High Cholesterol

How we measure and treat this common condition

Cholesterol is a type of fat in your blood that the body needs to build cells. However, when there is too much cholesterol in your blood, it can build up in the walls of the arteries. This can cause the arteries to harden and narrow, known as atherosclerosis, making it difficult for blood to flow through the body.

High cholesterol, also known as hypercholesterolemia, by itself does not cause symptoms, so you may not know your cholesterol is high. But if the artery becomes completely blocked, it can result in a heart attack or stroke.

In rare cases, high cholesterol can be caused by an inherited genetic mutation (familial hypercholesterolemia), but more often, it’s the result of unhealthy lifestyle choices.

Tests

We measure cholesterol with a simple blood test done after a nine- to 12-hour fast. The test tells us about your:

• Total cholesterol
• LDL (bad) cholesterol, the main source of blockage in the arteries
• HDL (good) cholesterol, which helps keep cholesterol from building up and protects against heart disease
• Triglycerides, another type of fat in your blood

Cholesterol is measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. Optimal levels for people without other health conditions are:

• Total cholesterol: Less than 200 mg/dL
• LDL (bad) cholesterol: Less than 100 mg/dL
• HDL (good) cholesterol: Above 60 mg/dL
• Triglycerides: Less than 100 mg/dL

FAQ's

Good Cholesterol vs. Bad Cholesterol

Q1: What do the numbers mean?

Your cholesterol check is made up of four numbers that create your lipid profile

• Main number: measures all the cholesterol in your blood
• LDL (low-density lipoproteins): “bad cholesterol” forms clots in the artery wall
• HDL (high-density lipoproteins): “good cholesterol” works as the helper cholesterol and scavengers bad cholesterol from your blood
• Triglycerides: fat found in the body

Q2: What is considered high cholesterol?

A cholesterol level over 200 is elevated and considered borderline, above 240 exceedingly high cholesterol. Total cholesterol should be below 200, a good cholesterol level between 100 to130 is recommended.

Q3: What causes high cholesterol?

• Genetic predisposition (how your body makes and clears LDL)
• Genetic factors reduce the amounts of good cholesterol
• Consuming a diet high in saturated fats (butter, oils) and trans fats (processed and packaged foods)

Q4: How do you manage high cholesterol?

Change your lifestyle through:

• Diet: Reduce intake of saturated fats (found in animal products, meat, butter, full fat dairy products like cheese), avoid trans fats (found in processed and packaged foods). It is better to consume Omega fatty acids (fatty fish like salmon) to help lower triglycerides
• Exercise
• Quit smoking
• Maintain a healthy weight (BMI lower than 30)

Q5: How often should you check your cholesterol?

Starting at age 18, it is recommended to have it checked every five years. If there is an abnormal panel or genetic risk, check it more frequently.

Q6: What are the risk factors for high cholesterol?

• Sedentary lifestyle (not active)
• Foods high in cholesterol (saturated fats and trans fats)
• Smoking
• Obesity
• Genetic predispositions

Treatments

Making healthy lifestyle changes often is the first line of defense against high cholesterol. This can include:

• Eating a heart-healthy diet
• Exercising regularly
• Maintaining a healthy weight

If making these lifestyle changes isn’t enough to lower your cholesterol, your doctor may recommend medication, such as statins, bile acid sequestrants or cholesterol absorption inhibitors.