Although the body needs cholesterol to function, keeping it within a healthy range is important. People with high cholesterol may manage it with lifestyle changes or medication.

Cholesterol is a waxy substance that the body needs for essential functions such as creating hormones, digesting certain foods, and maintaining cell membranes. Different types of cholesterol play different roles in the body.

High-density lipoprotein (HDL) transports cholesterol back to the liver for the body to excrete it. Some people refer to HDL as “good” cholesterol.

Low-density lipoprotein (LDL), or “bad” cholesterol, can build up in the arteries as plaques. Plaque made from LDL cholesterol can cause narrowing in the arteries and lead to cardiovascular disease.

Doctors measure total HDL and LDL cholesterol levels to assess a person’s risk of heart disease. They also look at levels of triglycerides which are fats in the blood.

This article discusses cholesterol numbers and what they mean. It also provides tips for lowering cholesterol and explores how doctors treat high cholesterol.

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A person may not know their cholesterol levels are high because they do not have any symptoms. However, some people, such as those with familial hypercholesterolemia (FH), may have bumps on their skin around the elbows, knees, and knuckles or yellow areas around their eyes.

People should check their cholesterol levels regularly, as high cholesterol levels increase a person’s risk of stroke and heart disease.

Doctors perform a blood test to assess an individual’s cholesterol levels. They are generally looking for total cholesterol and triglycerides to be within a specific range, with LDL being lower and HDL being higher.

Healthcare professionals advise that desirable lipid profile levels are as follows:

  • Total cholesterol: Between 125-200 milligrams per deciliter (mg/dL)
  • LDL cholesterol: Less than 100 mg/dL
  • HDL cholesterol: Greater than 40 mg/dL for males and 50 mg/dL for females
  • Triglycerides: Less than 150 mg/dL

The American Heart Association (AHA) explains that medical professionals calculate total blood cholesterol by adding HDL and LDL cholesterol levels plus 20% of the triglyceride level.

If a person has a total cholesterol level above 200 mg/dL, a doctor may diagnose them with hyperlipidemia, which is the medical term for high cholesterol and triglyceride levels. Hypercholesterolemia is a type of hyperlipidemia when someone has high LDL cholesterol levels.

Between 2015 and 2018, nearly 12% of American adults over the age of 20 had total cholesterol above 240 mg/dL.

If someone has triglycerides above 150 mg/dL, a doctor may diagnose them with hypertriglyceridemia, which is too many triglycerides in the blood.

Triglyceride levels over 500 mg/dL indicate moderate hypertriglyceridemia and levels over 886 mg/dL indicate severe hypertriglyceridemia.

A doctor takes account of all the numbers in a person’s cholesterol profile to get an overall picture of their risk for heart disease and stroke. They also consider a person’s overall health, family history, and other factors, such as weight, exercise, and smoking, when assessing heart disease risk.

A person should work with a healthcare professional to decide the best way to lower their cholesterol. A doctor may prescribe medication to decrease cholesterol and advise someone to change their diet and lifestyle.

However, some people may have a genetic condition such as FH.

The CDC advises that for people with FH, exercising and healthy eating habits are important. However, they may not be enough to lower their cholesterol to a healthy level. Therefore, doctors may also prescribe medication to a person with FH.

However, the CDC estimates that just over half of American adults who could benefit from cholesterol medication are currently taking it.

Medications and supplements

Statins work by preventing cholesterol from forming in the liver. They effectively lower LDL cholesterol and may help lower triglycerides and raise HDL cholesterol. Some people are should not take statins and a person should discuss possible side effects with their doctor.

Statins available in the United States include:

Other cholesterol medications that a doctor may prescribe include:

  • ezetimibe which is a cholesterol-absorption inhibitor
  • bile acid sequestrants such as cholestyramine, colestipol, or colesevelam
  • PCSK9 inhibitors such as alirocumab and evolocumab
  • fibrates such as gemfibrozil, fenofibrate, or clofibrate

Additionally, some supplements may help to lower cholesterol, including niacin and omega-3 fatty acids. However, supplements vary in formulation, and some omega-3 fatty acid supplements may increase a person’s LDL levels.

A healthcare professional may prescribe omega-3 fatty acids to manage hypertriglyceridemia. A person should speak with their doctor before taking any supplements.

Dietary changes

People may lower their cholesterol by making dietary changes. The CDC advises people to limit foods high in saturated fat, trans fat, salt, and added sugars. The Dietary Guidelines for Americans recommend a maximum of 10% of daily calories from saturated fats.

The CDC also advises that a person eats foods high in fiber and unsaturated fats, such as:

Lifestyle changes

In addition, people can make the following lifestyle changes to decrease their risk of stroke and heart disease:

Someone with high cholesterol may manage their condition through a combination of diet and lifestyle changes, and medication. They should speak with a doctor to decide which approach is best for their circumstances.

Because high cholesterol often presents no symptoms, people should regularly check their cholesterol levels. The CDC advises people to check at least once every 4-6 years if they do not have heart disease. However, some people may need a doctor to check their levels more often than this.

For people with FH, early diagnosis and treatment of the condition can reduce the risk of heart disease by about 80%.

High total cholesterol, LDL cholesterol, and triglyceride levels indicate that someone may be at risk of heart disease.

Doctors take all the numbers that make up a person’s cholesterol profile into account, as well as other factors such as genetic conditions, weight, and general health.

People may reduce their risk of heart disease by eating a balanced diet that limits saturated fats and includes foods that are high in fiber and unsaturated fats. In addition, people can check their cholesterol levels regularly, maintain a moderate weight and engage in frequent exercise.

A person should speak with a healthcare professional to determine the best course of treatment for them.