optimalbelow 100 mg/dL, for people with heart disease or diabetes
Near optimal100–129 mg/dL
Borderline high130–159 mg/dL
High160–189 mg/dL
Very high190 mg/dL and above

Total cholesterol

The ranges for total cholesterol in adults are:

Total cholesterol levels (mg/dL)
Normalbelow 200 mg/dL
Borderline high200–239 mg/dL
High240 mg/dL and above

HDL levels

Optimal HDL levels are those above 40 mg/dL. A level of 60mg/dL or higher may have protective effects on heart health.

Triglyceride levels

The ranges for triglyceride levels are:

Triglyceride levels (mg/dL)
Normalbelow 150 mg/dL
Borderline high150–199 mg/dL
High200–499 mg/dL
Very high500 mg/dL and above

According to the National Heart, Lung, and Blood Institute (NHLB), treatments to manage high cholesterol may include a combination of lifestyle and dietary changes and medications:

  • Eating a heart-healthy diet: Certain dietary patterns, such as the DASH eating plan, may help reduce LDL cholesterol. These diets increase the intake of vegetables, fruit, and whole grains, and limit the intake of saturated fats, refined carbohydrates, and added sugars.
  • Taking part in regular physical activity: Regular physical activity can help decrease LDL cholesterol and triglycerides and increase HDL cholesterol.
  • Maintaining a moderate weight: Losing 3–5% of excess weight can lower LDL levels and raise HDL cholesterol levels.
  • Managing stress: Chronic stress may lead to an increase in LDL cholesterol and a reduction in HDL cholesterol. People may want to practice relaxation techniques, such as breathing exercises, talk with a mental health professional, or incorporate meditation into their day.
  • Getting quality sleep: Getting enough quality sleep each night may help promote heart health and repair blood vessels. People can aim for 7–9 hours each night.
  • Quitting smoking: If people smoke or vape, quitting smoking can help reduce LDL cholesterol and increase HDL cholesterol. People with high cholesterol levels who smoke may have an increased risk of coronary heart disease. Quitting smoking and avoiding secondhand smoke also helps to protect the arteries.
  • Limiting alcohol intake: Excess alcohol can increase cholesterol and triglyceride levels.

Medications

Medications to treat high cholesterol include:

  • Statins: Statins are the most common medication for lowering cholesterol. Statins may help reduce the risk of heart attack and stroke in people who have high levels of LDL cholesterol.
  • Mipomersen, ezetimibe, lomitapide, or ezetimibe: A doctor may prescribe these medications to treat genetic causes of high cholesterol.
  • Bile acid sequestrants: If statins are not suitable or do not lower cholesterol enough, people may take bile acid sequestrants. These medications help prevent the body from absorbing fats and oils.
  • PCSK9 inhibitors: People take these medications through an injection under the skin. People may take PCSK9 inhibitors in combination with statins to treat genetic causes of high cholesterol or reduce the risk of heart attack or stroke.

If a doctor prescribes cholesterol-lowering medications to people, it is also important to maintain diet and lifestyle changes to help manage cholesterol levels.

People can also discuss any potential risks or side effects of cholesterol-lowering medications with a doctor.

The CDC recommends the following for preventing high cholesterol:

  • limiting the intake of saturated fats, which are present in animal products such as meat, cheese, and full-fat dairy, as well as tropical oils such as palm and coconut oil
  • limiting the intake of trans fats, which can occur in baked goods and fried foods
  • reducing intake of sodium and added sugars
  • replacing saturated and trans fats with vegetables, fruits, whole grains, lean meat, seafood, and low fat dairy products
  • increasing intake of foods high in fiber, such as oats, beans, lentils, and fruits and vegetables
  • consuming more unsaturated fats, such as avocados, vegetable oils, and nuts
  • achieving and maintaining a moderate weight
  • getting regular physical activity and aiming for 30-60 minutes of moderate-intensity exercise each day
  • avoiding or quitting smoking
  • limiting alcohol intake to no more than two drinks per day for males and one drink per day for females
  • speaking with a healthcare professional about preventing high cholesterol, particularly if people have other risk factors for heart disease or stroke

People may not be able to prevent high cholesterol if it is due to a genetic condition, such as familial hypercholesterolemia (FH). In FH, a mutation in a gene that helps remove cholesterol from the body causes high levels of LDL cholesterol.

Early diagnosis and treatment of FH can help improve health outcomes.

High cholesterol can increase the risk of plaque forming in the walls of the arteries, which can cause them to narrow. This can affect blood flow to the heart and increase the risk of heart attack, heart disease, and stroke.

Higher levels of HDL cholesterol may have protective effects on heart health and help reduce the risk of heart attack and stroke.

A healthy lifestyle may help keep cholesterol levels within normal ranges and help reduce the risk of heart disease and stroke.

Making dietary and lifestyle changes to support heart health and lower cholesterol in combination with medications can help people lower high cholesterol levels and keep them within a healthy range.

It is also important to evaluate other risk factors for heart disease and stroke that people may have, such as diabetes and high blood pressure. These factors may alter the ranges that people need to keep their cholesterol levels within.

Higher levels of HDL cholesterol can have protective effects on cardiovascular health, but high levels of LDL cholesterol and triglycerides can be a risk factor for cardiovascular problems, including heart disease and stroke.

Normal ranges may vary for each person, depending on whether they have other risk factors present, such as high blood pressure or diabetes.

Making healthy lifestyle and dietary changes and taking cholesterol-lowering medication can help lower high cholesterol.