Cholesterol in the Blood

Facts about cholesterol

Cholesterol is a fat-like, waxy substance that can be found in all parts of your body. It aids in the production of cell membranes, many hormones and vitamin D. The cholesterol in your blood comes from two sources: the foods you eat and your liver. However, your liver makes all of the cholesterol your body needs. Cholesterol and other fats are transported in your blood stream in the form of spherical particles called lipoproteins. The two most commonly known lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

What is LDL cholesterol?

LDL, or "bad" cholesterol, is a type of fat in the blood that contains the most cholesterol. It can contribute to the formation of plaque buildup in the arteries, known as atherosclerosis, which is linked to increased risk of heart attack and stroke.

You want your LDL to be low.

To help lower it:

  • Avoid foods high in saturated fat, dietary cholesterol and excess calories

  • Exercise

  • Maintain a healthy weight

  • Stop smoking 

What is HDL cholesterol?

HDL, or "good" cholesterol, helps to remove cholesterol from the blood, preventing the fatty buildup and formation of plaque.

You want your HDL to be as high as possible. Some people can raise HDL by:

  • Exercising for at least 20 minutes three times a week

  • Kicking the cigarette habit

  • Avoiding saturated fat intake

  • Decreasing body weight

For others, medicine may be needed. Because raising HDL is complicated, you should work with your physician on a therapeutic plan.

Checking your blood cholesterol level

A cholesterol screening is an overall look at, or profile of, the fats in your blood. Screenings help identify people at risk of heart disease. It is important to have what is called a full lipid profile to show the actual levels of each type of fat in your blood: LDL, HDL, triglycerides and others. Consult your physician regarding the timing of this test.

What is a healthy blood cholesterol level?

High blood cholesterol is a significant risk factor for heart disease and stroke. Lowering blood cholesterol through increased physical activity, weight loss, smoking cessation and proper diet lowers that risk. Blood cholesterol, however, is very specific to each individual and, for that reason, a full lipid profile is an important part of your medical history and important information for your physician to have. It's also very important to discuss the results of your lipid profile with your doctor. If you have previously received this test, talk to your doctor about how your results have changed over time. 

For most people, healthy levels are as follows:

  • LDL – less than 100mg/dL

  • HDL – 40mg/dL or higher for men; 50mg/dL or higher for women

  • Triglycerides – less than 150mg/dL

  • Total cholesterol – less than 150mg/dL

In some cases, your doctor may set an LDL goal even lower. Ask your doctor what your target LDL goal should be and what you can do to reach your goal. Even if you feel healthy, ask your doctor how often you should check your cholesterol. If you take medication to manage your blood pressure and/or cholesterol, be sure to keep taking the medicine even if your blood pressure and cholesterol goals are met. Meeting your goals means the medication is working. Ask your doctor to share and discuss blood pressure and cholesterol results with you to help keep you on track.

What treatments are available for high cholesterol?

Medical treatment may include:

  • Modification of risk factors. Some risk factors that can be changed include lack of exercise and poor dietary habits.

  • Cholesterol-lowering medications. Medications are used to lower lipids (fats) in the blood, particularly LDL cholesterol. Statins are a group of antihyperlipidemic medications and include simvastatin (Zocor®), atorvastatin (Lipitor®) and pravastatin (Pravachol®), among others. Bile acid sequestrants – colesevelam (Welchol®), cholestyramine (Questran®) and colestipol (Colestid®) – and nicotinic acid (niacin) are two other types of medications that may be used to reduce cholesterol levels.

Statistics about cholesterol

Elevated cholesterol is a risk for many Americans. Consider these statistics:

  • According to the American Heart Association, about 98.8 million American adults have total blood cholesterol levels of 200mg/dL and higher, and of those about 33.6 million American adults have levels of 240 or above.

  • Elevated cholesterol levels early in life may play a role in the development of adult atherosclerosis.

  • According to the American Heart Association, high blood cholesterol that runs in families will affect the future of an unknown (but probably large) number of children.

What are triglycerides?

Triglycerides are another class of fat found in the bloodstream. The bulk of your body's fat tissue is in the form of triglycerides.

Triglyceride levels and heart disease

The link between triglycerides and heart disease is under clinical investigation. However, many people with high triglycerides also have other risk factors such as high LDL levels or low HDL levels.

What causes elevated triglyceride levels?

Elevated triglyceride levels may be caused by medical conditions such as diabetes, hypothyroidism, kidney disease or liver disease. Dietary causes of elevated triglyceride levels may include high intake of fat, alcohol and concentrated sweets. A healthy triglyceride level is less than 150mg/dL.

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