Cholesterol is a waxy substance that’s found in the fats (lipids) in your blood. While your body needs cholesterol to continue building healthy cells, having high cholesterol can increase your risk of heart disease.
When you have high cholesterol, you may develop fatty deposits in your blood vessels. Eventually, these deposits make it difficult for enough blood to flow through your arteries. Your heart may not get as much oxygen-rich blood as it needs, which increases the risk of a heart attack. Decreased blood flow to your brain can cause a stroke.
High cholesterol can be inherited, but it’s often the result of unhealthy lifestyle choices, and thus preventable and treatable. A healthy diet, regular exercise and sometimes medication can go a long way toward reducing high cholesterol.
High cholesterol has no symptoms. A blood test is the only way to detect high cholesterol.
When to see a doctor
Ask your doctor if you should have a cholesterol test. Recommendations for the age of first screening vary. Retesting is usually performed every five years.
If your test results aren’t within desirable ranges, your doctor may recommend more frequent measurements. Your doctor may also suggest you have more frequent tests if you have a family history of high cholesterol, heart disease or other risk factors, such as smoking, diabetes or high blood pressure.
Cholesterol is carried through your blood, attached to proteins. This combination of proteins and cholesterol is called a lipoprotein. You may have heard of different types of cholesterol, based on what type of cholesterol the lipoprotein carries. They are:
- Low-density lipoprotein (LDL). LDL, or “bad,” cholesterol transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow.
- High-density lipoprotein (HDL). HDL, or “good,” cholesterol picks up excess cholesterol and takes it back to your liver.
Factors within your control — such as inactivity, obesity and an unhealthy diet — contribute to high LDL cholesterol and low HDL cholesterol. Factors beyond your control may play a role, too. For example, your genetic makeup may keep cells from removing LDL cholesterol from your blood efficiently or cause your liver to produce too much cholesterol.
Factors that may increase your risk of high cholesterol include:
- Poor diet. Eating saturated fat, found in animal products, and trans fats, found in some commercially baked cookies and crackers, can raise your cholesterol level. Foods that are high in cholesterol, such as red meat and full-fat dairy products, will also increase your total cholesterol.
- Obesity. Having a body mass index (BMI) of 30 or greater puts you at risk of high cholesterol.
- Large waist circumference. Your risk increases if you are a man with a waist circumference of at least 40 inches (102 centimeters) or a woman with a waist circumference of at least 35 inches (89 centimeters).
- Lack of exercise. Exercise helps boost your body’s HDL, or “good,” cholesterol while increasing the size of the particles that make up your LDL, or “bad,” cholesterol, which makes it less harmful.
- Smoking. Cigarette smoking damages the walls of your blood vessels, making them likely to accumulate fatty deposits. Smoking may also lower your level of HDL, or “good,” cholesterol.
- Diabetes. High blood sugar contributes to higher LDL cholesterol and lower HDL cholesterol. High blood sugar also damages the lining of your arteries.
Development of atherosclerosis
High cholesterol can cause atherosclerosis, a dangerous accumulation of cholesterol and other deposits on the walls of your arteries. These deposits (plaques) can reduce blood flow through your arteries, which can cause complications, such as:
- Chest pain. If the arteries that supply your heart with blood (coronary arteries) are affected, you may have chest pain (angina) and other symptoms of coronary artery disease.
- Heart attack. If plaques tear or rupture, a blood clot may form at the plaque-rupture site — blocking the flow of blood or breaking free and plugging an artery downstream. If blood flow to part of your heart stops, you’ll have a heart attack.
- Stroke. Similar to a heart attack, if blood flow to part of your brain is blocked by a blood clot, a stroke occurs.
The same heart-healthy lifestyle changes that can lower your cholesterol can help prevent you from having high cholesterol in the first place. To help prevent high cholesterol, you can:
- Eat a low-salt diet that includes many fruits, vegetables and whole grains
- Limit the amount of animal fats and use good fats in moderation
- Lose extra pounds and maintain a healthy weight
- Quit smoking
- Exercise on most days of the week for at least 30 minutes
- Drink alcohol in moderation, if at all