Cholesterol FAQs

Cholesterol is a waxy, fatlike substance that is naturally present in cell walls or membranes everywhere in the body. Your body uses cholesterol to produce many hormones, vitamin D, and the bile acids that help to digest fat. 

If you have too much cholesterol in your bloodstream, the excess may be deposited in the arteries of the heart, which could lead to heart disease. 

Several drugs and diseases can cause high cholesterol; however, for many people, a high-fat diet and inherited metabolic factors seem to be the main causes. 

High cholesterol doesn’t have any symptoms. The only way to know if you have high cholesterol is to have it checked, which can be done with a simple blood test, called a fasting lipoprotein profile.

Government and physician-supported guidelines state that healthy adults who are aged 20 years or older should have a fasting lipoprotein profile done once every 5 years. 

A simple blood test, called a fasting lipoprotein profile, checks for high fats in the blood. You may be asked to fast overnight before the test, hence its name. A fasting lipoprotein profile measures total cholesterol, LDL ("bad") cholesterol, HDL ("good") cholesterol, and triglycerides in your blood. 

A cholesterol test can be done without fasting, but then only the levels of total cholesterol and HDL ("good") cholesterol can be used. 

See Cholesterol Tests.

Just knowing your total cholesterol isn’t enough. 

Cholesterol is made up of 2 different types: HDL ("good") cholesterol and LDL ("bad") cholesterol. HDL cholesterol is considered good because it helps keep LDL ("bad") cholesterol from building up in the walls of your arteries and causing blockage. 

You also need to know your level of triglycerides because high triglycerides also increase the risk of heart disease, especially in people with diabetes. 

See Understanding Your Cholesterol level.

High cholesterol causes atherosclerosis (hardening of the arteries), which can lead to blocked coronary arteries, manifested by chest pain (angina) or a heart attack. Other serious problems, such as blocked arteries to the brain, causing threatened stroke (transient ischemic attack) and blocked arteries in the legs, causing pain, limping, and possibly even limb loss, are possible.

The primary prevention of high cholesterol is to adopt a healthy lifestyle. This lifestyle should include 30-60 minutes a day of exercise on most or all days of the week, a diet low in saturated fat and cholesterol, and not smoking.

If you have high cholesterol, the main goal of a treatment program is to lower your LDL ("bad") cholesterol level. There are 2 main ways to lower your LDL cholesterol level: lifestyle changes and drug treatment. Lifestyle changes include a low-saturated fat, low-cholesterol diet; exercise; and weight loss if you are overweight. 

If following a healthy diet, exercising, and losing weight don’t lower your risk for heart disease, then your doctor might prescribe a medication to help lower your cholesterol (see Understanding Cholesterol-Lowering Medications). Even if your doctor does prescribe a medication, you must still follow your healthy diet, be more physically active, stop cigarette smoking if you smoke, and control your other risk factors (eg, high blood pressure, diabetes) for heart disease.  

The risk factors you can’t control are your age (for men, 45 years or older; for women, 55 years or older) and your family history of early heart disease (for men, father or brother affected before age 55 years; for women, mother or sister affected before age 65 years). 

The risk factors you can control are lowering high blood cholesterol, which is high total cholesterol and high LDL ("bad") cholesterol; raising HDL ("good") cholesterol; quitting smoking; controlling high blood pressure; controlling diabetes; losing weight if overweight/obese; and keeping physically active. 

If you have diabetes, your risk of heart disease is high. To reduce your risk, you will need to lower your cholesterol under the supervision of your doctor.

|Web Links|

High Cholesterol 

American Heart Association 

National Cholesterol Education Program, Live Healthier, Live Longer – Cholesterol Counts for Everyone  

National Cholesterol Education Program, Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) 

National Cholesterol Education Program, High Blood Cholesterol – What You Need to Know

MEDLINEplus Health Information, US National Library of Medicine and National Institutes of Health, Cholesterol

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Author: Gary E Sander, MD, PhD, Professor, Department of Internal Medicine, Division of Cardiology, Louisiana State University School of Medicine and Medical Center.

Coauthor(s): Lauri Graham, Medical Writer, .com, Inc.

Editors: Alan D Forker, MD, Program Director of Cardiovascular Fellowship, Professor of Medicine, Department of Internal Medicine, University of Missouri at Kansas City School of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, ; Michael E Zevitz, MD, Clinical Assistant Professor, Department of Medicine, Rosalind Franklin University of Medicine and Science, Chicago.