When there’s too much cholesterol in your blood, it can collect in the walls of your arteries, fueling a progressive buildup of plaque — a disease known as atherosclerosis. When this plaque becomes big enough, your arteries can become blocked, which can limit the blood flow to the rest of your body.
High cholesterol is one of the key risk factors that can put you in the “red zone” (high risk) for coronary heart disease if it is not managed properly. The good news is that there are ways, including diet, exercise, and medicine, that can help you and your doctor get your cholesterol to the lowest risk level possible.
What Is Cholesterol?
The Good, the Bad, and Triglycerides
Understanding Cholesterol Numbers
How Is High Cholesterol Diagnosed?
The Keys to Treating High Cholesterol
Talking With Your Doctor About Cholesterol
What Is Cholesterol?
Cholesterol is a lipid (or fatty substance) in your blood that is naturally produced by your body. It also comes from the foods you eat. Healthy amounts of cholesterol in your blood are okay. In fact, your body needs cholesterol to produce cell membranes and certain hormones. However, too much cholesterol in your blood can build up in the walls of your arteries in the form of a substance called plaque. Over time, plaque will begin to clog your arteries, narrowing them and slowing blood flow and reducing the supply of oxygen that the blood carries to your heart.
When not enough blood and oxygen are reaching your heart, you may feel chest pain. If pieces of the plaque break off and enter your bloodstream, they can cause a clot. Clots can completely block blood from reaching part of the heart or brain, potentially causing a heart attack or stroke.
The Good, the Bad, and Triglycerides
There are three main components that are important to managing your cholesterol: LDL cholesterol, HDL cholesterol, and another substance called triglycerides
- LDL cholesterol (LDL-C), also known as “bad” cholesterol
LDL (a lipoprotein) carries cholesterol throughout the bloodstream as LDL-C. LDL-C is called “bad” cholesterol because it’s the type that is primarily responsible for clogging your arteries with plaque. When there is too much LDL cholesterol circulating in the blood, it can lead to potentially serious conditions, like a heart attack or stroke. As a rule, you want to keep your LDL-C low
- HDL cholesterol (HDL-C), also known as “good” cholesterol
Like LDL, HDL carries cholesterol in the bloodstream, as HDL-C. HDL-C is considered “good” because it helps return cholesterol to the liver, where it can be removed from the body. As a rule, you want your HDL-C high
- Triglycerides
Triglycerides, like cholesterol, are another lipid carried by a lipoprotein. High triglycerides, like LDL-C, can be dangerous to your health. As with LDL cholesterol, lower is better for triglycerides.
Understanding Cholesterol Numbers
This chart, adapted from the National Cholesterol Education Program (Adult Treatment Panel III Report, 2002), is a general guide to understanding the numbers used to measure your cholesterol levels. If you have other medical conditions, your doctor may set an LDL-C target goal lower than what’s on this chart. Only your doctor can determine your risk level.
How Is High Cholesterol Diagnosed?
You can’t feel it, so how can you tell if you have high cholesterol? The only way to know for sure is by having a cholesterol screening test, also known as a fasting lipid test. A cholesterol test is a simple blood test that can be performed in your doctor’s office or in a lab. Since high cholesterol may not have symptoms you can feel, it’s important to talk to your doctor about it, get tested, and then follow his or her recommendations if you need to do something about it.
Your doctor can put cholesterol into perspective for you, based on your overall health, family history, and other factors that make cholesterol more or less of a risk for you. You should be prepared with the right questions and make sure you understand your doctor’s treatment recommendations. To help make the most of your visit, try using the Conversation Starter. This interactive tool features short videos that can show you what questions you can ask and how your doctor may respond.
The Keys to Treating High Cholesterol
There are a number of options you can discuss with your doctor to help get your cholesterol levels out of the red zone and toward the green. First, your doctor may suggest that you improve your diet and get more exercise. If you stick with eating a lower-fat, lower-cholesterol diet and exercising several times a week, your cholesterol level is not the only thing that will benefit. This can help you lose weight, have more energy, reduce stress and blood pressure, and help control diabetes if you have it.
Some people can’t lower their cholesterol enough by eating a healthy diet and developing an exercise plan. If you’re in this category, be sure to ask your doctor about your options, including cholesterol-lowering medicines.
Talking With Your Doctor About Cholesterol
Questions for your doctor
- What do my cholesterol numbers mean?
- Which numbers are most important, and why?
- What is my cholesterol goal?
- What are the benefits of taking medicine, and are there risks associated?
- Is there risk associated with not taking medicine?
- Do I need to keep up the diet and exercise if I’m also taking medicine?
- How do I stay motivated about changing my lifestyle to manage cholesterol?
- Why are weight control, eating well, and physical activity important in managing cholesterol?