Cholesterol: What Your Level Means

What is cholesterol?

Cholesterol is a waxy substance your body uses to protect nerves, make cell tissues and produce certain hormones. Your liver makes all the cholesterol your body needs. Your body also gets cholesterol directly from the food you eat (such as eggs, meats and dairy products). Too much cholesterol can have negative impacts on your health.

Why is a high cholesterol level unhealthy?

While some cholesterol is needed for good health, too much cholesterol in your blood can increase your risk for heart disease, including heart attack or stroke.

If you have high cholesterol, your body may store the extra cholesterol in your arteries. Your arteries are blood vessels that carry blood from your heart to the rest of your body. Buildup of cholesterol in your arteries is known as plaque. Over time, plaque can become hard and make your arteries narrow. Large deposits of plaque can completely block an artery. Cholesterol plaques can also split open, leading to formation of a blood clot that blocks the flow of blood.

If an artery that supplies blood to the muscles in your heart becomes blocked, a heart attack can occur. If an artery that supplies blood to your brain becomes blocked, a stroke can occur.

Risk factors for heart disease

• Already had a heart attack
• A man, 45 years of age or older
• A woman, 55 years of age or older
• A woman who is going through menopause or has completed menopause
• Have an immediate family member (parent or sibling) who has had heart disease
• Cigarette smoking
• High blood pressure or diabetes
• Overweight or obese
• Inactive

When should I start having my cholesterol level checked?

You can’t tell if you have high cholesterol without having it checked. All adults 20 years of age and older should have their cholesterol checked every 5 years. If your cholesterol level is high or you have other risk factors for heart disease (see the box above), you may need to have it checked sooner and more often.

A blood test known as a lipid panel is usually the way cholesterol is checked.

Are there different types of cholesterol?

Yes. Cholesterol travels through the blood in different types of bundles, called lipoproteins.

Low-density lipoprotein (LDL) delivers cholesterol to the body. High-density lipoprotein (HDL) removes cholesterol from the bloodstream.

This explains why too much LDL cholesterol is bad for the body, and why a high level of HDL is good. The balance between the types of cholesterol tells you what your cholesterol level means (see the box below).

For example, if your total cholesterol level is high because of a high LDL level, you may be at higher risk of heart disease or stroke. If your total level is high only because of a high HDL level, you're probably not at higher risk.

Total cholesterol level

• Less than 200 is best.
• 200 to 239 is borderline high.
• 240 or more means you're at increased risk for heart disease.

LDL cholesterol levels

• Below 100 is ideal for people who have a higher risk of heart disease.
• 100 to 129 is near optimal.
• 130 to 159 is borderline high.
• 160 or more means you're at a higher risk for heart disease.

HDL cholesterol levels

• Less than 40 means you're at higher risk for heart disease.
• 60 or higher greatly reduces your risk of heart disease.

What can I do to improve my cholesterol level?

If you have high cholesterol, it may be necessary for you to make some lifestyle changes. If you smoke, quit. Exercise regularly. If you're overweight, losing just 5 to 10 pounds can help improve your cholesterol levels. Make sure to eat plenty of fruits, vegetables, whole grains and fish- all of which promote heart health. Avoid saturated and trans fats, which can raise cholesterol levels. Also limit your overall cholesterol intake to less than 300 milligrams per day and 200 milligrams if you have heart disease.

What about medicine to lower cholesterol?

Depending on your risk factors, if healthy eating and exercise don't work to lower your cholesterol level, your doctor may suggest medicine.